Extensive Services for Breast Cancer Patients

Psycho-Oncology Consultation Hours
Cancer represents a huge challenge not only for the affected person but also for their family members. In this context, psycho-oncological support can be essential to face the radical changes brought by the illness. Psycho-oncological psychotherapy helps patients regain inner strength and, at times, discover new perspectives and a deeper understanding of themselves and their situation. The therapeutic path is personalized according to the individual’s concerns and needs.

Outpatient Oncological Rehabilitation
The diagnosis and treatment of cancer can be physically and emotionally debilitating. Outpatient oncological rehabilitation is a valuable resource for recovery and overall well-being. The rehabilitation program is tailored to individual needs, aiming to facilitate physical and psychological recovery.

In this field, we collaborate with specialists from the Association Triangolo, who support us in providing high-quality care.

Oncological Nursing Care

Professional nursing care, provided by oncology-trained nurses, is dedicated to treating, advising, and supporting cancer patients and their families throughout all stages of the disease, in a targeted and autonomous manner. Approximately 85% of oncological therapies are administered on an outpatient basis.

At Centro Seno Ticino, nurses work closely with medical oncologists and Breast Care Nurses. All nurses have specialized oncology training and several years of experience in the field, enabling them to respond holistically to the needs of patients and their families, while also helping to reduce disease symptoms and/or side effects of treatments.

What this means for you:

Targeted information
before therapy begins, including nursing consultations aimed at preventing and managing side effects of oncological treatments such as fatigue, oral mucositis, nausea, vomiting, skin changes, alterations in appearance, and much more.

Safe and precise administration
of complex pharmacological therapies, in accordance with international standards.

Minimization of hair loss
during chemotherapy using the “Paxman” scalp cooling system. We have three “Paxman” devices with six cooling stations available for our patients.

Instruction on nursing tasks
that patients perform independently during therapy, such as self-administration of injections or dressing changes.

Support and guidance
to face emotional and practical challenges during treatment, including referrals to specialists for nutritional counseling or psycho-oncological support.

Palliative care
focused on quality of life, offering relief and enhancing patient well-being.

Treatment

A breast cancer diagnosis can trigger profound emotional crises in affected women, who may experience phases of fear, denial, resignation, and doubt. Some patients require a special level of qualified care during this time, as well as empathetic and attentive listening to address their questions and concerns. The Breast Care Nurses, together with the entire Centro Seno Ticino team, are available to support patients and their families at every stage of the illness.

Breast Care Nurse

A Breast Care Nurse is a consistent, professional, and compassionate point of contact for patients and their families. She is a nurse with specialized training in breast care, specifically aimed at women with breast cancer.

Supports
during the diagnostic process by addressing physical, psychological, and social concerns, helping to ease fears and promote peace of mind and confidence during a particularly difficult period.

Listens,
remaining a constant point of reference throughout the treatment journey and even in the post-treatment phase.

Informs
by providing clear explanations of the care process and helping patients understand the often-technical medical language.

Helps
women deal with personal and medical issues related to the illness, providing clarity and structure during uncertain times.

Accompanies
patients, upon request, to medical consultations, appointments, exams, and treatments.

Advises
on suitable accessories and specialized treatments, such as physiotherapy, lymphatic drainage, aesthetic courses, and more.

Promotes
health awareness and social activities, ensuring that patients receive all necessary information and understand it thoroughly.

Family and friends are a vital source of support. The Breast Care Nurse is also available to assist them and encourages them not to hesitate in seeking help if needed.

Approach to Care

The diagnostic and therapeutic journey for breast cancer is often long and demanding, requiring patients to engage on multiple levels as they face new daily challenges.
Counselling aims to help patients draw on their own inner resources and strengths to face the many demands that come with this diagnosis. Discovering hidden strengths, activating them, and learning to rely on them is often the best way to navigate the difficult stages of illness.
Maintaining a positive outlook towards therapy is crucial to achieving the best possible outcomes.

Genetic Counseling

In 90% of breast cancer cases, no clear cause can be identified. However, factors such as hormone therapy, lifestyle, radiation exposure, obesity, and diet may play a contributing role.

