Breast-Conserving Surgery (BCS)

Breast-Conserving Surgery (BCS) is a treatment for breast cancer, in which tumour and healthy tissue surrounding the tumor(margins) are removed but remaining breast tissue is preserved. Breast-Conserving Surgery (BCS) may be referred to as a lumpectomy, quadrantectomy, partial mastectomy, or segmental mastectomy, depending on the amount of tissue removed; which is performed along with axillary lymph node staging.

What should you know prior to getting Breast-Conserving Surgery (BCS)?

• The size and location of the tumor, as well as the size of your breasts and other considerations, all play a role in determining how much of the breast is removed.
• A woman who has Breast-Conserving Surgery (BCS) can maintain most of her breasts, but it is always combined with radiation treatment after surgery.
• Following BCS, the majority of women will go on to get radiation therapy. In addition, various treatments, like hormone therapy or chemotherapy, might be administered to certain women.
• A woman’s odds of long-term survival are unaffected by whether she opts for Breast-Conserving Surgery (BCS) plus radiotherapy or a mastectomy.
• Before you get treatment for breast cancer, talk to your surgeon about your options for breast reconstruction or Oncoplasty.
• However, not all breast cancer patients will also have BCS. Talk to your primary care doctor to find out if BCS is an option for you as a treatment.
• As a result of BCS, you might have pain, a scar or indentation where the tumor was removed, a firm or hard surgical scar, or sometimes lymphedema, which is a type of swelling in the arm.

Who is eligible for Breast-Conserving Surgery (BCS) and when is it performed?

Many women who have been diagnosed with breast cancer at an early stage have the opportunity to benefit from Breast-Conserving Surgery (BCS). The fact that a woman can keep most of her breasts is the primary benefit of this surgery. On the other hand, the vast majority of women will also require radiation therapy, which will be administered by a radiation oncologist (a doctor who specializes in radiation). It is less likely that women who have their entire breasts removed (mastectomy) for malignancies that are in the early stage will need radiation treatment; however, they may be sent to a radiation oncologist for evaluation because every patient’s cancer is different.

If any of the following apply to your condition:

• Are worried about the possibility of breast loss
• Are ready to undergo radiation therapy and are able to attend all of their scheduled visits.
• Neither radiation therapy nor breast conservation surgery (BCS) has been performed on that breast yet.
• Have only one location of cancer in the breast, or have numerous spots of cancer in one quadrant (multifocal) that are close enough to each other that they can be removed together without significantly altering the appearance of the breast.
• Have a tumor that is less than two inches in diameter (five centimeters) and is likewise small in proportion to the size of the breast
• Are not pregnant or, do not require radiation therapy right away if they are pregnant (to avoid risking harm to the fetus)
• Do not have a gene mutation (change) such as a BRCA or ATM mutation, as this could potentially change your goal of treatment but does not increase risk of developing breast cancer a second time.
• Be sure that you do not suffer from any of the significant connective tissue illnesses such as scleroderma or Sjogren’s syndrome, as they can make you extremely sensitive to the negative effects of radiation therapy.

Dr. Mansi is your one-stop solution for Breast-conserving Surgery (BCS)

Dr. Mansi Chowhan is a recognized surgical oncologist who has worked in the field for more than 12 years. During her post-graduate studies, she was honored with a gold medal for her outstanding performance. She specializes in breast oncoplasty, head and neck surgery, and reconstructive operations, making her a highly qualified surgeon. Dr. Mansi has been practicing medicine for over 12 years and has worked at some of the most prestigious hospitals in the Delhi-National Capital Region (NCR), including Fortis Healthcare (Delhi and Gurgaon), Artemis Hospital (Gurgaon), Paras Hospital (Gurgaon), and the Asian Institute of Medical Sciences (Faridabad).

Have all of the cancerous cells been removed?

During BCS, the surgeon will attempt to remove all of cancer, in addition to some of the normal tissue that is surrounding it. This can be challenging at times, depending on the location of cancer in the breast of the person being treated. After the operation, the tissue that was removed will be carefully examined in the laboratory by a specialist who is known as a pathologist. It is termed to have negative margins or clear margins if the pathologist examines the removed tissue and finds no invasive cancer cells at any of the margins of the removed tissue. It is preferable to leave at least 2 millimeters (0.08 inches) of normal tissue between the tumor and the margin of the tissue that was taken from the patient who has DCIS. When DCIS cancer cells are discovered close to the borders of the tissue (inside the 2mm), this condition is referred to as having a narrow margin. One can say that tissue has a positive margin if cancer cells (either invasive or DCIS) are discovered at the edge of the tissue. A positive margin indicates that some cancer cells may still be present in the breast after surgery, hence, the surgeon will typically need to remove additional tissue from the patient’s breast. A re-excision is the name given to this surgical procedure. After the second operation, if cancer cells are still identified at the boundaries of the tissue that was removed, it is possible that a mastectomy will be required.

Following Breast-Conserving Surgery (BCS), patients may opt to have breast reconstruction surgery.

Before you go in for Breast-Conserving Surgery (BCS), you should discuss with your breast surgeon how the procedure can affect the appearance of your breasts. The larger the piece of the breast that is removed during surgery, the greater the likelihood that the breast’s shape will be altered as a result of the procedure. If your breasts seem considerably different after surgery, you may be able to have a sort of reconstructive surgery or have the size of the breast that was not damaged by the procedure lowered so that your breasts are more symmetrical (even). It is even possible to perform this procedure at the same time as the primary operation. It is of the utmost importance to have a conversation with your primary care physician (and maybe a plastic surgeon) prior to undergoing cancer surgery in order to obtain a sense of how your breasts are likely to look following the procedure and to learn about your available options.

The Onco Team