ADVANCES IN BREAST CANCER SURGERY

Types of Breast tumor Surgeries:

Wide Excision/ Lumpectomy: Tumor along with normal surrounding tissue is excised. Sufficient for benign tumors of breast. Benign phylloid tumors require a much wider resection margin of 2-3 cm.

Simple Mastectomy: Breast tumor along with whole breast tissue and nipple areola are excised. Axilla is not addressed in this surgery. Usually done for ductal carcinoma in situ and phylloid tumor.

Modified Radical Mastectomy: Breast with tumor at appropriate margins and nipple areola complex is excised along axillary lymph node dissection. 10-15 axillary lymph nodes are considered aequate as per guidelines. All stations of lymph nodes (I-III) suspected of having lymph nodes should be excised.

Breast Conservation Surgery: As the understanding of tumor biology is increasing and as the technologies are increasing, oncology surgery has improved to provide more and more functional results. Patient sections plays very important role. Suitable tumor with surrounding breast tumor with negative margins is excised. Axilla is addressed as standard.

Recent Advances:

Sentinel Lymph Node Biopsy: Sentinel lymph node is the first draining level lymph node of breast tumor. Usually a radioactive dye is injected around tumor before surgery and blue dye is injected in breast tissue at time of surgery. Gamma camera probe is used to identify the radioactivity and targeted node identified. It is excised and sent for frozen section during surgery. If tumor cells are absent than there is no need to address higher axillary lymph nodes. If tumors cells are identified than complete axillary surgery is done.

Skin Sparing Mastectomy  and immediate breast reconstruction:  preserve normal body image.