Common Specialities
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Common Treatments
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Overview

What is Breast Cancer?

Surgery is a common procedure when it comes to treating breast cancer, as the main objective is to remove the cancer cells as much as possible. There are different types of surgery for breast cancer, depending on your medical history and the type and stage of cancer that you are suffering from. The two main types of surgeries are:

  • Lumpectomy, which is also known as partial or segmental mastectomy. This surgery involves removing only that part of the breast where cancer has been detected, along with some normal tissues surrounding it. The portion of breast that is removed depends on factors such as the size and location of the cancerous tumor.
  • Mastectomy, which involves the removal of the entire breast, including all breast tissues and at times even the nearby tissues. In some cases, patients may also undergo double mastectomy, where both the breasts are removed.

Indication

A breast cancer patient may require a surgery in the following conditions:

  • If one is in a locally advanced stage of breast cancer
  • Suffering from Paget’s disease (cancer cells form in/around the nipple)
  • Multiple tumors in different areas of the breast
  • Recurring of the cancer in the breast even after radiation
  • A connective tissue disease such as lupus or scleroderma, where the side effects of radiation cannot be tolerated by the skin
  • The patient is pregnant and radiation may affect the unborn baby

Pre Procedure

The following preparations need to be taken before undergoing a surgery for breast cancer:

  • Have a detailed discussion with your surgeon as well as your anaesthetist regarding the complete procedure of the surgery. You can ask questions to your doctor and clear your doubts, if you have any.
  • If you wish to have a breast reconstruction at the same time, you will also have to meet and discuss the same with your plastic surgeon before the surgery
  • Inform your doctor regarding the medicines, supplements and the vitamins that you are taking
  • Discontinue taking medicines that may increase the risk of bleeding in the course of the surgery, like blood thinners and aspirin
  • You have to stop eating or drinking anything 8-12 hours prior to the surgery. Your doctor will instruct you in this matter.

During Procedure

The surgery is normally performed by administering general anaesthesia. An incision is made around the affected breast. The tumor and the surrounding tissues are then removed. There are different procedures by which the surgery can be performed:

  • Axillary node dissection where several lymph nodes are removed from the armpit on the side where the tumor was located
  • Sentinel lymph node biopsy where only one or two lymph nodes are removed and then tested if they have cancerous cells in them
  • Total mastectomy which involves removing of the entire breast
  • Skin-sparing mastectomy where all the breast tissue, nipple and areola are removed but not the breast skin
  • Subcutaneous mastectomy, which is removal of the breast tissue only, and not the skin, nipple and areola

After Surgery and Cost :

Once the surgery is completed, the incision is stitched back that gets dissolved or has to be removed later. There may be plastic tubes placed in the surgical area for draining any fluid that may accumulate post surgery. The tubes will be sewn in place, with the other ends being attached to a small-sized drainage bag.

Post Procedure

After the completion of the surgery, you will be shifted to the bed and your pulse, breathing and blood pressure will be monitored by your doctors. There will be a dressing over your surgery site. You may feel numb, pain or a pinching sensation in your underarm area. You will be prescribed pain medications for it.

Before you are discharged from the hospital, you will be provided proper instructions regarding care at home, how to take care of your incision and drainage, recognising and informing your doctor if you see any sign of infection. There may also be some restrictions in your daily activities initially. You can also consult your doctors to have a clear knowledge when you can resume wearing a bra or breast prosthesis.

Risk & Complication

A breast cancer surgery can have the following risk or complications:

  • Bleeding from the incision site
  • Infection in the area of surgery
  • Temporary swelling
  • Pain and stiffness of the shoulder
  • Hard scar tissue formation at the surgical site
  • Hematoma, where there is a build-up of blood in the site of the surgery
  • A feeling of numbness, especially under the arm, if the lymph nodes have been removed
  • Change in the appearance and shape of the breast, especially if a large portion has been removed.

More Info

You will have to go for follow-up appointments so that the doctors can monitor your progress of recovery after the surgery. You may have to go for radiation therapy if the tumor was a large one, there were several lymph nodes that were cancerous, if the cancer had spread in the nipple or skin, or there are any cancer cells remaining even after the surgery. In case your cancer is found to be sensitive to chemotherapy, you can discuss other modes of treatment like hormone therapy with your oncologist. Apart from that, involving yourself with a counsellor or support group can help you recover fast emotionally. A healthy lifestyle with good food habits, along with cutting off tobacco and alcohol, will ensure a faster recovery and a healthy life ahead.

