Breast conserving surgery
In the United States, breast cancer is the major cause of cancer deaths among women. Around 9,000 Thai women are diagnosed with breast cancer each year, making it the second leading cause of cancer deaths among Thai women, and numbers continue to rise.
Breast cancer is caused by cell abnormality within the mammary glands or milk ducts. When the body cannot control the abnormal growth of cells, these cells grow rapidly and spread to other organs, such as bones, liver, lungs and brain.
Prof. Dr. Supakorn Rojananin,
Breast Surgeon and Senior Director of the Breast Center, Bangkok Cancer Hospital Wattanosoth), gave more details about breast cancer and how the latest surgical technique can give confidence to women.
“Women aged over 40 years are at risk of breast cancer. The exact cause of breast cancer is unknown but women who have a close relative who has had breast cancer are more likely to build up breast cancer. Other risk factors include: the start of menstruation at an early age; women who have never had a child; a history of radiation treatment around the breast; consumption of contraception; taking hormone medication over a long period of time; obesity and smoking.”
The stage of breast cancer development ranges from 0-4.
- Stage 0: the earliest detection of breast cancer development when the cancer cells still remain within the epithelial layer of ducts or glands. Discovered at this stage, patients have a 100% chance of survival.
- Stage 1: cancer measuring less than 2 cm, confined in a limited area which has not spread to the lymph nodes.
- Stage 2: cancer between 2-5 cm begins to spread into the lymph nodes.
- Stage 3: breast cancer over 5 cm invades the lymph nodes but not to other organs.
- Stage 4: cancer spreads to other areas of the body.
“Over 85% of patients come to see the doctor with a lump in their breast that has surpassed the early stages. Therefore, a digital mammogram is recommended to detect breast abnormality at the earliest stage.This advanced digital diagnostic radiology technique is similar to X-rays but uses 30-60% less radiation while offering high-resolution images. Early detection of breast cancer increases the chance of successful treatment and complete recovery.”
In the past, breast cancer surgery at any stage entailed removal of the whole breast, so-called mastectomy. But, the latest breast conserving surgery combining with breast irradiation at early stages of breast cancer allows surgeons to remove only the cancerous lump and rebuild the shape of the breast after surgery, thereby reducing the psychological impact on patients.
Some women who are not candidates for breast conserving surgery require a mastectomy. In this case, breast reconstructive surgery is needed to rebuild a total breast using the patient’s skin, fat and muscle and / or the implants. In addition, radiotherapy, chemotherapy, hormonal therapy and targeted therapy are performed to fit the individual’s requirement.
To prevent women from developing breast cancer, a monthly breast self-examination seven days after their period ends is recommended for women aged over 20.
“To examine your right breast,for example, you need to lie down and put a pillow under your right shoulder.Use your index, middle and ring fingers of your left hand, keeping the fingers flat and together, to perform a circular motion starting at the nipple and moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down or from left to right. Follow the same pattern to ensure that you cover the whole breast area.Then, use the same method to examine your left breast.”
“To look for anything unusual, stand in front of a mirror with your shoulders straight and your arms on your hips. Look for any abnormality in size, shape and skin colour. Look for redness, soreness, rash, dimpling, puckering, swelling or bulging of the skin, or if the nipple has changed position or inverted. Then raise your arms and look for the same changes and any signs of fluid coming out of one or both nipples.”
“Depending on the stage of the disease,cancer cells can come back even after being totally eliminated. There is no fool-proof method of breast cancer prevention but early detection is one of the most effective means of stopping it before it becomes a bigger problem.”
“Apart from a monthly breast self-examination, women over 40 should have an annual breast cancer check-up by medical professionals and have digital mammogram and ultrasound. With the higher technology by using mammogram and ultrasound of the breast, cancer can be detected even smaller in size and earlier than a breast self examination can feel. Women who have had a close family member with breast cancer should have an annual breast cancer check-up starting from the age of 35.Those whose cancer has already been totally removed should visit their doctor for a check-up every 6 months. If you know how to take care of yourself and detect cancer at early stage, breast cancer can be cured and you don’t have to lose your breast.”