Breast Cancer Surgery: Past and Present

 

Breast cancer is a common type of cancer that affects women worldwide, accounting for about 13.5% of all cancer cases in India. It is increasingly affecting younger women as well. Surgery is the main treatment for localized breast cancer, often combined with other therapies like chemotherapy, hormone therapy, and radiation. Over the years, there have been significant advancements in breast surgery aimed at improving patients' quality of life and ensuring their safety.

In the past, most women with breast cancer underwent mastectomy (removal of the breast). However, now, 50-70% of patients can have breast conservation surgery, where only the tumor and surrounding area are removed, preserving the breast. This is possible for many early breast cancers and some locally advanced cases with the appropriate use of chemotherapy before surgery.

Oncoplastic surgery principles are used to maintain the breast's appearance and feel as normal as possible after tumor removal. This involves surgical planning and using nearby fat to fill the defect created by tumor removal, preserving the breast's shape and size.

Whole breast reconstruction is offered to women undergoing mastectomy. It involves creating an artificial breast mound resembling a natural breast using the patient's own fat or muscle, with or without an implant. This surgery can be done during cancer surgery. Nipple and skin-sparing mastectomy, where the breast tissue is removed while saving the skin envelope and/or nipple, is also an option for some women.

There has been a shift from complete axillary lymph node dissection (removal of all lymph glands in the armpit) to sentinel lymph node biopsy (SLNB) in selected cases. SLNB allows for the removal of a few draining nodes, reducing the risk of side effects like arm stiffness and swelling (lymphedema). Newer procedures like LYMPHA are also being used to reduce the chances of lymphedema by connecting lymphatic vessels to veins during nodal surgery.

All these advancements have helped ensure that women with breast cancer can be cancer-free and safe while minimizing major changes in their bodies. The journey of a cancer patient is challenging, but with these medical and surgical developments, most patients can have minimal scars and side effects and retain a close to 'normal' quality of life and body image after treatment.

Before undergoing any cancer treatment, it is crucial to consult with a radiation oncologist. If you are seeking the best oncologist in Delhi, you can Book an Oncologist Appointment. Dr. Dodul Mondal, who currently serves as the Director of Max Super Speciality Hospital in Saket, Delhi.