What is the Breast Health Department?
The Breast Health Department at American Hospital is a department modeled under the leadership of Prof. Dr. Abdullah İğci, bringing together the “screening-diagnosis‑treatment‑follow-up” chain under one roof. Healthcare professionals who are specialists in their field and part of a multidisciplinary team (Radiologist, Surgeon, Pathologist, Medical Oncologist, Radiation Oncologist, Nuclear Medicine Specialist, Plastic Surgeon, Physical Therapist, and Psychologist) evaluate the patient's file together and determine the most appropriate treatment method. Consultation rooms provide services for both women and men with breast enlargement (gynecomastia). The department's digital infrastructure collects all data together, from biopsies to breast ultrasound images.
What Diseases Are Treated in the Breast Health Department?
The Breast Health Department treats a wide range of conditions, from benign lesions to malignant tumors. Even if the patient comes in with a diagnosis of a “simple cyst,” unnecessary biopsies are avoided by investigating underlying hormonal or genetic causes; at the same time, potentially dangerous changes are not overlooked.
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Fibroadenoma: These are well-demarcated, mobile masses that typically develop in women under the age of 35 due to estrogen fluctuations. If a typical appearance is detected during clinical examination and ultrasound, follow-up at 6‑12-month intervals is sufficient; excisional fibroadenoma surgery is recommended for rapidly growing, painful, or larger than 3 cm masses, and this procedure is performed using techniques that leave minimal scarring on the breast.
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Cyst / Cysts: These are sacs filled with fluid, and their size may change during the hormonal cycle. In symptomatic cysts, fine needle aspiration under ultrasound guidance both reduces pain and allows for cytological examination of the fluid; in recurrent cysts, excision of the cyst wall provides a permanent solution.
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Mastitis: Although it is most often a bacterial infection during lactation, it can also occur in conditions that weaken the immune system, such as smoking or diabetes. Early initiation of broad-spectrum antibiotics and appropriate milk drainage are usually sufficient; drainage guided by ultrasound may be necessary in cases with abscesses.
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Breast pain (Mastalgia): Many causes may be responsible, such as cyclical hormonal changes, cystic structures, or hidden infections. In a multimodal approach, a personalized treatment plan for breast pain is developed, incorporating dietary adjustments, non‑steroidal anti-inflammatory drugs, and low-dose hormone regulators when necessary.
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Gynecomastia: It is the glandular enlargement of the male breast due to androgen‑estrogen imbalance, certain medications, or obesity. Early-stage hormonal regulation and weight control are attempted; gynecomastia surgery involving liposuction and gland excision in permanent tissue provides aesthetic and psychosocial relief.
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Nipple Discharge: Women may experience spontaneous or compression-induced nipple discharge. Spontaneous bloody or clear discharge from the nipple is important. It must be examined.
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Benign breast changes (Papilloma, fat necrosis, etc.): Cancer is ruled out with advanced imaging and biopsy; then the decision for surgery or follow-up is made based on the size‑symptoms of the lesion.
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Breast cancer: Comprehensive screening, genomic subtype determination, and personalized treatment protocols are the department's core areas of expertise.
What Are the Stages of Breast Cancer?
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Stage 0 (Ductal/Lobular in situ): The cells have not crossed the basal membrane and there is no lymph node involvement. Lumpectomy preserves the aesthetic integrity of the breast and increases long-term survival to over 98% when performed with clear surgical margins.
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Stage I: ≤2 cm invasive tumor, known for sentinel lymph node negativity. If the tumor does not belong to a highly aggressive subtype (if there is no high proliferation score among breast cancer risk factors), single-modality surgery and short-course radiotherapy are often sufficient.
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Stage II: A mass measuring 2‑5 cm or 1‑3 positive lymph nodes are detected. Neoadjuvant chemotherapy shrinks the tumor; as a result, 50% of cases initially scheduled for mastectomy gain the chance to undergo breast-conserving surgery after chemotherapy.
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Stage III: The tumor involves the chest wall, skin, or ≥4 lymph nodes. With aggressive combination therapy (dose‑dense chemotherapy, wide-field radiotherapy, and reconstruction-planned mastectomy), the local control rate increases to 70%; breast reconstruction is mostly postponed to a later stage.
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Stage IV: Distant organ metastasis is present; bone, lung, and liver are the most common sites. Current research suggests that while smart drugs and immunotherapies can extend median survival to nearly 5 years, removing the primary tumor in selected patients may improve quality of life.
What Diagnostic Methods Are Used in the Breast Health Department?
According to the principle of “early diagnosis, half treatment”, diagnostic steps progress gradually based on breast density, patient age, and risk score.
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Section & Self-Breast Examination: A physician's examination detects stromal changes that mask palpable masses; the three-finger technique shown to the patient encourages daily examination in the mirror.