The cost of a breast cancer surgery may be approximately Rs. 3, 23,350 – Rs. 4,52,700.

Popular Health Tips

Prevention and Screening for Breast Cancer: Information for women and their families

MBBS, MS - Obs and Gynae, MRCOG(London), DNB, Fellowship In Uro Gynaecology
Gynaecologist, Mumbai
Prevention and Screening for Breast Cancer: Information for women and their families

Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. It occurs in both women and men, although breast cancer in men is rare.

Risk factors:

More importantly, you can lower your risk of having breast cancer by the following measures:

  •  Have regular physical activities, do at least 150 minutes of moderate-intensity aerobic physical activities per week (e.g. climbing stairs or brisk walking)
  • Avoid alcohol drinking;
  • Maintain a healthy body weight and waist circumference - aim for a body mass index (BMI) between 18.5 and 22.9, and a waist circumference of not more than 80cm for women; and
  • Have childbirth at an earlier age and breastfeed each child for longer duration factors include:

What are the common symptoms of breast cancer?

The symptoms of breast cancer may not be easily noticed at an early stage. Any of the following changes in the breast can be a symptom of breast cancer:

• Breast lump;

• A change in the size or shape of the breast;

• A change in skin texture of the breast or nipple (e.g. red, scaly, thickened or “orange-skin” appearance);

• Rash around the nipple;

• In-drawing of the nipple;

• Discharge from one or both nipples;

• New and persistent discomfort or pain in the breast or armpit; and

• A new lump or thickening in the armpit

What is breast cancer screening? Should I screen for breast cancer if I do not have any symptom?

Screening means examining people without symptoms in order to detect disease or fi nd people at increased risk of disease. It is often the fi rst step in making a defi nitive diagnosis. For breast cancer screening, its purpose is to fi nd women who have breast cancer, before they have any symptom, in order to offer them earlier treatment.

Mammography is widely used as a screening tool. It is an X-ray examination of the breasts. During mammography, the breast is pressed between 2 plates to flatten and spread the breast tissue, in order to obtain a clear image. Some women may find it uncomfortable or painful but the discomfort is usually short lasting. Mammography screening is safe in general and only a very small dose of radiation is used in the procedure. One in 5 female breast cancer patients may be missed by mammography.

5637 people found this helpful

Breast Lumpectomy - All You Should Know!

DNB - General Surgery, MBBS, FMAS.Laparoscopy
General Surgeon, Jaipur
Breast Lumpectomy - All You Should Know!

Lumpectomy is a surgery where a cancerous or benign tumour is removed from a breast along with some surrounding tissues. The amount of tissue removed varies according to the nature of the tumour. It is a form of breast-conserving surgery. It is also called a partial mastectomy.

Lumpectomy is the first option of treatment for women diagnosed with early-stage breast cancer.

What is the goal of lumpectomy?

Lumpectomy aims to remove the cancerous cells from the breast and at the same time maintaining the appearance of the breast. Studies have proved that for early stage breast cancer, lumpectomy is as effective as mastectomy (complete removal of the breast).

Doctors may recommend lumpectomy to remove precancerous cells as well.

Pre lumpectomy measures-

If you are under any other medication or if you suffer from allergies, inform your doctor. Other pre-surgery measures include-

• Stop taking aspirins or any pain relieving medication

• Your doctor will recommend you to not drink or eat anything 8-12 hours prior to the surgery.

The procedure:

A mammogram and a biopsy reveal the exact location of a tumour. Lumpectomy is performed under general anaesthesia. The surgeon makes a small incision over a tumour to extract the cancerous cells and the surrounding tissues. Sometimes doctors have to perform sentinel lymph node surgery or axillary node dissection.

The surgeon then closes the incisions with sutures. The sutures may dissolve over time or may have to be extracted later by a doctor.

If you have undergone lumpectomy and sentinel node biopsy, you will be discharged on the same day as the surgery as soon as your blood pressure stabilizes.

However, after lumpectomy with axillary node extraction, you may have to stay in the hospital for 2-3 days.

Therapy after lumpectomy

Your oncologist will recommend a follow-up radiation therapy to destroy the mutated cells that may have remained in the area where a tumour had developed. Radiation reduces the risk of breast cancer recurrence.

You might also have to undergo hormone therapy. Some types of breast cancer need female hormones like estrogen and progesterone to grow. Hormone therapy inhibits the development of cancerous cells by not allowing these hormones to reach the cells.

