Cosmesis refers to the preservation, restoration of a body part in it’s original form. Breast cosmesis is an important aspect and an endpoint of breast conserving therapy. The surgeons who carry out surgeries related to breast removal or upliftment, need to be precise in getting the other breast in exact shape to maintain symmetry. Their next priority is to make everything look good in the process.
Cosmesis plays a critical role in a woman’s physical and emotional recovery. Being fully treated and getting themselves out of danger is always the first priority but once women are out of danger, they would obviously be concerned about their looks, hence good cosmesis is a necessity.
Factors Affecting Good Cosmetic Outcome
Cosmetic outcome which follows the breast-conserving surgery is dependent on various factors like:
Though the best method to assess good cosmesis in breast cancer surgery is still not clear but there are certain objective and subjective methods in combination, known to give a fairly good assessment of cosmesis.
Methods and materials involved to determine good cosmetic outcome
The general methods followed to ensure good cosmesis are Breast Retraction Assessment (BRA) and percentage Breast Retraction Assessment (pBRA). These are the objective measurements of the amount of breast retraction, determined primarily by comparing positions of nipple in relation to the sterna notch between the treated breast and contralateral breast.
The pBRA technique has been proved to have low intra and interobserver variability. Lower values of percentage Breast Retraction Assessment have been shown to correlate with improved cosmetic outcomes, hence making percentage Breast Retraction Assessment a reliable and an objective measure of cosmesis.
How is cosmetic assessment generally done?
In a particular case, evaluation of cosmesis was done before treatment, around 6-8 weeks post-treatment, 3-4 months post treatment, 6-8 months post-treatment, then every 6 months period for next 4-5 years and finally the assessment was down to yearly basis. The qualitative evaluation of cosmesis involved comparing treated breast with the untreated breast using the rating system.
The global cosmetic result, appearance of the scar made due to surgery, breast size, breast shape, colour of the skin, location of the areola and nipple and shape of the nipple and areola. All these were scored on a 4-point scale,
Physical measurements to calculate Breast Retraction Assessment and percentage
Breast Retraction Assessment were taken in a live example, while patients were in a seated position with both arms at the side of the body. Both the assessments were determined prior to the treatment as well as at the follow-up. As Percentage Breast Retraction reports retraction in terms of percentage, so it was used for analysis. On each occasion both the patients and physician reported the perceived cause of cosmesis as mainly because of radiation, surgery, unknown or no significant change.
Breast cancer is the most common cancer that affects women. It is also deemed to be one of the major reason of death among women, though lung cancer is the leading cause of this. The chances that a woman may die of breast cancer is about 2.7% of the women who are suffering. Breast cancer is known to affect men as well, in certain cases. Breast cancer may be genetic but, in certain cases, it is caused due to excess intake of alcohol. Surgery is an option, but treatments also include therapies like radiation and chemo.
Treatment for breast cancer
Breast cancer can be treated in several ways; however, the treatment depends upon many factors. These factors include the type of breast cancer, its stage, sensitivity of a person to the hormones, age of the patient, health of the patient and most importantly, preferences of the patient. The most common treatment options for breast cancer are radiation therapy, biological therapy, chemotherapy, hormone therapy, and surgery.
Cytotoxic drugs are important medications that are used to eliminate cancer cells. This medication is used if the chances of the cancer cells spreading are high. This process is known as the adjuvant chemotherapy.
Many a time, the tumor increases in size and surgery becomes essential. This is when the chemotherapy is administered to reduce the tumor size and make it easier for the surgeons to remove the tumor. This process is referred to as neoadjuvant chemotherapy. Chemotherapy can treat metastasized cancer or cancer that has affected other body parts, thereby reducing the symptoms, mostly in the advanced stages.
Radiation is targeted towards the tumor in controlled doses so that the cancer cells are destroyed. Radiation therapy is mostly advised to the patients after they go through surgery, to eliminate the cancer cells that may still be there.
Hormone blocking therapy
Most people go through breast cancer that is hormone sensitive. The hormone blocking therapy helps in preventing the recurrence in this type of breast cancer. The hormone blocking therapy is also used to reduce the size of the tumor, but this method is also suggested after a person goes through surgery.
There are some drugs that fall under this category that is used for destroying the various types of the breast cancer.