In contrast, approximately 10% of all breast cancers have a clearly identifiable cause. The predisposition to the disease is inherited from one or both parents. An increased incidence of breast cancer across multiple generations, very early onset, or the presence of breast cancer in male family members are strong indicators of a hereditary predisposition to breast cancer. When breast cancer has a genetic origin, there is also an increased risk of cancers in other organs, and close relatives may also be at risk. During genetic counselling, a specialist will assess whether genetic testing is appropriate. If so, the tests are arranged, the results are discussed in detail, and the possible medical, psychological, and familial implications are thoroughly evaluated.

Radiotherapy

Even after the complete surgical removal of a malignant breast tumor, follow-up radiotherapy is often recommended. This is because microscopic cancer cells may still be present—cells that are invisible to the surgeon but could later cause a recurrence of the disease, either locally or in other parts of the body. Some precancerous conditions, such as ductal carcinoma in situ (DCIS)—a precursor to invasive breast cancer—can also lead to recurrence in the breast. Therefore, radiotherapy is often performed even in cases of DCIS. In certain situations, radiation of the chest wall and lymph node regions may be indicated after a mastectomy as well.

Today, radiotherapy is administered almost exclusively using a linear accelerator, which emits ionizing radiation (photons or electrons). These rays interact with the irradiated tissue and can lead to the destruction of cancer cells. One advantage of linear accelerators is the ability to deliver high-dose radiation in relatively short treatment times.

With careful planning and execution, significant side effects can usually be minimized. It’s important to distinguish between Acute side effects, such as: Skin redness, Superficial skin lesions, Breast swelling, Fatigue.
These typically disappear completely after treatment ends. And Late side effects, which may appear weeks or months after the end of treatment and may be permanent, such as: Skin changes or Breast tissue hardening. Side effects involving the ribs, lungs, or heart are rare. To minimize exposure to these organs—especially the heart—modern technologies enable three-dimensional, respiratory-gated radiotherapy. This means the radiation is only delivered during inhalation, when the heart is furthest from the radiation field. If the lymph node regions must also be irradiated, the risk of arm swelling (lymphedema) increases slightly.

Pharmacological Therapies (Chemotherapy)

The term “chemotherapy” generally refers to a type of pharmacological treatment used for malignant tumors. The medications used are known as cytostatics (from Greek kytos = cell, statikos = to halt). Chemotherapy can be administered intravenously or taken orally in tablet form.
In some patients with breast cancer—both in early and advanced stages—tumor cells can be inhibited or destroyed through the administration of these cytostatic drugs. They work by damaging the nucleus and other components of tumor cells, thereby inhibiting their uncontrolled proliferation. Treatment may involve a single cytostatic agent or a combination of several drugs.
Since chemotherapy affects the entire body, healthy cells—such as those in hair follicles or the intestinal lining—can also be affected. However, with careful planning and proper implementation, side effects are generally manageable. Moreover, healthy cells typically recover quickly once treatment ends.

Targeted and Personalized Therapies

The term “targeted therapies” refers to a wide range of treatments that act on specific molecular or genetic characteristics of cancer cells. These therapies include: Monoclonal antibodies, Kinase inhibitors (enzymes/proteins), Angiogenesis inhibitors and Antibody-drug conjugates.
Unlike chemotherapy, targeted therapies do not directly destroy tumor cells. Instead, they block key receptors or functional proteins, effectively “starving” the tumor.
However, these therapies are only effective if the tumor cells express the corresponding molecular targets.
Although these treatments mostly affect cancer cells and spare healthy cells, side effects can still occur. Targeted therapies can be given alone or in combination with chemotherapy, and administered via infusion, subcutaneous injection, or oral tablets.

Endocrine Therapies

About 80% of all malignant breast tumors have receptors that respond to the female hormones estrogen and progesterone. This means that tumor growth is stimulated by these hormones.
Endocrine therapy takes advantage of this hormonal dependency by blocking hormone receptors or suppressing hormone production. This approach can:
Prevent the spread of distant metastases
Help protect the healthy breast from developing cancer
Endocrine therapy is typically administered as daily oral tablets. In younger, premenopausal women, ovarian function may be temporarily suppressed with an injection, given every 1 to 3 months.
As endocrine therapy can cause side effects, one of the goals of our post-treatment monitoring is to help relieve them with appropriate measures.

