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April 2010
Conservative Surgery for Breast Cancer
Dr Shaikat Gupta
 
Sudeshna noticed a painless lump in her right breast during her monthly self examination, which she has been doing since puberty. When scans and mammography revealed the lump to be malignant, this young couple’s world went topsy turvy.
 

The Crab Spreads Silently
It is really unfortunate to note that cancer is still one of the most feared ailments today, when cancer treatment has taken giant leaps, both in curative and palliative terms. The key to successful treatment of any type of malignant disease is early detection. Statistics reveal that one in 10 women will be diagnosed with breast cancer! The fact that the Crab spreads silently without causing significant symptoms contributes to the high mortality rate as well. Uncontrolled proliferation of cells, which characterises cancer, rapidly spreads from the soft tissues of the breast to the lymph nodes and spreads to other organs as well. Known as metastasis, this is the worst fear of doctors.

Bad Cut
Surgery ranks high among the choice of therapy for breast cancer. But like Sudeshna, many women find it hard to accept the trauma of removal of the whole breast. Not only does it rob an aesthetic feminine beauty, but often invites complications like frozen shoulder, decreased arm mobility, etc. The unpleasant consequences of the surgery, both in physical and psychological terms, often acts as a major roadblock on the road to recovery. This powerful mental weapon in the constant battle against the Crab is lost while not coming to terms with it. Postoperative blues and mood swings considerably affect the family and social life as well. Undergoing another surgery for implanting a prosthetic breast, which has a high price tag, is an area mostly treaded by a fortunate few. All these translate to the fact that despite the surgery, the desired quality of life is not achieved in many patients.

6 Ways to Maintain Your Breasts

1 Perform self-examination every month after your period stops.
2 Have a breast examination by a doctor or nurse, every year, starting at age 20.
3 Learn the normal feel of your breasts, and check them regularly.
4 Report to your doctor if you notice any change of colour of the breast or nipple, discharge from the nipple, unusual cracking or sudden heaviness of one or both the breasts.
5 Have a mammography done yearly after the age of 40.
6 Remember, most incidences of breast cancers can be cured completely if detected at an early stage.

Conservative Surgery

As an alternative to radical mastectomy (cutting and removing the entire breast), conservative surgery of the breasts has been a widely accepted solution for both doctors and patients. Conservative surgery refers to the attempt to conserve with minimum intervention by the scalpel, than to radically destroy and remove a diseased body part. Breast conserving surgery is considered an option especially when the cancer is relatively small.

The cancerous region is precisely located with radiological investigations like mammography, ultrasonography and scanning. Then the cancer is entirely removed, with only a surgical margin of healthy tissue, to give an acceptable appearance. This is followed by radiotherapy for the desired result.

Conservative surgery is just as effective as mastectomy – and you don’t have to get the entire breast removed! The doctor counselled Sudeshna that there was no additional risk of the cancer coming back if she decided to undergo a breast conservation surgery. She threw a glance at her husband, and nodded.
*Name changed to protect privacy
Dr. Shaikat Gupta is Consultant - Surgical Oncology at Apollo Gleneagles Hospitals, Kolkata

    
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