Is removal of the breast the only option in treatment of breast cancer?
When a 31-year-old consultant from an MNC entered my clinic with her fiancé, I could feel a sense of despondency enveloping this attractive young woman. The documents that were placed in front of me contained a core biopsy report that supported the diagnosis of breast cancer. She could not believe that a lump she had discovered a week earlier could turn her life upside down. Even though the lump was roughly 2.5 cm in size, I could feel lymph nodes in the armpit. Imaging revealed no signs of metastasis to the other organs. She had come to me terrified of her diagnosis. I reassured her that the tumor was both curable and treatable.
She had been advised to undergo a modified radical mastectomy, which involves the removal of both breasts and the lymph nodes under the armpit. She wondered if she could keep her breast and still achieve the same treatment outcome. She was dealing with the difficult situation of losing an organ, a crucial component of her femininity, to cancer. It seemed brutal!
This would have been her only option a few years ago, but today breast conservation is not only a possibility but also a necessity wherever possible. Breast conservation surgery or BCS is done while keeping the oncological and reconstructive principles in mind. Curing the disease is a priority, and maintaining the quality of life is as essential.
The journey that has led to BCS is fascinating, and the ongoing effort to improve it for the patient has motivated the progress.
Did you know that mutilating procedures like amputation of the breast followed by radical mastectomy and extended radical mastectomy (removal of the breast, chest muscles, and lymph nodes in the armpit removal from the chest) remained in vogue for a larger part of the 20th century.
However, in the 1960s, the trials focused on the question of “Are we doing too much?“ because it was believed that breast cancer was a systemic disease rather than a local disease.
The treatment of breast cancer was revolutionized from radical mastectomy to Breast conservation treatment by landmark trials like NSABP B-04 and NSABP B-06 trial. A woman suffering from breast cancer had a choice where she could retain her organ, and forego the psychological and emotional trauma associated with an otherwise mutilating surgery.
Breast conservation therapy has replaced previous forms of treatment for some patients as a result of advancements in chemotherapy, radiation therapy, hormone therapy, and targeted therapy. While breast preservation is an option for people with early-stage breast cancer, this treatment is also an option for those with locally advanced breast cancer when chemotherapy is first given to reduce the tumor size. When surgery is performed after chemotherapy (Neo adjuvant chemotherapy), the breast can be preserved as the tumor shrinks in size and downstages.
That is exactly what we did with our young lady that had walked into our clinic. We were able to preserve this young woman’s breast in a condition that was very close to normal thanks to the assistance of our medical oncologist colleagues. She walked away cancer free while still retaining her symbol of feminity.
Your fight is our fight!
To know more about breast cancer and breast conservation treatment visit our website https://titlibreastcare.com/
Consultant Breast and Oncoplasty Surgeon.
