BREAST CONSERVATIVE THERAPY

What is Breast Conservative Therapy/Surgery (BCS)?

Breast Conservative therapy means excision of the tumour in the breast with a minimal margin of 1 mm followed by radiotherapy to eradicate any microscopic residual disease.

What is the goal of Breast Conservative therapy(BCS) ?

The goal of Breast Conservative Therapy is to

Excise the tumour in the breast entirely with a minimum margin of 1 mm on all the sides

To give a breast with good cosmesis

To achieve low recurrence

For whom is Breast Conservative Surgery done?

Breast Conservative therapy is done in woman who have a small tumour in a large breast so that, after excision with a margin of normal tissue the breast still looks good. The patient must also be fit for radiotherapy. The tumour must be restricted to only one area of the breast. When you see us in the clinic we will make a decision as to whether Breast Conservative therapy would be applicable for you.

For whom is Breast Conservative Surgery not done?

Breast Conservative Therapy is not done in patients with large tumours or small breasts because after excision the breast will not good especially after radiotherapy.

It is also avoided in patients who can not tolerate radiotherapy like pregnant women, patients who have previously received radiotherapy those with connective tissue disorders

It is also not done in patients who do not want to have Breast Conservative Therapy and radiotherapy.

If there is more than one tumour in the breast and if they are in different areas of the breast it would be preferable to undergo mastectomy (removal of the breast)

If the mammogram shows diffuse micro-calcification

If the patient has persistent positive margins after excision

If Breast Conservative Surgery can not be done what are the other option that I have if I would like to get my breast cancer excised and still have a nice breast?

If the tumour in the breast is large in a large breast, oncoplastic therapeutic mammoplasties can be done which is similar to a breast reduction. The patient would need radiotherapy after this procedure as well.

The patient may undergo a mastectomy (removal of the breast) followed by reconstruction of the breast.

Can Breast Conservative therapy be done if the axillary lymph node is present?

Breast Conservative Therapy can be done whether the axillary lymph node is present or not.

Do we necessarily need to do radiotherapy after Breast Conservative Surgery?

Yes. Radiotherapy is essential after you do Breast Conservative Surgery.

What are the chances of re-operation after Breast Conservative Surgery?

Studies from UK* and Germany** have shown that approximately one in every 5 women would have a positive margin with Breast Conservative Therapy and that they would need re-operation to remove the tumour and of this 40% had to undergo mastectomy or removal of the breast. We would try to reduce this by doing a frozen section of the tumour. Where in we would biopsy the tissues while the patient is on the operating table and proceed according to the result.