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...SURGERY FOR BREAST CANCER IS NOT ABOUT REMOVING BREASTS, ALWAYS…(contd.) The treatment of breast cancer has undergone major improvements and this has been reflected in how the outcomes have changed dramatically for the better. While curing the disease is a priority, maintaining quality of life is as important. The journey that has been covered before us is no less fascinating and the constant endeavor to make it better for the patient has driven the change. Mutilating surgeries in the form of amputation of the breast and then radical mastectomy (removal of the breast, muscles of the chest and the lymph nodes in the armpit ) or the extended radical mastectomy( same as radical mastectomy but with the additional removal of lymph nodes inside the chest) remained in vogue for a larger part of the 20th century. ...to be continued.....More history in the next update
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One of the first decisions you may have to make is which type of operation you'll have. You may be offered a choice of breast-conserving surgery, (usually referred to as lumpectomy or wide local excision) or a total mastectomy (removal of all the breast tissue including the nipple area). Sometimes it can be helpful to talk through your choices with your breast care nurse and discuss how each would affect you. Dr. Geeta Kadayaprath - Breast Cancer Treatment in Delhi
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SURGERY FOR BREAST CANCER IS NOT ABOUT REMOVING BREASTS, ALWAYS… While all this continued as the standard of care for the first 65 years of the 20th century, some smart minds in the medical field started questioning the necessity of performing such radical surgeries to get optimum results. Trials got underway to compare mastectomy versus breast conservation surgery in the 1970s. A pathologist turned surgeon, Dr Umberto Veronesi, pioneered the most convincing trial in Milan. He was able to show that breast conservation surgery (removal of the lump with a surrounding 1 cm margin of normal breast tissue) followed by radiation therapy to the rest of the breast in properly selected patients yielded the same results as a complete removal of the breast. I am quite convinced that it is the pathologist in this surgeon who urged him to go for this trial. He had probably seen while looking at the breast as a pathologist that far too much was being done to address small cancers in the breast. Finally, women with breast cancer had a choice…. For more information on breast cancer, please contact Dr Geeta Kadayaprath, Breast Surgeon, Max Cancer Centre, Delhi, India
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SURGERY FOR BREAST CANCER IS NOT ABOUT REMOVING BREASTS, ALWAYS… In the 1960’s, the conviction that breast cancer was a systemic disease at inception and not a local disease, prompted trials to address one question- ‘Are we doing too much?’ Radical mastectomy was replaced by modified radical mastectomy- a procedure not as mutilating as radical mastectomy ( the chest muscles were preserved)but still one, which involved loss of an organ. Moreover, to a woman, it meant much more than the loss of an organ. It probably entailed a huge psychological blow besides casting a shadow on her feminity. She, being the woman she was, in those days, came to terms with this loss, in the best manner possible. All that mattered to her was her getting well, on her feet and ready to discharge the duties of a wife, mother, daughter and more. And there was really no choice then because the doctors treating her were also convinced that sacrificing the breast was the only chance of getting well. More tomorrow.....on Evolution of treatment
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SURGERY FOR BREAST CANCER IS NOT ABOUT REMOVING BREASTS, ALWAYS… When 32 year old Neena, an HR consultant in an MNC, walked into my clinic, accompanied by her husband and parents, I could sense an air of hopelessness surrounding this good looking young lady. The papers that were laid in front of me carried a needle biopsy report, which confirmed the diagnosis of breast cancer. Fortunately, for her, the size of the lump was about 2cms and there were no lymph nodes that I could feel in the armpit. There was no evidence of spread to the other organs on imaging. I soon realized she had been through the discussion of surgery and she had come to me for a second opinion. I soon found out why she had decided to come for a second opinion. She had been advised a modified radical mastectomy (complete removal of the breast along with the lymph nodes in the armpit). She was a successful career woman with everything going for her till yesterday and today she was grappling with this tough predicament- losing an organ, an integral part of her feminity to cancer- it was almost cruel!.......... ....To be continued.....watch this space for more.......

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