Let not the huge number of breast cancer cases in India or all over the world, cloud your ray of hope. Proper monitoring, early detection and several other factors influence your chance of getting treated and healed from this much dreaded disease. But again, no treatment is absolute in this context; your doctor might as well prescribe a particular treatment depending upon the stage of breast cancer you are in and the spread of the same. There are certain general treatments which can be classified as follows.
A majority of breast cancer patients undergo a surgery of some type whenever the need to remove a tumor becomes dire. Breast conserving surgery, reconstructive surgery, mastectomy and lymph node surgery are some of the most prominent surgery techniques.
Breast Conserving Surgery (BCS)
Also known as segmental or partial mastectomy, BCS involves partial removal of the breast detected with cancerous tissues. The area to be removed would depend on the size and location of the spread of the tumor. BCS can again be classified into Lumpectomy and Quadrantectomy. Lumpectomy requires removal of an outlining margin of normal tissue in addition to the breast lump whereas the latter technique removes one quarter of the breast. In this regard, radiation therapy is also administered after BCS as and when necessary. Besides, women who are above 70 years of age and have a tumor measuring less than 2 cm can opt out of radiation therapy.
Mastectomy is the complete removal of the entire breast surgically. Simple or total mastectomy is the most commonly used; the entire breast along with the nipple is removed leaving the lymph nodes under the arm and muscle tissues beneath the breast, intact. A double mastectomy which involves removal of both the breasts is more of a preventive surgery for women who are at very high risks of breast cancer. Skin sparing mastectomy is usually advised to patients who have a breast reconstruction plan under strict guidance of a doctor and a plastic surgeon. In this surgical process, barring the nipple and areola, the skin is left intact. But this is possible to administer only when the tumor is a small one or when it is not within the vicinity of the skin surface.
Nipple sparing mastectomy is another variant of the skin sparing technique. This is more applicable to women who are detected with breast cancer at an early stage near the outer part of the breast. Here, the breast tissue is removed keeping the nipple and breast skin intact. If cancer is detected, the nipple has to be removed or else the surgeon can administer a small dose of radiation to the nipple tissue to prevent any recurrence of cancer. Radical Mastectomy used to be a very elaborate and extensive affair and has been replaced by a modified approach to the same. In this case, apart from complete removal of the breast, the auxiliary lymph nodes (situated underarm) are also removed keeping the pectoral or chest wall muscles intact.
Lymph Node Surgery
There are cases when the spread of the breast cancer reaches the lymph nodes of the underarm. Such a situation calls for lymph node surgery where some nodes are sampled to be studied under the microscope. This actually lays the foundation for staging the cancer spread and determining the treatment accordingly. Auxiliary Lymph Node Dissection or ALND involves removal of around 20 such lymph nodes. It may be done when a preliminary biopsy report shows presence of cancer cells in the nodes. ALND can also be carried along with or after a BCS or mastectomy.
Sentinel Lymph Node Biopsy or SLNB is safe and has relatively much lower rates of side effects; this process determines the presence of cancer cells without removing so many lymph nodes thus preventing the patient from being vulnerable to lymphedema. A radioactive substance or dye is injected into the tumor for identifying lymph nodes which have taken the color of the dye and are likely to contain cancerous cells. These nodes are removed subsequently.
Given, the groundbreaking researches in cancer treatment, which have seen the day’s light in modern times, surgery is just a fractional part of the entire gamut. There still remains a lot to be discussed especially regarding what our ethnic roots of Ayurveda has to offer when it comes to treating breast cancer.