Dr Parveen Mendiratta
Breast cancer represents a significant and escalating health crisis in India, becoming one of the leading causes of cancer-related deaths among women. In 2022, India ranked highest in the world in number of estimated breast cancer deaths with 98,337 deaths. With a rising incidence rate, it is estimated that approximately 1 in 28 women in India will develop breast cancer during their lifetime.
Fortunately, Breast cancer treatment has seen remarkable advancements, particularly in surgical techniques. As the primary treatment method for many breast cancer cases, surgery now focuses on precision, minimizing side effects, and improving both functional and aesthetic outcomes for patients.
Breast Conservation and Oncoplastic Surgery
Oncoplastic surgery merges cancer-removal surgery with cosmetic surgical techniques, providing better aesthetic outcomes without compromising cancer treatment. Surgeons remove the tumor while reshaping the breast to minimize deformities. This approach often involves volume displacement or tissue rearrangement, allowing patients to maintain a more natural breast appearance post-surgery. It offers a balance between complete cancer removal and breast conservation.
Sentinel Lymph Node Dissection
Sentinel lymph node biopsy has replaced traditional axillary lymph node dissection in many cases. It allows surgeons to identify and remove only the first few lymph nodes (sentinel nodes) to which cancer cells are most likely to spread. This significantly reduces the risk of complications like lymphedema, which can arise from more extensive lymph node removal.
Minimally Invasive Techniques
Robotic assisted nipple sparing surgery and Robotic assisted lymph node dissectionhave gained momentum in breast cancer treatment, reducing postoperative pain, recovery time, and scarring. Robotic mastectomies, in particular, offer precision and control, especially in complex cases, allowing surgeons to preserve the skin and deliver superior cosmetic outcomes.
Intraoperative Radiation Therapy
Intraoperative Radiation Therapy is an advanced technique in which radiation is delivered directly to the tumor site during surgery, immediately after the tumor is removed. This method targets the cancer cells more precisely, potentially reducing the need for lengthy radiation treatments post-surgery. It is particularly beneficial for patients with early-stage breast cancer, as it minimizes radiation exposure to healthy surrounding tissues.
Advances in Breast Reconstruction
Breast reconstruction options have expanded significantly. Autologous reconstruction, using the patient’s tissue (e.g., from the abdomen), is gaining preference due to its natural look and feel. The DIEP flap (Deep Inferior Epigastric Perforator) and Latissimus Dorsi Flap techniquesare leading choices, allowing reconstruction without sacrificing muscle, thereby minimizing recovery time and preserving strength.
Breast cancer surgery has undergone significant advancements, with a focus on less invasive techniques that enhance cosmetic results and reduce recovery times. These modern approaches offer increased hope and better options for patients.
As the field evolves, the emphasis on precision and patient-cantered care is crucial for improving treatment outcomes and overall quality of life. With ongoing research and technological progress, the future of breast cancer surgery promises even more refined and effective treatments, making recovery smoother and offering renewed optimism for women suffering from Breast cancer all over the world.
(The author is Head of Department, Surgical Oncology, Yatharth Hospital, Greater Noida)