Your doctor will advise you to avoid strenuous physical activities for at least a month after the surgery.

Lumpectomy is a safe surgical procedure that can root out tumours or precancerous cells from the breast without deforming the shape of it.

3367 people found this helpful

Good Cosmesis In Breast Cancer Surgery!

MBBS Bachelor of Medicine and Bachelor of Surgery, MS - General Surgery
Oncologist, Pune
Good Cosmesis In Breast Cancer Surgery!

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:

  • Location of the lump or tumor
  • Weight of the specimen excised upon,
  • Number of surgical procedures followed,
  • Volume of breast operated upon,
  • Length of scar
  • Adjuvant treatment in the form of chemo or radiotherapy followed after the surgery

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,

  • Excellent result with no difference
  • Good result with slight difference
  • Fair result with moderate difference
  • Poor result with huge difference


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.

3274 people found this helpful

Breast Cancer - What Are The Risk Factors?

Gynaecologist, Gurgaon
Breast Cancer - What Are The Risk Factors?

Breast cancer is a very common form of cancer that develops in the cells of your breast. The cancer typically forms in either the ducts of your breast (the pathway through which milk reaches the nipples from the glands) or the lobules (the glands which produce milk).

Breast cancer can affect both males and females. However, it is more commonly observed in women aged between 45-55 years.

Look out for these symptoms!
Signs and symptoms of breast cancer include the following-

  1. Discharge of blood from the nipples
  2. A lump near the breast or the armpit
  3. Scaling or peeling of skin around the breasts
  4. Sore nipple
  5. Breast pain
  6. Swelling of lymph nodes in the armpit or on the neck
  7. Change in the shape and size of the nipple or the breast
  8. An inverted nipple

What are the risk factors?

  1. Age- Breast cancer usually strikes at an older age. Women aged over 55 years are most often diagnosed with invasive breast cancer.
  2. Family history- If you have someone in your family who’ve had a history of breast cancer, then you too may develop this disease later in life.
  3. Inherited genes- Mutation of certain genes- BRCA1 and BRCA2- can put you at a higher risk of developing breast cancer.
  4. Obesity- People with Body Mass Index (BMI) higher than or equal to 30 are at risk of developing breast cancer.
  5. Alcohol consumption- Aggressive or frequent alcohol consumption can make you prone to breast cancer.
  6. Early menstruation- Those who’ve had their first menstrual cycle before the age of 12, are more likely to get affected by breast cancer in the later stage.
  7. Postmenopausal therapy- Women undergoing hormonal therapy or medications combining progesterone and estrogen to treat menopause have greater risk of having breast cancer.

What is the treatment for breast cancer?
After a thorough evaluation of your overall health condition, your doctor will determine the options to treat your breast cancer depending on the type, size and stage of the cancer. The usual methods of curing breast cancer are-

  1. Lumpectomy- This is a minimally invasive surgical procedure whereby smaller tumors are removed from the lumps of your breast. Your doctor will only remove a portion of the cancerous lump, leaving the remaining portion of the breast intact. This allows for better symmetry of your breast. However, you may need to undergo chemotherapy or radiation therapy following a lumpectomy to make sure that all the cancer cells are destroyed.
  2. Mastectomy- This surgical procedure is performed to remove all of the breast tissues including the ducts, lobules, nipples and areola.
  3. Sentinel Node Biopsy- In order to determine whether or not the cancer has metastasized to other body parts including the lymph nodes, your doctor will first discuss with you the importance of removing the lymph nodes which are likely to be in the receipt of the lymph drainage from the tumor.
  4. Breast removal- In certain cases where people have a greater risk of developing breast cancer due to family history or a genetic susceptibility, removal of both the breasts are prescribed by doctors.

The rate of survival for breast cancer has increased in recent times owing to modern treatment techniques. Nearly 90% of breast cancer patients survive for at least 5 years after the treatment is done.

4279 people found this helpful

Breast Cancer Survivor Stories - Get Inspired!

MBBS, MD-Radio Therapy
Oncologist, Ghaziabad
Breast Cancer Survivor Stories - Get Inspired!

Though breast cancer has become very common, the good news is that more women than ever are living a healthy life to tell their survival stories. They have not just survived, but are thriving. Let us take you through a couple of survivor stories which not just gives strength and hope, but also the immense courage to stand up and fight it. The names are, however, changed to prevent identity.