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Mammography (Digital + Tomosynthesis): Low-dose X‑rays detect microcalcifications as small as 3 mm, particularly due to post‑menopausal breast fatty tissue; tomosynthesis eliminates overlapping tissue issues, reducing the false positive rate by 30%.
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Contrast-Enhanced Spectral Mammography: A mammography technique performed by injecting contrast material into a vein, allowing cancerous areas within dense breast tissue to appear brighter. It assesses the diagnosis and prevalence of breast cancer in areas with dense breast tissue.
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Breast Ultrasound: First step in young women with dense breast tissue; prevents unnecessary biopsies by distinguishing between cysts‑solid masses. Doppler mode reinforces suspicion of malignancy with increased vascularity.
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Magnetic Resonance (MRI): 3T dynamic contrast-enhanced imaging is the gold standard in BRCA-positive or implanted patients. DWI and ADC maps provide additional clues in distinguishing between benign‑malignant lesions.
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Biopsies:
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Tru‑cut: Samples obtained with a 14G automatic gun are sufficient for histological grade and hormone receptor analysis.
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Vacuum-assisted: It completely removes microcalcifications by sampling 360°, so that if there is an invasive focus in the pathology, it is not missed.
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Surgical biopsy: Used for lesions that are not suitable for needle biopsy, such as retromammary or complex lesions; performed under local/general anesthesia, and scarring is minimized using special suturing techniques.
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Genetic Testing & Risk Analysis: BRCA, PALB2, CHEK2 panel; for those who test positive, “preventive oncology” practice is applied with prophylactic mastectomy and MRI imaging.
What is the Importance of Screening and Early Diagnosis in Breast Cancer?
Breast cancer progresses silently; it can take an average of 5‑8 years for the lump to reach a size that can be felt. Regular screening mammography detects cases at stage T1N0, increasing five-year survival to 99%; at this stage, breast-conserving surgery is sufficient for most patients, and axillary dissection and adjuvant chemotherapy are generally not required.
Annual contrast-enhanced MRI in women who are BRCA1/2 carriers in the high-risk group increases sensitivity to 92% compared to mammography; the absence of radiation exposure allows for safe screening starting at age 25.
Our screening program is not exclusively for women. In cases of gynecomastia, where men experience breast enlargement, a hard, unilateral lump may be a sign of male breast cancer; annual examination and ultrasound are also recommended for men with a positive family history.
What Are the Treatment Methods Used in the Breast Health Department?
Treatment selection is shaped by the tumor's biology and the patient's age‑lifestyle. American Hospital provides each patient with a personalized treatment plan.
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Surgical Approaches:
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Breast-conserving surgery: Breast symmetry is preserved using oncoplastic techniques; radiotherapy is applied to the excised cavity, reducing local recurrence to below 4%.
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Types of mastectomy
(total, skin-sparing, nipple-sparing, endoscopic): Preferred for multifocal or extensive tumors; simultaneous breast reconstruction with silicone implants or autologous tissue preserves the patient's body image.
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Axillary surgery: If the sentinel node is negative, the entire axilla is preserved; if positive, a dissection involving the removal of 10‑15 lymph nodes is performed. Microsurgical lymphatic repair techniques can be used to reduce the risk of lymphedema.
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Systemic Treatment:
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Chemotherapy: Taxane‑anthracycline-based regimens are administered via a port catheter; dose‑dense protocols shorten the treatment duration while increasing efficacy. Side effect reduction technologies such as “cooling caps” are standard practice in the Breast Health Department.
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Targeted & Immunotherapy: In HER2‑positive patients, the combination of trastuzumab + pertuzumab increases the pCR (pathological complete response) rate to 60%; agents such as atezolizumab are used in PD‑L1-positive triple‑negative types.
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Hormone therapy: In ER/PR-positive cases, tamoxifen (premenopausal) or an aromatase inhibitor (postmenopausal) is administered for 5‑10 years; since estrogen effects are among the risk factors for breast cancer, this blockade reduces the risk of recurrence by half.
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Radiotherapy: IMRT/VMAT techniques in a linear accelerator reduce the dose to the heart and lungs to <5 Gy; in some patients, treatment with partial breast irradiation is completed in five days, allowing the cycle to be completed without disrupting work‑life balance. Side effects (skin erythema, fatigue) are generally mild‑moderate and subside within a few weeks.
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Non-Surgical Benign Procedures: Large breast cysts or symptomatic fibroadenomas can be shrinked in 15 minutes using radiofrequency ablation; this painless procedure does not require anesthesia and allows patients to return to work the next day. Gynecomastia surgery is completed in a short time by combining LASER liposuction and gland excision.