Planning Treatment for Breast Cancer - Surgery for Breast Cancer

Surgery for breast cancer

Surgery usually involves removing part, or sometimes all, of the breast (mastectomy). The type of operation you have usually depends on the size and position of the cancer. Your surgeon will recommend surgery that keeps as much of the breast tissue and the shape of the breast as possible. This is called breast-conserving surgery. However, in some situations removing all of the breast (mastectomy) is advised. Your doctor and breast care nurse will talk you through your options.

Your surgery may also involve having the lymph nodes in your armpit removed or you may have tests to check the nodes. Sometimes women are given treatment with hormonal therapy or chemotherapy to shrink the cancer before they have surgery.

In early breast cancer, studies show that removing the lump followed by radiotherapy is as effective as a mastectomy. Some women may be asked to choose for themselves which operation to have

Types of surgery for breast cancer include:

·         Wide local excision (lumpectomy)

·         Mastectomy

Wide local excision (lumpectomy)

This is when the cancer and an area of surrounding tissue is removed. It’s called a wide local excision or lumpectomy. This operation removes the affected breast tissue and for most women the appearance of their breast after a lumpectomy is good.

If the lump is very small, a fine wire (guide wire) is used to mark the area to be removed so that the surgeon can find it more easily. The doctor or radiologist will inject some local anaesthetic into the area to numb it before inserting the wire, using x-ray or ultrasound to guide them. 

Occasionally, an operation called a quadrantectomy is done. This removes a larger area of breast tissue. The effect on the appearance of the breast will be more noticeable than after a lumpectomy. The treated breast will be smaller than your other breast and there may be a noticeable dent in it. Women can have surgery to reduce the size of the other breast (mammoplasty) so that both breasts are the same size. 

After these operations you’ll need to have radiotherapy to the remaining breast tissue to destroy any cancer cells that may have been left behind.  

Some women may need to have all of the breast removed (mastectomy). A mastectomy is usually advised if:

·         the lump is large in proportion to the rest of the breast

·         there are areas of cancer in different parts of the breast (multi-focal)

·         there’s widespread DCIS in the breast

·         you’ve previously had radiotherapy to the chest, for example, to treat Hodgkin lymphoma.

Mastectomy

Types of Mastectomy

A mastectomy removes all of the breast tissue. At the same time, you may have a test to check the lymph nodes in your armpit, or have some (or all) of the nodes removed.

A radicalmastectomy is where all the breast tissue, the muscles behind the breast and the lymph nodes in the armpit are removed. It’s only done if the cancer is found in the muscle under the breast. But this type of mastectomy is rarely needed as chemotherapy or hormonal therapy can usually be given before surgery to shrink the cancer. This means a mastectomy that removes only the breast tissue can then be done. 

Breastreconstruction

If you’re having a mastectomy, you’ll usually be offered breast reconstruction at the same time. This is when a new breast shape is formed. Breast reconstruction is very specialised surgery. Surgeons who do this type of operation may be plastic surgeons or oncoplastic surgeons, who are trained in both breast cancer surgery and reconstruction surgery.

Different techniques are used – for example, muscle from the back or the tummy area, or a silicone implant can be used. Some women may decide not to have it done immediately – it can be done months or even years after a mastectomy.

Medworld India offers comprehensive care for patients with Breast Cancer, including advanced diagnosis, best treatment options . A team of Surgical Oncologists, Radiation Oncologists, Medical Oncologists, Urologists, Rehabilitation team and other medical specialties work together to treat each Breast Cancer patient We consider each patient's type and extent of Breast Cancer to recommend the most appropriate treatment plan. They also carefully consider and select the treatment option that will allow the patient to maintain quality of life with good survival rate.

Why should you choose to get Indian hospitals offer the Best Cancer Treatment in India at affordable prices. MedWorld india associated Best Cancer Treatment Hospitals in India have the latest technology and infrastructure to offer the Most Advanced Cancer Treatment at low cost.;

At MedWorld India Affiliated Best Cancer Hospitals are to deliver highest quality and advanced oncology care in a supportive and compassionate environment to all our patients, and to advance the treatment and prevention of cancers through innovative research.

MedWorld India Affiliated Best Cancer Hospitals in India offer:

·         World class results for Cancer Treatment

·         World Class equipment for investigations, radiotherapy and surgery

·         Cancer specialists with great qualifications and experience

·         India has many super specialists ( specialization in one particular area: Breast Cancers, Stomach Cancers, Prostate Cancers, etc)

·         Low cost of cancer treatment

·         India offers the perfect combination of expertise and economical costs

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Advanced Treatment (non-invasive) for Bladder Cancer - Best Cancer Hospital in India

INITIAL BLADDER CANCER TREATMENT

The most common first treatment of non-muscle invasive bladder cancer is surgery to remove any abnormal appearing areas inside the bladder; this is called transurethral resection of bladder tumor (TURBT).

Transurethral resection of bladder tumor (TURBT) — Transurethral resection of bladder tumor (TURBT) is a procedure in which a physician uses a cystoscope to see inside the bladder and remove any abnormal-appearing areas. A cystoscope is a long thin tube that contains a light and a camera.