Help yourself and others too: For most women, getting diagnosed with blood cancer can mean the end of life. While for the medical person, it is just another individual, for the individual, there is an entire world to think of, her world. What will happen to her family, her job, her life in total. Each person is different, and so the approach has to be different. It should not be a routine combo of surgery, chemo, and radiation. While some hospitals do it, giving a personalized touch helps. That is what happened Susan, who had a complete set of people including dietitian and psychiatrist to help her. The change that she saw with this approach led her to give a helping hand to others. She presently helps people fight and overcome breast cancer and has an extremely fulfilling life.

Shrink the tumor, not your life: For a person with two kids, Tina was aghast when she was diagnosed with breast cancer. She was just 31, and her second daughter was just turning 1, she was extremely distraught. But, her family stood with her through those testing times when she would not have time to run with her daughter or walk along with her mother. With immense support from her family, she is now free of cancer and is a Zumba instructor and now spends quality time with her daughter.

An experiment that worked: At 46 years of age, Maya was diagnosed with stage 3 breast cancer. She found a lump in her breast, which turned out to be breast cancer. The doctor said she would need it removed, and she also opted for surgery. What worked for her, though, is the fact that she was advised to try tamoxifen, which was not so strongly recommended during the initial times. She went ahead and tried, and even after 30 years down the line, is still free of cancer.

Two lives saved: At 23, Sonia was diagnosed not just with stage 4 breast cancer, but also with pregnancy. Re-testing yielded negative results. So she went ahead with chemo and radiation, but the abdominal fullness continued, and when tested again, the tests confirmed her pregnancy. She carried it through, and delivered 4 weeks prematurely but is very healthy and cancer-free now. In case you have a concern or query you can always consult an expert & get answers to your questions!

3802 people found this helpful

Popular Questions & Answers

I have undergone surgery for breast cancer and my custom panel report states INVASIVE CARCINOMA BREAST TUBULAR LOBULAR VARIANT LUMINAL B LIKE HER 2 NEGATIVE. What treatment can I undergo?

DNB (Surgical Oncology), MS - General Surgery, MBBS
Oncologist, Vadodara
Hi ma'am, Please send the detailed histopathological report, according to which Adjuvant treatment (chemotherapy/radiation) therapy will be planned.

I have armpit pain my mother has breast cancer and I have pain in my armpit the pain is continuously sometimes it is more painful.

Tata Memorial Hospital, J. S. S. University, Mysore, Karnataka, India
Oncologist, Mumbai
If your mother is having breast cancer then you are at a higher risk then general population for developing breast cancer. Start screening 10 years prior to age your mother developed breast cancer by self breast examination every monthly 1 week after menstruation and yearly clinical examination by doctor. Mainly breast cancer present with painless lump in breast or armpits, nipple bleeding or ulceration, change in shape of breast etc. Armpit pain is not a sign to worry about cancer kindly check my health tips and contact me in private enquiry/consult for more details.
4 people found this helpful

My mom is having a reddish purplish mark on her right breast from some days Can be it something other than breast cancer? And we got CBC done some days back, it was normal!

DM - Oncology, MD - Internal Medicine
Oncologist, Bhubaneswar
Hi. Reddish purple marks on breast do not necessarily mean cancer. However considering your mother age it would be prudent to do a mammogram for her as a screening tool for breast cancer.

For breast cancer TNM staging system, can we stage a breast mass through history, inspection and palpation of breast alone? Do we still need to do biopsy?

DNB (Surgical Oncology), MS - General Surgery, MBBS
Oncologist, Vadodara
Yes Biopsy is the must and only sure short way to confirm that the breast pump is malignant and not benign. Once you have confirmed the diagnosis of cancer then yes you can stage it by clinical examination of breast, axilla and neck, abdomen.

Table of Content

What is Breast Cancer?

The following preparations need to be taken before undergoing a surgery for breast cancer:

After Surgery and Cost :

Play video
Breast Cancer - How To Treat It?
Breast cancer is an abnormal growth of cells in the tissues of the breast. Mainly it occurs in females but less than 1% of all the breast cancer cases develop in males. The majority of breast cancers start in the milk ducts. A small number start in the milk sacs or lobules. It can spread to the lymph nodes and to the other parts of the body such as bones, liver, lungs and to the brain.
Play video
Hereditary Breast Cancer
Breast cancer is the most common forms of cancer in females, affecting one in every eight women in the US. There are huge awareness campaigns, which revolve around ways to recognize if you are prone for it and how to identify the disease in its early stages. Knowing the symptoms can help in early diagnosis and thereby early intervention and better prognosis.
Play video
Mammogram - Breast Cancer Screening
A clinical or self-breast exam involves feeling the breast for lumps or other abnormalities. A number of screening tests have been employed, including clinical and self-breast exams, mammography, genetic screening, ultrasound, and magnetic resonance imaging.
Play video
Basic Health Issues Faced By Women
Hello friends,

