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Breast Conservation Surgery
- Days In Hospital 3 days
- Outside Hospital Stay 15 days
- Success Rate 92%
Minimum Cost
$ 3000
Maximum Cost.
$ 6000
Overview of Breast Conservation Surgery in India
Breast Conservation Surgery (also known as lumpectomy) is a surgical procedure used to remove cancerous or other abnormal tissues from the breast. A lumpectomy is performed by the surgeon excising cancerous and other abnormal tissue from the breast and a small amount of the healthy tissue beneath the cancerous/abnormal tissue to ensure that all of the cancerous/abnormal tissue has been removed.
Lumpectomy, or breast conservation surgery, is called so because only some of the breast is removed, as opposed to a mastectomy, which removes the entire breast tissue. A lumpectomy may also be called an excisional biopsy (excising the cancer/abnormal tissue) or quadrantectomy (removing one-fourth of the breast). Lumpectomy is the preferred treatment for patients with early-stage breast cancer. It may also be used to confirm a breast cancer diagnosis. A coalition of treatments (including lumpectomy) is typically followed by radiotherapy to reduce the chance of cancer recurrence.
What Is A Lumpectomy?
A lumpectomy is also called a partial mastectomy (or segmentectomy) and is an operation for breast cancer where a piece of your breast (the tumor) is removed, but your breast is left intact. Lumpectomy for diagnosing the presence of malignant (cancerous) vs. benign (noncancerous) tumors is called a diagnostic lumpectomy; however, lumpectomy is more commonly performed as treatment for existing breast cancer with the goal of removing the entire tumor to eliminate any and all cancer cells by doing so, rather than through total mastectomy.
Therefore, lumpectomy is often referred to as "breast-conserving surgery." Lumpectomy is most commonly followed by radiation therapy to help prevent the return of breast cancer (recurrence).
When is Lumpectomy Surgery Needed?
If a biopsy reveals a positive sign of cancer and the tumour is thought to be tiny and in its early stages, doctors may advise a lumpectomy. Certain noncancerous or precancerous breast irregularities can also be removed with a lumpectomy.
Who are the Candidates for Lumpectomy Surgery?
Women who've just been diagnosed with early-stage breast cancer should consider lumpectomy surgery as an option if they meet the following conditions:
- Their cancer is classified as Stage I or Stage II.
- Their ductal carcinoma in situ (DCIS) is classified as early-stage.
In addition to these staging criteria, two other important criteria for determining if a patient is a good candidate for lumpectomy include:
- The size of the tumour is similar to or smaller than the size of the breast.
- There is only one tumour in the breast (no multifocality).
- Radiation therapy can begin after lumpectomy surgery.
Who Shouldn’t Have A Lumpectomy?
Your healthcare provider might recommend not doing a lumpectomy if you have:
- More than one tumor in the same breast.
- A large tumor in the breast in relation to breast size.
- Cancer that has spread from the breast to the skin or to the chest wall.
- A type of breast cancer that grows rapidly (for example, inflammatory breast cancer).
- A strong family history of breast cancer or a genetic mutation (such as BRCA) that puts you at high risk for recurrent cancer.
- An earlier lumpectomy that recurred after radiation was used.
If there are potential dangers with radiation therapy, a lumpectomy may not be an appropriate choice, because:
- If you have received radiation therapy to that breast previously, any further treatments will expose you to excessive radiation.
- If you have a condition of the skin that increases your chances for complications from radiation therapy, such as scleroderma or Sjögren’s syndrome.
- If you’re pregnant (unless your timing allows for a lumpectomy during the third trimester, with subsequent radiation after delivery).
Types of Breast Conservation Surgery:
There are different methods of having a lumpectomy performed, as follows:
An excisional biopsy is primarily a way to determine whether or not you have cancer (it is a biopsy). This procedure is when a surgeon removes the lump and sends it to a lab to be tested by a pathologist to see if the tumor is either benign or malignant.
A wide local excision is a type of surgery used to remove the tumor and a small amount of healthy tissue that surrounds the tumor (this is called a "margin"). After this is done, the pathologist will check the margin to ensure that there are no cancer cells present. If there are no cancer cells found in the margin, then the surgical procedure successfully removed all of the cancer.
A quadrantectomy is a type of lumpectomy where about a quarter of your breast is removed, along with the tumor (along with some surrounding healthy tissue) and the area of your breast that includes your milk ducts.
A re-excision of margins occurs after a wide local excision if tests show that there are still cancer cells in the margin of healthy tissue that was removed initially. If this is the case, then the surgeon must go back into the site of the original surgery and remove more tissue to ensure that there are no remaining cancerous cells.
Procedure:
When you come in for your presurgical consultation, the doctor will walk you through both the benefits and risks of the surgery. You’ll also get a list of things you need to avoid and other instructions to follow before the procedure. Lumpectomies are outpatient, so you’ll go home the same day. Be sure to give your doctors a full medical history during this visit.
You’ll need to follow a few key instructions:
- Don’t stop taking aspirin or other blood thinners on your own — your doctor has to give you the green light first. Stopping these helps lower your risk of bleeding.