If at all the patient requires surgery, it depends on his or her diagnosis reports and his or her will to undergo surgery. The types of surgery include Lumpectomy, Sentinel node biopsy, Mastectomy, Axillary lymph node dissection, and Reconstruction. Reconstruction is the method which the doctors make use of to make both the breasts look similar after the surgery is complete. There are several treatment options available to treat breast cancer, and it depends on the choice of the patient to opt for surgery. Surgery helps in eliminating the risk of the spreading of the cancer cells, and it is one of the most effective treatments for breast cancer.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Breast cancer is a type of cancer, which occurs due to the development of cancerous cells in breasts. Women are usually affected by breast cancer and breast cancer is one of the most common forms of cancer after skin cancer. Usually fatal if not diagnosed in its early stage, breast cancer is a very serious medical ailment. Read on more to find all about the different symptoms, causes, preventive measures and treatment of breast cancer.
Symptoms: Breast cancer has few distinct characteristics and if you have a few or all the following symptoms you could be more likely to suffer from breast cancer.
Causes: Studies and researches remain inconclusive on what causes breast cancer. Breast cancer occurs due to abnormal division of the cells located in the breast, which over time accumulate and form lumps. They
Risk factors: There are certain factors, which increase the probability of contracting breast cancer. Increasing age, personal and family history of breast cancer, obesity, radiation exposure, pregnancy at an older age, postmenopausal hormone therapy are some of the factors that increase the chances of breast cancer.
Treatment: Several forms of surgical methods exist to treat breast cancer. Depending on the condition and spread of the disease a suitable surgery is performed. These include mastectomy, lumpectomy, axillary lymph node dissection and removal of both breasts. Other forms of treatment include chemotherapy or the use of high doses of drugs to destroy cancerous cells. Radiation therapy where X-rays are used to destroy the cancer cells is also effective.
Being diagnosed with cancer is a scary thought but with medical intervention, most breast cancer cases can be treated. The most common forms of treatment are radiation and chemotherapy. Along with this, there are many forms of alternative and complementary treatment that may be followed. This can help reduce the side effects of chemotherapy and radiation and boost the immune system. Here are some things you can do as an alternative and complementary form of treatment.
It is important to note that these forms of treatment should not replace medical treatment but should be carried out along with it. You must also ensure that your doctor is aware of any supplements of alternative forms of treatment that you may be taking along with the medical treatment.
Breast Cancer can be detected at various stages. Some women might feel a difference in their breast area, with a lump or kind of a skin rash around the nipple or they could see that their nipple has become inverted, so then the treatment procedures would be different. The different stages of cancer and their respective treatment procedures are discussed below:
Stage I Breast Cancer - Treatment
In this case, breast cancers are at their nascent stage, either they have not spread to the lymph nodes or might have spread to only a small area. Treatment options are as follows:
Stage II Breast Cancer-Treatment
This is the stage when cancer has spread to some nearby lymph nodes. The treatment methods followed are:
Stage III Breast Cancer – Treatment
In stage III breast cancer, the size of a tumor is more than 5 cm, with cancer spreading on to the nearby lymph nodes. The treatment procedures followed are:
In case you have a concern or query you can always consult an expert & get answers to your questions!
Breast cancer(स्तन कैंसर) is on the rise in india. Surveys show that every 4 out of 5 Indian women who have breast cancer, suffer from an advanced stage of the disease by the time they reach the doctor. Urban women are at two times more risk of being diagnosed with breast cancer than rural women. Being overweight, eating unhealthy food, and consuming excessive alcohol or tobacco are some of causes that can make you susceptible to this disease.
How you can avoid breast cancer?
Breast cancer may run in family. If there is no family history of breast cancer, you start doing mammogram at 40 yrs of age but if there is a family history you start even earlier as advised by your gynaecologist.
In the last week, I have seen two patients who have presented with features of a breast abscess but they ultimately turned out to be breast cancers. Although, inflammatory breast cancers are a known entity and they can present as breast abscesses but this fact is not well known among patients and many general practitioners, which leads to late detection of these cancers.
With this case, I want to highlight some pointers to diagnose these lesions early. A 39-year-old, nonlactating mother presented to with complaints to swelling in the right breast for the last 3 weeks. She had already taken a course of antibiotics from a general practitioner but did not get relieved of her symptoms. On examination, she had a swelling involving the skin fold below the breast (inframammary crease) with swelling and hardness spreading till the lower part of the breast. In addition to this, she had lymph nodes (glands) in the underarm area (axilla) as well.
Breast cancer is devastating for any woman more so if she is in the prime age.
The usual process suspicion followed by an examination, investigation, confirmation and then treatment depending on the stage of the disease and follow-up.
On confirmation of breast cancer, either the lady undergoes partial mastectomy, nipple sparing mastectomy, total mastectomy or radical mastectomy. This is followed up by Chemotherapy, radiation therapy or both for a period of time which is thought to be the end of treatment.
This leaves the patient traumatized with the loss of an important part of her body with the ill effects of radiation which also leads to severe burning sensation and pain in the area of radiation.