What is breast cancer?
Breast cancer is the most common cancer affecting women in India. About 1 lakh new cases are being detected in India every year. Early detection and access to appropriate multidisciplinary care have a tremendous impact on survival & quality of life.
Each breast cancer patient’s personal treatment team includes numerous experts, including a breast surgeon, reconstructive surgeon, medical oncologist, radiation oncologist and a specially trained support staff.
Breast Cancer surgical options:
The cancer can be removed as a lump (lumpectomy) with a margin of normal tissue around it (called wide local excision). This leaves the majority of the breast untouched (breast conserving surgery). The alternative to this is to remove the whole breast (mastectomy).
A mastectomy or a lumpectomy is advised dependent upon the type of cancer, size and evidence of other cancer cells elsewhere in the breast. With both options few lymph glands from the armpit are usually removed at the time of the cancer excision (sentinel lymph node biopsy). The nodes are checked for any cancer spread. If there is known cancer in the lymph glands then all the lymph glands are removed (axillary node clearance).
The choice of lumpectomy or mastectomy might influence the need for radiotherapy. The decision regarding the need for chemotherapy and hormone therapy after surgery is usually based on the post surgery pathology report and is independent of the nature of surgery (i.e) lumpectomy or mastectomy
Survival outcomes are identical for both lumpectomy and mastectomy. But lumpectomy may not always be possible in all patients.
Oncoplastic procedures are sometimes done to improve cosmetic outcomes of breast preserving operations. The breast volume that is lost after a lumpectomy can be replaced by muscle tissues from the back to maintain the shape of the breast. Sometimes the breast after a lumpectomy can be reshaped with the remaining breast tissue to give better cosmetic outcomes. This may involve reducing the breast size in very large breasts or a breast lift in sagging breasts. These procedures not only remove the cancer but reshape the breast to look better. The opposite breast may also require a breast lift or a breast reduction to keep both the breasts symmetrical.