I am Dr. Meeta Airen. I am an obstetrician and a gynaecologist. Today I am going to discuss some basic problems which usually women face and they feel shy to discuss with anyone. These problems they are related to their vaginal health and the first and foremost thing I just want to discuss is the maintenance of vaginal hygiene. Most of the women are unaware of how to maintain vaginal hygiene. In this respect, I would tell you that the vagina is having numerous good bacteria which maintains the acidic vaginal ph and they keep the harmful bacteria away and prevent infection. For maintaining this you should wash the vaginal area once or twice daily with clean water or plain soap. And regarding pubic hair, you should rather than waxing or shaving you should preferably do clipping of the hairs and as waxing or shaving results in cuts abrasions and in growing hairs and create the problem for you. During periods you should change the sanitary napkins every four to five hourly because if you keep more than this timing the bacteria starts growing and it may result in infection.

The other unawareness is how to decide whether menstrual cycle is normal or it is abnormal. So normal menstrual cycle constitutes cycle length between 25 to 35 days and bleeding continues for about 3 to 7 days. Anything which is other than this duration is considered abnormal and it should be and it should warn the visit to a gynecologist. Friends in this scenario of increasing rates of cancer you should be very vigilant for your health specially regarding breast cancer and cervical cancer and you should be doing regular screening regarding these 2 cancers. For breast cancer screening you should do self breast examination monthly and if you find any lump any other abnormality in the breast you should visit a gynecologist. Then regarding cervical cancer screening this cancer screening should be done by all the women who are sexually active till the age of 65 years and it should be done every 3 yearly.

This cancer screening is done by doing Pap smears testing which is done on OPD basis and it is a small procedure and it is usually available in various gynecologists clinics. Nowadays cervical cancer vaccine is also available which should be given to all the girls more than 9 years of age. It is given it is better to give as early as possible to the girls before they becomes sexually active. There are 2 important conditions which are nowadays becoming prevalent in the society one is PCOD and infertility. These 2 topics I want to discuss with you all because incidents of these 2 are increasing nowadays. PCOD you might have hard in some of the other areas.

It is Polycystic Ovarian Disease. Incidents of PCOD is increasing in young females and ladies and the reason behind this increase is certainty lifestyle then lack of exercise and binging on unhealthy junk food. This condition PCOD is a small problem but it may result in some serious complications in your body like it may initially result in irregular menses and then later on it may create metabolic syndrome in your body which create further more complications and it further results it may results in infertility also. There are some natural remedies which clears PCOD and these natural remedies are exercising regularly switching to the healthier food as compared to the junk food.

By doing this in some conditions medicines are also required but along with the medications if you do the natural remedies the condition can be cured. The last condition which I want to discuss is infertility. In the present scenario in the society there is increased incidents of infertility among the couples. The reason behind this increased incidents is one the couple are the young generation is delaying their marriages and conception. The other reason which is seen relating to infertility is the excessive exposure of cell phone radiations which is present everywhere in the society. How this increasing age results in infertility is that in female s body after the age of 30 the egg reserve and the quality of eggs it reduces which is the main culprit for reducing fertility after the age of 30. And cell phone radiations are also harming the fertility of girls and boys. There are various studies going on however conclusive studies have not been there but many studies are indicative of the effect of radio frequency waves on the fertility of males and in females. Do dear friends hope this top of mind will help you in some way.

Take care of your health. Thanks!
Play video
Breast Cancer
Hello Friends,

I am Dr. Rohan Khandelwal, Oncologist. All you know that the breast cancer is so common nowadays. 1 out of 21 women in India are kore prone to breast cancer. Breast cancer hone ke multiple reasons hain. Islia iska early diagnosis important hai. Iska cure available hai. Symptoms like lump in breast, pain, nipple discharge, consult a Dr. Agar aap 40 se kam hai to ultrasound and jyada hai to mammography. Hum iBreastExam se test krte hain. Hum breast scan krte hain with device in 10 mins. It is painless and it can pick the lump. It is important that you should be aware of any lump in your breast. Ye cancer painless lump se start hota hai. Islia ise ignore na kren.

Thank You!
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