Breast cancer surgery

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Outpatient consultations

Secretaries

  • Opening hours: from Monday to Friday, 8.30am to 4.30pm
  • Telephone: +33(0)2 31 45 50 11
  • Location: 1st floor

Hospitalisation

Department missions

Care

  • Surgical care for breast carcinoma
  • Immediate or delayed breast reconstruction
  • Prophylactic breast and gynaecological surgery
  • Surgical opinion for referred patients
  • Overall care for Breast Care Path patients
  • Multidisciplinary Team (MDT) meetings for breast cancer, specific presurgical MDT and breast cancer MDT

Research

  • Participation in national clinical trials
  • Internal research projects and clinical studies
    • Intraoperative radiotherapy
    • Breast reconstruction

Teaching

  • Hosting and training of interns in obstetric gynaecology each semester
  • Hosting of externs and nursing trainees in the operating theatre
  • Training dispensed at the nursing school and theatre nursing school

The team

Surgeons

  • Dr Sandrine Martin-Françoise
  • Dr Jean-François Le Brun
  • Dr Enora Dolivet-Audigie
  • Dr Hélène Planque

Head nurse

  • Sébastien Jaffré

Outpatient nurses

  • Julie Tanquerel
  • Séverine Savary
  • Anne-Marie Richard
  • Laure Frelon

Medical assistants

  • Pauline Passerel
  • Sandrine Sede

Healthcare offer and expertise

The breast surgery team works in close collaboration with the oncology, radiology and radiotherapy teams in order to optimise and to define the most appropriate treatment strategy for each patient, in a concerted manner.

During the surgery consultation, the type of surgery adapted to suit the patient is defined. The surgical procedure, which is integrated within the overall therapeutic strategy, is explained in detail thanks to an animated software application which offers improved understanding of the techniques employed.

Outpatient surgery (one-day hospitalisation and return to home the same evening) is encouraged for the majority of patients, whenever the procedure and the patient’s state of health allows so. In the case of conventional hospitalisation, the duration is short, and adapted in line with the surgical procedure.

The development of loco-regional anaesthesia during breast surgery offers improved comfort and satisfactory post-operative pain relief, hence leading to faster recovery.

The Breast Care Path, organised by specialised nurses, proposes monitoring before, during and after surgery as per individual patient needs.

Since 2016, we have been conducting breast surgery associated with intraoperative radiotherapy, thanks to Intrabeam®. This technique offers advantages in certain types of breast cancer for treatment can be completed in one day. All cancer types are not eligible for this technique. It must be jointly validated by the surgeon, radiologists, medical oncologists and radiation oncologists.

We have our own outpatient consultation department for monitoring wound healing and any post-operative complications. These consultations are conducted by specialised nurses (outpatient care department), and appointments can be made by phone.

For patients wishing to do so, we propose breast reconstruction techniques, either in the form of internal breast implants, by autologous muscle grafting (latissimus dorsi flap), and / or autologous fat grafting (lipomodeling). Breast reconstruction is most often performed after treatment; however, it is more and more frequently proposed at the same time as breast cancer surgery. The chosen technique, based on the surgeon’s expertise, is adapted to suit the patient’s own wishes and to her morphology. Pre- and post-operative monitoring is ensured by our own specialised nurses, in close collaboration with the surgeon, hence enabling personal patient follow-up. The breast reconstruction process can sometimes require several operations or aesthetic improvements. The last phase of this process is the recreation of the nipple, either using a skin flap or by applying a ‘trompe l’oeil’ tattoo.

Breast reconstruction is an integral part of the patient’s overall care. This phase is important for patients wishing to recover a satisfactory body image. Information sessions are also organised in the ERI information and encounters area, reuniting patients, our nurses and a surgeon.

The department’s equipment and facilities

  • Intrabeam ®: intraoperative radiotherapy technique for certain types of breast cancer
  • Immediate and delayed breast reconstruction surgery:
    • Submuscular or subcutaneous (skin) breast implants
    • Latissimus dorsi flap technique
    • Lipomodeling, either exclusively or in complement to the aforementioned techniques

Results

2019 activity data

  • 1,804 breast surgery procedures
  • 51 intraoperative radiotherapy procedures
  • 278 breast reconstruction procedures (combined)

Research themes / Projects

  • Evaluation of the population treated by INTRABEAM. In collaboration with the radiotherapy and radiology departments, we are currently studying patients treated by surgery and intraoperative radiotherapy, in order to determine patient satisfaction and the long-term benefits of this novel technique.
  • Study of patient understanding of information provided during pre-operative consultations, via the use of a learning information software package (E-Consult®)

Publication

  • E-consult: To better inform patients Jean-François Le Brun, Julie Babin-Commeny, Sandrine Martin-Françoise, Guillaume Babin, Journal of Clinical Oncology 37, no. 15_suppl, published online May 26, 2019.

Partnerships

  • At regional level:
    • Regional reference centre in Lower Normandy, for breast cancer, medical advice and second opinions for peripheral hospitals.

Dispensed training

  • Initial training:
    • Training of interns in obstetric gynaecology (2 interns/semester)
    • Hosting of externs and nursing trainees in the operating theatre
  • Continuing education:
    • Teaching at the nursing school and theatre nursing school
    • Presentation of breast surgery and breast reconstruction during Oncology Thursdays
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