In most cases, this procedure is done in an operating room while the person is under anesthesia. After the procedure, you can usually go home, sometimes with a catheter for a few days.

In certain cases, usually in people with more aggressive microinvasive cancers, a second TURBT will be performed several weeks after the first to be sure that no tumor was missed during the original cystoscopy. If there are new areas that appear abnormal, they will be removed. If there are no new abnormal-appearing areas, you will begin adjuvant therapy.

BLUE LIGHT (FLUOROSCENT) CYSTOSCOPY

Enhanced visualization of tumors and improved removal can be accomplished with the advent of a cystoscopy procedure using ultraviolet (blue) light together with a dye that is injected into the bladder at least an hour beforehand. Usually performed while a patient is under anesthesia, this FDA-approved dye and procedure is gradually gaining increased acceptance in the United States, although it has been in use in Europe for over a decade. The main advantage appears to be about a 20 to 25 percent increased detection of tumors or carcinoma in situ (CIS) that is not seen under standard white light cystoscopy. This also helps define the margins of the bladder tumor for complete removal.

 Use of blue light cystoscopy results in a 10 to 15 percent absolute decrease in tumor recurrence at about two years. A similar technological advance does not require a dye at all but uses blue green filters to highlight areas of increased blood vessels often feeding the tumor. This technique is called narrow band imaging or NBI and can be done in the office with a flexible cystoscope. While not as rigorously studied as blue light cystoscopy, the results of clinical trials show a similar degree of increased tumor detection compared to standard white light cystoscopy.

ADJUVANT BLADDER CANCER THERAPY

Even in people who have their bladder tumor completely removed with TURBT, up to 50 percent of people will have a recurrence of their cancer within 12 months. Because of this high recurrence rate, adjuvant (additional) therapy is usually recommended. The type of adjuvant therapy recommended depends upon your risk of recurrence:

●Some people who are at low risk of recurrence will be advised to have a single dose of intravesical chemotherapy at the time of the initial TURBT. This is thought to help prevent floating tumor cells dislodged from the TURBT to seed and start new tumors.

"Intravesical" means that the treatment is put inside of the bladder, usually through a catheter (a flexible tube passed through the urethra, where urine exits). This allows a high concentration of the treatment to be applied directly to the areas where tumor cells could remain, potentially destroying these cells and preventing them from reemerging in the bladder and forming new tumors.

●Some people who are at intermediate risk of recurrence will be advised to have either a full six-week course of intravesical chemotherapy, most commonly mitomycin.

●People at high risk of recurrence or worsening will be advised to start intravesical BCG, usually within two to six weeks of the first treatment. This is most commonly followed by additional booster treatments (maintenance therapy) once a complete response is obtained. Occasionally, however, patients are advised to consider bladder removal (cystectomy) especially if the disease is extensive.

Intravesical chemotherapy — Chemotherapy refers to the use of medicines to stop or slow the growth of cancer cells. The most commonly used intravesical chemotherapy for bladder cancer is mitomycin. This is put inside the bladder in one of two ways:

●One regimen involves giving the mitomycin once, immediately after TURBT. The solution is left in the bladder for 30 to 60 minutes, then allowed to drain out through a catheter.

●Alternately, the mitomycin can be given on a weekly basis for six weeks. With this regimen, the bladder is filled with mitomycin with a catheter, the solution is left for one to two hours, then the person urinates. A maintenance treatment may be given once per month for up to one year.

Intravesical BCG — Bacillus Calmette-Guerin (BCG) is a live bacterium related to cow tuberculosis. It is a common treatment for non-muscle invasive bladder cancer, particularly for cancers that have a risk of worsening over time. BCG is believed to work by triggering the body's immune system to destroy any cancer cells that remain in the bladder after TURBT.

BCG is in a liquid solution that is put into the bladder with a catheter. The person then holds the solution in the bladder for two hours before they urinate. The treatment is usually given once per week for six weeks, starting approximately two to three weeks after the last TURBT. Further booster (maintenance) treatments can extend the benefit of BCG.

Benefits of intravesical BCG — Intravesical BCG, in combination with TURBT, is the most effective treatment for non-muscle invasive bladder cancer. BCG therapy has been shown to delay (although not necessarily prevent) tumor growth to a more advanced stage, decrease the need for surgical removal of the bladder at a later time, and improve overall survival .

Types of Breast Cancer Surgery - Breast Cancer Treatment at World Best Hospitals in India

With advancement in technology, breast cancer is no longer an incurable disease. With the latest technology available at best cancer hospitals in India, breast cancer can now be detected at very early stages and can be completely treated.

The approach used for cancer treatment in India is multidisciplinary, which involves Surgical Oncology, Radiation Oncology, Medical Oncology and rehabilitation after cancer surgery. The top cancer specialists in India use the latest international protocols for the treatment of cancer which includes the following depending upon the patient’s condition and requirements

The goal of breast cancer surgery is to remove the tumor and some of the surrounding healthy tissue. Your surgeon will try to save as much of your breast as possible. But sometimes the whole breast must be removed.

