乳腺外科
Breast Surgery
Breast Surgery
Introduction
My name is Chiaki Nakauchi and I have been appointed as the chief director of Breast Surgery at Iseikai International General Hospital. I would like to extend my warmest greetings.
It is said that one in nine Japanese women develop breast cancer in their lifetime, and in 1995 breast cancer surpassed gastric cancer to become the most common cancer among women. One might think of the Breast Surgery Department as involving only “surgery”, but since we do not have an internal medicine department dedicated specifically to breast-related diseases, this department not only involves surgery but just “all kinds of treatments and diagnosis related to the breasts”.
Our department covers everything from examinations, diagnoses, surgery, and drug treatment to matters related to the genetics of breast cancer, so please feel free to consult with us. As a breast-related physician of the Japan Breast Cancer Society, I can provide comprehensive breast-related treatment, and as a certified cancer treatment physician, I can also coordinate drug treatment according to each condition. We are also qualified to treat hereditary breast and ovarian cancer syndromes, and we also accept consultations regarding genetics. In addition to that, please feel free to contact us with any concerns you can think of, such as concerns specific to women, and we will do our best to help you.
Our department works closely with the Department of Breast and Endocrine Surgery at the Osaka University Graduate School of Medicine, which is my alma mater. We have a breast surgery outpatient clinic that specializes in comprehensive medical checkups, including breast cancer, as well as detailed examinations and diagnosis. Mammography is performed by a female technician, and you can immediately receive an explanation of the results from the breast surgeon in the examination room. In addition to this, even ultrasound examinations are performed by a breast surgeon on the spot and the results are explained immediately.
We focus on shortening the time it takes to get results, ensuring an accurate diagnosis, and resolving your concerns as quickly as possible. Our staff will work together as a team to ensure that the disease is detected as early as possible and that each patient receives treatment that satisfies them. In addition, if you would like to be treated by a female doctor, please let the staff know and we will be able to accommodate you.
Characteristics of this department
The test uses a combination of mammography and ultrasound, and the doctor in charge directly interprets the mammography and performs the ultrasound, allowing the results to be explained on the spot. For patients who have no abnormalities detected, the examination can be completed in one day. If necessary, a breast MRI examination will also be performed. Diagnosis is quick, and if there are abnormal findings, a pathological test is performed on the same day, and the results are available one to two weeks later. The diagnostic department also performs stereo-guided needle biopsies to diagnose minute calcifications.
Treatment is a combination of surgery, radiation therapy, and drug therapy. Regarding drug treatment, we provide outpatient chemotherapy both before and after surgery in a chemotherapy room staffed by certified cancer chemotherapy nurses.
Regarding surgery, after determining whether or not preoperative chemotherapy is required, the patient chooses breast-conserving surgery or total removal, and if necessary, we also support reconstructive surgery in cooperation with our hospital's plastic and reconstructive surgeon. In collaboration with plastic surgeons, we can perform breast reconstruction procedures (implant, latissimus dorsi flap, DIEP, etc.) that are covered. Sentinel lymph node biopsy is reliably detected using a combination of RI and dye methods.
Post-operative lymphedema is handled by a lymphedema therapist and a lymphedema specialist who has completed lymphedema training. Radiation therapy is performed by radiologists to treat all cases after conservative treatment, recurrence, and metastasis. We actively conduct genetic testing for breast cancer, and we have a doctor who has attended HBOC educational seminars and a certified genetic counselor on staff to assist patients who test positive and are likely to have a genetic tumor. Counseling and medical examinations are also available for family members.
For end-of-life care, the anesthesiology and palliative care department and a certified cancer pain care nurse are also involved, and we handle it as a team. We also work in cooperation with the reproductive medicine department to handle fertility issues for young breast cancer (AYA generation breast cancer) and treatment policies for breast cancer during pregnancy.
Genetic testing for hereditary breast cancer
It is said that 5-10% of breast cancers are hereditary. About half of these are hereditary breast and ovarian cancer syndromes (HBOC). HBOC is diagnosed when variants (mutations) are found in the BRCA1 and BRCA2 genes.
For those with breast cancer, if you meet certain conditions, such as being under 45 years old, having a relative with breast or ovarian cancer, having bilateral breast cancer, or having male breast cancer, you can receive genetic testing for the BRCA1 and BRCA2 genes with insurance. However, those who do not meet these conditions cannot receive the testing.
At Iseikai International General Hospital, those who wish to receive genetic testing for the BRCA1 and BRCA2 genes can do so at their own expense. We also accept testing (single-site testing) for those whose family members have been diagnosed with HBOC through genetic testing and whose variants are known.
Breast cancer specialists and certified genetic counselors will provide counseling, so please apply by phone if you wish to receive it.
Main diseases
General mammary gland diseases
Breast cancer, malignant mammary tumors other than breast cancer, benign tumors including mastopathy and fibroadenoma, chronic and acute mastitis, etc.
Treatment
We have introduced clinical pathways for inpatient treatment of aspiration pneumonia, urinary tract infections, dehydration, etc. This involves creating a plan for treatment (infusions, antibiotic drips, etc.) and examinations (blood tests, X-rays, etc.) for each illness from admission to discharge, and then proceeding with treatment according to that plan. We believe that this will lead to standardization of treatment and shortened hospital stays, allowing patients to receive better medical care.
Outpatient schedule
Morning 9:00～12:00（Reception8:00-11:30）/
Afternoon to Evening 13:30～16:30（Reception13:00-16:00）
| Mon | Tue | Wed | Thurs | Fri | |
|---|---|---|---|---|---|
| Morning | ● | ● | ● | ● | ● |
| Afternoon to Evening | ● | - | ● | - | - |
Medical equipment
- Mammography
- Ultrasound
- Pathological examination (cytology, tissue diagnosis, special staining for HER2, etc.)
- Breast needle biopsy device (core needle)
- Breast suction tissue biopsy device (Devicore, Celero, ATEC system)
*Mammography-guided and ultrasound-guided biopsies can be performed under various guides
Medical track record of the clinical department
-
Surgical method Number of procedures Breast malignant tumor surgery 53 Breast tumor removal 21 Anti-cancer drug intravenous catheter implantation 8 Lymph node dissection 4. Axillary 2 Mastectomy 1 Breast abscess incision 1 Integrated parenteral nutrition catheter implantation 1 Anti-cancer drug intravenous catheter implantation 1 Lymph node removal 2. Long diameter 3cm or more 1 Lymph node removal 1. Long diameter less than 3cm 1 CV port removal 1 Total number of medical departments 91 -
Anesthesia method Number of cases General anesthesia 71 Local anesthesia 24 Conduction anesthesia (nerve block) 4 Epidural anesthesia 1 Total number of medical departments 100
Academically certified facility
- Japanese Surgical Society Surgical Specialist Training Facility
[Japanese Society of Surgical Sciences https://www.jssoc.or.jp/servlet/JssServlet] - Japanese Breast Oncoplastic Surgery Society Implant Implementation Facility
[Japan Breast Oncoplastic Surgery Society http://jopbs.umin.jp/medical/shisetsu/] - Japan Breast Oncoplastic Surgery Society Expander Implementation Facility
[Japan Breast Oncoplastic Surgery Society http://jopbs.umin.jp/medical/shisetsu/]
Regarding clinical research
Click here for more information on clinical research