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A breast surgeon is a specialist surgeon who focuses on the diagnosis of breast related diseases and conditions and manages these issues either conservatively or, in most cases, surgically.
Primary healthcare workers such as nurse and general practitioners refer patients with breast conditions, that affect men and women, to these specialists. These patients will usually present with symptoms such as breast tenderness, enlargement, skin changes, nipples discharging clear fluid, milk or blood, retracted nipples and masses being felt.
The breast surgeons will then assess the patient to determine whether they have a benign condition that would need to be managed conservatively, such as mastitis which is inflammation of the breast tissue which can be managed with anti-inflammatory medications and antibiotics, or if there are signs of a more malignant issue, such as an aggressive breast cancer.
A breast surgeon needs to complete a series of training programmes before they can specialise in their chosen sub-specialty. The specialist will first have to attend a medical school where they will take part in a medical and surgical undergraduate training programme which takes 5-6 years to complete. Thereafter, they must complete a 1-2 year internship phase where they are exposed to the numerous medical and surgical disciplines that exist.
The now qualified doctor is allowed to specialise and they will enter into a surgical residency programme that takes 5 years to complete. The doctor is now a general surgeon and can decide to specialise further if they want. In this case, the surgeon will complete a 1 year fellowship training programme in breast surgery.
Conditions managed by a Breast Surgeon
As mentioned, a breast surgeon will deal with many breast related conditions that range from mild to severe. The following are such conditions:
Breast masses can be benign or malignant. Regarding the benign masses, such as fibroadenomas, the patient and specialist need to discuss whether it would be beneficial to remove such a mass or not. An indication for removal would be if the mass causes so much discomfort that it affects the patient's everyday activities.
Malignant masses would need to be managed surgically since aggressive cancers can spread quickly to the other breast and to other organs such as the lungs and liver. These patients would be sent for investigations, such as ultrasound or mammography of the breasts and biopsies of the mass would be taken to determine the aggressiveness and staging of the cancer. The type of surgery performed would then depending on the results of the lesion.
Infections and inflammations
Inflammatory changes and infections affecting the breast tissue can be managed by the patient's primary healthcare worker most of the time, but there are cases that need to be referred for further management. These would include issues such as severe bacterial mastitis, chronic subareolar abscess, retromammary abscess, syphilis of the breast and tuberculosis of the breast.
Infective conditions that haven't caused an abscess yet would need to be managed in hospital with intravenous antibiotics. In the case of tuberculosis of the breast, the patient would need to be isolated while they are still able to pass the bacterium on to others. Abscesses of the breast are managed surgically by incising and draining them in the operating room.