+352 621 47 83 94 
1b rue Thomas Edison L-1445 Strassen
Project 20 interviews
«Professionals speak about their daily work and their missions»
Interview with the Dr Marc Stieber specialist in obstetrics and gynaecology.
Dr Marc Stieber, a specialist in obstetrics and gynaecology, has been working at the Robert Schuman Hospital (HRS) in Luxembourg for many years. He is also the referral doctor at the Clinique Bohler at HRS for thegynaecological department in the Woman, Mother and Child Centre.
In this role he coordinates lots of projects, is responsible for all the certification steps regarding the breastcancer centre, organises multi-disciplinary meetings with colleagues — the radiologists, gynaecologists, oncologists – and works in close collaboration with external partners like the Centre François Baclesse (CFB) in Esch or the National Health Laboratory (LNS) in Dudelange.
Dr Stieber’s subspeciality involves accompanying patients who are suffering from breast cancer, and it is thisspeciality which we are most interested in for this article. Of course, he is also an expert in breast surgery andoncologic gynaecology.
In order to establish the appropriate treatment, Dr Stieber needs to discuss the results of the mammograms, echographies (ultrasounds) and biopsies with his colleagues from the multidisciplinary team. They then all decide on what type of treatment to apply, and in which order (surgery, chemotherapy before surgery,immunotherapy, hormone therapy).
The team relies on recommendations from specialist international medical conferences, and in addition takes into account the individual situation of the patient.
Some patients require a standard operation, which involves removing the tumour, and if necessary, thesentinel node in the axillary lymph. Some may need an axillary dissection with a certain number of lymph nodes. The day before or the same day of the operation, a specialist in nuclear medicine injects a slightlyradioactive substance around the nipple. This substance becomes concentrated in one or those nodes whichdrain the area around the tumour. A device called a gamma sonde is used to help find the one or the nodesthat respond to radioactivity, the so-called sentinel node(s), and to remove just that one or those.
Depending on the localisation of the tumour, the size and the size relationship between the tumour and the breast, Dr Stieber applies different techniques of oncoplastic surgery to refill the deficit of tissue using surrounding breast or fat tissue, to restore the original shape as well as possible.
For oncological, genetic, or aesthetic reasons breast- conserving surgery may not always be an option. In some cases, removing the whole breast, (a mastectomy), is offered. In many cases, and depending on the patient’s wishes, the plastic surgeon can perform an immediate reconstruction – at the same time as mastectomy surgery,
using a silicone implant, by transplanting the latissimus dorsi muscle (taken from the back), by transplanting muscle tissue – fat or fat alone from the belly, partly using microsurgical techniques. The length of the operation depends on the chosen technique, anywhere between one and six hours.
For some patients who have contraindications to immediate reconstruction, a delayed surgery is possible, after the finalization of all adjuvant treatments.
It is recommended to wait between 12 and 18 months after radiotherapy. Some patients don’t want a reconstruction at the beginning, but perhaps decide later that they would like to have it done.
Before surgery, all possibilities are discussed with the patient. It has to be very clear what the implications are from an oncological point of view, what the patient expects, and what the specialists in senology, oncoplasticand reconstructive surgery will have to perform during the operation.
Each patient, then having had all the information related to treatment and surgery, is free to decide what is best regarding treatment and her body image.
According to Dr Stieber, teamwork is essential. In this way the best care is guaranteed to the patient.
All aspects related to therapy, appropriate treatment and complementary care are discussed, to offer the patient the best care possible.
Message from Dr Stieber to all patients:
Rely on your team, they help you make the best decisions. Take full advantage of all this support offered to you.
Count on the commitment of the team, but have this strong will to fight, while relying on all the support offered.
Thank you so much Dr Stieber for your dedication, and the invaluable support you give your patients.
The interview was conducted by Ms. Françoise Hetto-Gaasch, member of the committee of Europa Donna Luxembourg in May 2022.
Europa Donna Luxembourg Asbl
1b rue Thomas Edison L-1445 Strassen
Tél. : 621 47 83 94
E-mail : europadonna@pt.lu