Tumor Surgery

In most cases, surgery is the first therapeutic option after a breast cancer diagnosis. The goal is to completely remove the tumor. For many decades, the standard procedure was total breast removal (mastectomy). However, over the past 25 years, the approach has changed significantly. Today, total breast removal is only necessary in a minority of cases; in approximately two-thirds of patients, breast-conserving surgery is possible. Breast-conserving procedures—especially when performed using modern oncoplastic techniques—offer significantly more aesthetically pleasing results compared to mastectomy. Importantly, we now know that breast-conserving therapy (including postoperative radiotherapy) offers no compromise in oncological safety for the patient.

However, mastectomy may still be necessary in some cases. Factors considered include the size and location of the tumor, breast size, tumor type and spread, and, of course, the patient’s personal preferences.

If a patient undergoing mastectomy wishes to reconstruct the breast (either immediately—primary reconstruction—or later—secondary reconstruction), the reconstructive plastic surgeons at Centro Seno Ticino offer all internationally recognized reconstruction options. These include silicone implants and reconstruction using the patient’s own tissue.

Axillary Lymph Nodes

Over the past twenty years, there has been a clear trend toward less radical and less aggressive breast surgery, especially regarding the axillary lymph nodes. These nodes are crucial, as they are typically the first to be affected by metastases in the spread of breast cancer.

For proper treatment, it’s essential to know whether the axillary lymph nodes are involved. While in the past lymphatic tissue was routinely removed in all breast cancer cases, today this is necessary in only 20–25% of cases. Thanks to new techniques, it is now possible to intraoperatively identify and selectively remove the “sentinel lymph nodes”—those most likely to be affected. With this sentinel node technique, usually only 1–2 lymph nodes are removed, significantly reducing the risk of complications compared to traditional removal of 10–20 nodes. As a result, side effects such as lymphedema, reduced sensation, and limited arm mobility, which were previously common, are now rarely observed.

Breast Reconstruction Surgery

The goal of breast reconstruction is to maintain or restore quality of life. It’s important to note that breast reconstruction does not negatively affect the course of a potential breast cancer. Together, we will develop a personalized treatment plan tailored to your needs and oncological considerations. As specialists, we can offer you all recognized reconstruction options:

• Tissue expanders/implants/matrix support
• Autologous tissue reconstruction, including:
• From the abdomen (DIEP flap)
• From the inner thigh (TMG flap)
• From beneath the gluteal fold (PAP flap)
• From the buttocks (S-GAP flap)
• From the back (latissimus dorsi flap)
• From the flank (rotation flap)
• Breast reconstruction with autologous fat grafting (lipofilling)
• Reshaping procedures as part of breast-conserving tumor surgery
• Nipple reconstruction

Lymphedema

Lymphedema may develop without an identifiable cause, or as a result of surgery and/or radiotherapy for breast cancer. The foundation of treatment is always compression therapy combined with lymphatic drainage. In selected cases, surgical treatment may improve lymphedema. Depending on the severity and cause, options may include liposuction or microsurgical techniques. To determine the best treatment for your case, we use both a clinical examination and the latest imaging technologies for lymphatic mapping.

Mammography

Mammography is an X-ray examination of the breast. It is used for the early detection of breast cancer and to clarify findings from palpation or other clinical abnormalities in the breast. Tomosynthesis (3D mammography technology) allows for the creation of detailed tomographic images of the breast, improving diagnostic accuracy.

Ultrasound

Breast ultrasound can complement mammography: In young women, it is often used as the first-line imaging method, to further evaluate findings from palpation, to clarify abnormalities detected by mammography or as an additional tool in cases of dense breast tissue

Breast MRI

Breast MRI is used in specific clinical situations to provide more detailed imaging.

Computed Tomography (CT)

CT scans are used in selected cases to provide further diagnostic insight.

Biopsy Procedures

(Punch biopsy or vacuum-assisted biopsy)
A tissue sample may be necessary to determine whether clinical findings or palpable abnormalities are benign or malignant. At Centro Seno Ticino, we perform all image-guided breast biopsies: Ultrasound-guided punch and vacuum-assisted biopsies, Tomosynthesis-guided vacuum biopsy and MRI-guided vacuum biopsy. The tissue sample is analyzed in a laboratory to assess its biological characteristics. Based on these specific findings, a personalized treatment plan is developed.