Marking Process with Acetate

Marking of the cancer area and metastatic lymph within the breast on transparent acetate.

It is a method that allows the patient to be monitored during Neoadjuvant Chemotherapy. In patients who have previously received reduction therapy, the cancerous area becomes much smaller after chemotherapy and sometimes may even disappear completely.

Due to its size and spread to the armpit, patients who are scheduled for Neoadjuvant Chemotherapy are taken to surgery after chemotherapy is completed. When planning surgery, the breast is marked from the beginning to avoid leaving any residue behind that could cause the cancer to grow again.

When neoadjuvant chemotherapy is planned for the patient, the breast mass and metastastic lymph nodes are first marked (by placing a coil and drawing on acetate) when the patient arrives. Thus, even if the tumor shrinks during treatment, surgery is performed in accordance with the tumor profile of the patient when first diagnosed. In cases where the cancer in the breast has several foci or the tumor is large, it is difficult to determine the exact boundaries of the cancer area that has regressed with chemotherapy, as a single marker coil only marks the middle of the carcinogenic area.

In our clinic, the cancer area within the patient's breast tissue, other suspicious areas and armpit metastatic lymph nodes are also marked on the acetate. Opr.Dr., president of the Dusseldorf Senology Institute, Germany. As Rezai points out, this marking technique has three very beneficial effects.

1. During Neoadjuvant Chemotherapy, the effectiveness of Chemotherapy is monitored in the cancer tissue, starting from the early period. Today's modern Chemotherapy agents cause tumor shrinkage from the first use. The shrinkage in the tumor and lymph nodes can be monitored through the drawn tissue trace.
2.  This technique also allows monitoring during chemotherapy for the possibility of the cancer developing resistance to Chemotherapy. If the cancer develops resistance during chemotherapy, the shrinkage may stop and the structure may even begin to grow again.  The exact measurements determined on the drawing, frequent USG findings and undesirable changes in the clinically observed tumor are consulted with the Oncology clinic applying the treatment. Depending on the oncologist's preference, the chemotherapy treatment protocol is changed or the patient is taken to surgery earlier to prevent delays.
3. During neoadjuvant chemotherapy, it is also observed that the tumor and axillary metastatic lymph nodes regress significantly and may even disappear completely. Since the main cancer tissue, other areas of suspicious spread within the breast, and armpit metastatic lymph nodes have been drawn and monitored from the beginning, safe and adequate surgery can be performed within the breast even if the mass has completely disappeared. This type of marking allows breast-conserving surgery to be preferred and cosmetics to be better protected.

1. Neoadjuvan Kemoterapi sırasında erken dönemden başlayarak kanser dokusunda Kemoterapinin etkinliği izlenir. Günümüzün modern Kemoterapi ajanları daha ilk kullanımdan itibaren tümörde küçülmeye sebep olmaktadır. Çizilen doku izi üzerinden tümördeki ve lenf nodlarındaki küçülme izlenebilmektedir. 
2. Bu teknik ayrıca kemoterapi sırasında kanserin Kemoterapiye direnç geliştirmesi ihtimalinin de izlenmesi sağlar. Eğer Kemoterapi sırasında kanserde direnç gelişirse küçülme durabilir hatta yapı yeniden büyümeye başlayabilir. Çizim üzerinde belirlenen kesin ölçüler sık olarak USG bulguları ve klinik olarak izlenen tümördeki istenmeyen değişiklikler , tedaviyi uygulayan Onkoloji kliniği ile konsülte edilir. Onkolojinin tercihi üzerine kemoterapi tedavi protokolü değişir veya hasta daha erken dönemde cerrahiye alınarak geç kalınması engellenir.
3. Neoadjuvan kemoterapi sırasında tümörün ve koltuk altı metastatik lenf nodlarının çok geriledikleri ve hatta tümüyle kaybolabildikleri de görülür. Daha önceden ana kanser dokusu , meme içindeki diğer şüpheli yayılım alanları ve koltuk altı metastatik lenf nodları  baştan çizilmiş ve takip edilmiş olduğu için kitle tümüyle kaybolmuş olsa bile meme içinde güvenli ve yeterli cerrahi yapılmış olur. Bu şekildeki işaretleme meme koruyucu cerrahilerin tercih edilmesine ve kozmetiğin daha iyi korunmasına olanak sağlar .