- Don’t eat for 8 to 12 hours before surgery, especially if you’re getting general anesthesia. This helps keep you from feeling sick or throwing up after the procedure.
- Bring someone with you on the day of surgery. You’ll need support, and it’s a huge help to have someone there to listen to any instructions, since anesthesia can leave you a bit out of it for a while.
Locating the area to be removed
Finding the lump in the breast comes first. Surgeons remove just the suspicious area and a bit of healthy tissue around it. Usually, they use imaging or ultrasound to pinpoint the spot before starting the lumpectomy. If the lump is easy to feel by hand, they might skip this step. Once they know exactly where the tumor is, they can take it out without much trouble.
Preparing for lymph node excision
Sometimes, the surgeon suggests taking out lymph nodes in your armpit or near the lump in your breast. For early-stage breast cancer, they usually recommend something called a Sentinel Node Biopsy, where they remove just a few lymph nodes to check if the cancer has spread. But if the surgeon thinks the cancer’s already moved beyond the original spot, they’ll probably need to take out more lymph nodes.
There are a couple of main ways to do this:
- Sentinel node biopsy
- Axillary lymph node dissection
During the procedure
During a lumpectomy, doctors put you under general anesthesia so you’re fully asleep. The surgeon cuts over the tumour—or wherever the guide wire or radioactive seed is—to take out the cancer and a bit of the healthy tissue around it. They send what they remove to the lab for a biopsy.
They use a pretty similar approach for a sentinel node biopsy or when they need to take out lymph nodes from the armpit. Afterwards, they stitch up the incisions carefully, doing their best to keep as much of the healthy breast tissue as possible.
Reconstructive surgery
A reconstructive surgery specialist, who will repair or reshape the shape of your removed breast, may be part of your care team. Some people choose to wait until their breast tissue has healed (with proper settling of shape) before having this type of surgery.
Ask your doctor about reconstructive surgery options for you. If your tumour is small, you may find that you will not require reconstruction, but if you do, understanding how this type of procedure will affect your care and healing time is important.
What Happens After A Lumpectomy?
The cells in the tumour and in the lymph nodes will be examined by a pathologist after the lumpectomy to see if there are any signs of cancer. The next steps will be determined by the results. A perfect scenario would show that you have no cancer in your lymph nodes and that you had a negative margin in the tumour, which means that there were no (negative) cancer cells in the healthy tissue.
You may be required to undergo other tests/treatments if your lymph nodes are determined to contain cancerous cells based on the results.
If the margins of your tumour(s) were assessed as being positive, further surgical removal will be necessary to ensure all cancerous cells have been removed.
If your test results show unique characteristics in your cancer cell types, the use of specific treatment will be necessary. For instance, if your cancer cells have hormone receptors, they may use hormones (e.g., estrogen) in your body to accelerate their growth, which may require the utilisation of hormone therapy to counteract this.
Radiation Therapy
Usually, people get radiation therapy every day for three to six weeks after a lumpectomy. Still, the schedule really depends on your specific diagnosis. The best thing to do is ask your doctor what your plan will look like.
Sometimes, you won’t need radiation at all. Take ductal carcinoma in situ, for example—it’s a type of breast cancer with a pretty low risk of coming back, so radiation isn’t always necessary. Your doctor will lay out your treatment options based on what’s right for you.
Best Doctors in India
Cost of Breast Conservation Surgery in India
Breast cancer surgery usually runs between $3,000 and $6,000, but that’s just the starting point—other treatments can add to the bill, and it depends a lot on what you need.
In India, the price you pay really comes down to the stage of cancer, which hospital you pick, and the city where you get treated.
Still, the full package in India ends up about 70% cheaper than what you’d pay in the US or Europe.
|
Treatment |
Cost (USD) |
|
Surgery |
3000 - 6000 |
|
Chemotherapy |
600 -1200 per cycle |
|
Radiation therapy |
4000 - 7000 |
|
Targeted therapy |
1500 - 3000 per cycle |
Top Hospitals in India
Indications of Breast Conservation Surgery:
The various tests and procedures that can be used to diagnose breast cancer include the following:
Physical Breast Exam: The physician examines the breast and drains the lymphatic system under your arms (the axillary region). They are searching for any lumps or abnormalities.
Mammogram: An X-ray of your breast to see if you have any breast cancer is one of the most commonly done tests for detecting breast cancer.
Breast Ultrasound: This is a method of creating images of the inside of your breast using sound waves. This test is done when a new lump is found to distinguish whether or not it is filled with fluid (cyst) or solid (tumor).
Breast Biopsy: A biopsy is performed on potential patients to confirm whether or not they have breast cancer. A specialised needle is guided by imaging (X-ray) so that a piece of tissue is taken from the suspicious area. A small piece of metal will be left behind in the area where the biopsy was performed to identify the location again in future imaging tests.
Breast MRI: An MRI machine creates images of the inside of the breast using magnetic and radio waves. A dye contrast will be used before an MRI to create contrast. An MRI does not use radiation to create an image.
Risk Factors:
The potential complications associated with a lumpectomy are as follows:
- Blood loss
- Infection
- Hard scar tissue
- Deformity or change in the breast shape
- Temporary swelling
- Bruising
- Pain
- Tenderness