Breast Cancer: Surgical Treatment

The main treatment of breast cancer is surgical treatment. Surgery is the mainstay of primary breast cancer in all cases. There are many forms of surgery which are done for treatment of breast cancer. Radical mastectomy or modified radical mastectomy is removal of the breast along with the breast tumor and the normal tissue. But these days’ breast-conserving surgeries are preferred.

Breast-conserving treatments (or surgery), consisting of the removal of the primary tumor by lumpectomy (removal of lump or the tumor) with or without giving radiotherapy to the breast. The survival after breast-conserving treatments is as good as that of radical mastectomy or modified radical mastectomy (or some times give better result) with or without radiotherapy. If radiotherapy is given after breast-conserving surgery the chances of recurrence of breast cancer is greatly reduced. But there is always a possibility of recurrence after breast-conserving treatment but the overall 10 year survival rate is at least as good as that after more radical surgery. Postoperative radiation therapy to regional nodes following mastectomy (Radical mastectomy or modified radical mastectomy or breast-conserving surgery) is also associated with an improvement in survival. Since radiotherapy can reduce the rate of local or regional recurrence, it is strongly recommended following mastectomy for women with high-risk primary tumors.

At present, nearly one third of women in the United States are managed by lumpectomy (breast-conserving surgery). Breast-conserving surgery is not suitable for all patients. It is not suitable for tumors more than 5 cm (or for smaller tumors if the breast is small), for tumors involving the nipple and areola complex; for tumors with extensive intraductal disease involving multiple quadrants of the breast, for women with a history of collagen-vascular disease. It is also not suitable for women who do not have the motivation for breast conservation or who do not have access to radiotherapy. But the group who are not suitable for breast-conserving treatments do not constitute as the number of radical (mastectomy) treatment done. So many women still undergo mastectomy, who could safely avoid this procedure and probably would if appropriately counseled.

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