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Fact Files of Breast Cancer
With timely detection breast cancer can be cured completely. Interventions include a combination of surgery, chemotherapy, radiation and lifestyle changes. With timely detection breast cancer can be cured completely. In our previous issues we have told you how to prevent breast cancer and what to do to detect the disease at an early stage.
Q. When is surgery necessary?
Surgery is required when breast cancer is in the I, II or III stage. In stage I and II surgery is followed by chemotherapy. Then we further treat the patient with radiation and hormone therapy (in the case of a hormone-sensitive person). But in stage III chemotherapy comes first. This is then followed by surgery. And later, by radiotherapy and hormone treatment.
Q. What are the different types of surgical options?
It depends on the stage. We can perform a breast conservation surgery known as lumpectomy in the early stages. In an advanced stage, the breast removal surgery called mastectomy, is advised.
Q. What do patients need to know before opting for surgery?
Most importantly, patients need to know whether the cancer is confirmed. Then they should be aware of its stage. And finally, they should be clearly told about the difference in the quality of cure after a breast conservation surgery and a breast removal surgery.
Q. What is lumpectomy?
Lumpectomy, with clear margins, is part of a breast conservation surgery. This basically means removing the cancerous lump and keeping the remaining breast as it is. But this surgery is always accompanied by auxiliary lymph node dissection (removal of nodes from the armpit) and/or sentinel node biopsy. Before deciding on a lumpectomy, we need to confirm that no other part of the breast has any tumor, or its precursor, by doing mammography.
Q. When is mastectomy recommended?
In stage III mastectomy is necessary. Also, in the case of early-stage tumors which are multi-centric or have extensive micro-calcification outside the primary tumor-bearing area (with the potential of spreading at different spots in the breast), we go in for a mastectomy. Besides, when a patient is unable to take post-operative radiotherapy, a mastectomy is advised.
Q. What are your views on breast reconstruction?
For both the doctor as well as the patient, the first choice is to conserve the breast. But if it is not feasible then reconstruction can be considered. The cosmetic result is good in some patients. But since nature can never be imitated fully, some patients do not find it satisfactory. Sometimes modifications are required in the opposite breast.