You should talk with your doctor about each of these operations. That way you can pick the best one for you. Your doctor may recommend a specific operation based on the size, location, or type of breast cancer you have. Each surgery has different side effects, and it is important that you go over your medical history with your doctor so that you can make the best decision.

Types of Breast Cancer Surgery

Breast cancer surgeries differ by the amount of healthy tissue that is removed with the tumor. Some lymph nodes under the armpit are usually removed as part of the operation so they can be checked for cancer cells. This will help your doctor plan your treatment after surgery.

Types of breast cancer surgery include:

·        

1.  Lumpectomy
2. Partial or segmental mastectomy or quadrantectomy
3. Simple or total mastectomy
4. Radical mastectomy
5. Modified radical mastectomy

Lumpectomy for Breast Cancer

Lumpectomy is also called breast-conserving surgery. The surgeon removes the tumor and a little bit of healthy tissue around it. A second incision under the armpit may be made to remove the lymph nodes. The goal of a lumpectomy is to leave as much of your healthy breast tissue alone as possible. After the lumpectomy, radiation is usually used to treat any cancer cells that were left behind.

Lumpectomies are best for women who have small, early-stage breast cancers.

Some women shouldn’t get a lumpectomy:

·         Women who have already had radiation for their breast cancer

·         Women who have two or more areas of cancer in the same breast that are too far apart to be removed through one incision

·        

Women who have large tumors

If you have a large tumor, sometimes you can get chemotherapy or hormone therapy to shrink it first, and then have a lumpectomy.

Partial or Segmental Mastectomy or Quadrantectomy

In a partial or segmental mastectomy or quadrantectomy, the surgeon removes more breast tissue than with a lumpectomy. The cancerous area and a surrounding area of healthy tissue are removed. Radiation is usually given afterward. 

Simple or Total Mastectomy

With a simple or total mastectomy, the entire breast is removed, but no lymph nodes are removed. Simple mastectomy is most frequently used to prevent new cancer from developing or when the cancer does not go to the lymph nodes. This procedure is usually performed to treat in situ, microinvasive, and stage IA breast cancers.

Radical Mastectomy

In a radical mastectomy, the surgeon removes the whole breast and nipple, lymph nodes in the armpit, and chest muscles under the breast. This operation is rarely done today because a modified radical mastectomy is as effective and is less disfiguring. 

Modified Radical Mastectomy

The surgeon removes the entire breast along with the nipple. Some lymph nodes in the armpit are removed. The chest muscles are not removed.

After Your Surgery

After breast cancer surgery, many women get breast reconstruction surgery. This can be done right after the breast cancer surgery or later on. The surgeon makes a normal-looking breast either with breast implants or the patient's own tissue from another part of the body.

Your hospital stay depends on the kind of surgery you get. Lumpectomies can be done on an outpatient basis, with the patient recovering in a short-stay observation unit afterward.

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Importance of a PET scan - To diagnose and Identify Cancer

PET (Positron Emission Tomography) scan

Positron Emission Tomography (PET) is a powerful imaging technique in Radiation Oncology that holds great promise in the diagnosis and treatment of many diseases, particularly cancer. A non-invasive test, PET scans accurately image the cellular function of the human body. In a single PET scan your physician can examine your entire body. PET scanning provides a more complete picture, making it easier for your doctor to diagnose problems, determine the extent of disease, prescribe treatment, and track progress.

PET (Positron Emission Tomography) and CT (Computed Tomography) scans are advanced imaging techniques that physicians use to locate and pinpoint disease states in the body. A PET scan shows the biological function of the body before anatomical changes take place, while the CT scan provides information about the body’s anatomy such as size, shape and location. By combining these two scanning technologies, a PET/CT scan enables physicians to more accurately diagnose and identify cancer, heart disease and brain disorders. 

A PET scan helps in detecting the abnormalities of those areas of the body where chemical activity is happening. This scan is most effectively used for those people who have brain disorders, cancer or heart disease.

• Brain disorders : The different areas of the brain having majority of activities while performing various tasks can be revealed by a PET scan. Specific brain abnormalities can also be evaluated by this scan that includes:
  • Seizures
  • Memory disorders
  • Tumors
• Cancer : Bright spot of cancer cells can be seen in a PET scan due to their high metabolism rate as compared to normal cells. The scan helps in determining:
  • Whether the cancer has recurred
  • The response of the cancer to the treatment
  • The spread and extent of some cancers
• A proper interpretation of the PET scans is required as some non-cancerous conditions may look like cancer. It is also possible that certain cancer types may also not appear on PET scans. Following are the different cancer types that will appear on PET scans such as:
• Thyroid
• Brain
• Pancreatic
• Lymphoma
• Breast
• Melanoma
• Lung
• Cervical
• Esophageal
• Colon

MedWorld India  offer free, no obligation assistance to international patients to find world Best medical treatment in India. A large number of people from all over the world are now traveling to India for top class medical treatment like Heart Surgery, Cancer Care, Spinal fusion surgery in India, IVF hospital in India , sleeve gastrectomy surgery in India, and other major surgeries. India offers an unmatched cost and quality advantages because it has world Best hospitals

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