The Bare Facts of Breast Cancer & Surgery

10 Main Causes Of Breast Cancer

1. Gender: Females are far more at risk

2. Family history: 2% of cases

3. Genetic Mutation : –

    • Tumor suppressor gene BRCA 1 of chromosome 17 delivers the risk of 35-45%.
    • In men, a high-grade ER-negative may place them at a higher risk
    • Estrogen sensitivity (BRCA-2- on chromosome 13)
    • OVARIAN cancer.

4. Diet: A low phytoestrogen diet, high alcohol consumption, a diet high in saturated fats.

5. Nulliparity: Females who have never given birth

6. Late pregnancy: After 35 years of age

7. Have not breastfed: mothers who do not breastfeed increase their chances of breast cancer

8. Obesity: There is a higher risk of breast cancer among obese women

9. OCP: More than 5 years of oral contraceptive pills consumption

10. Cancer of other breast: A breast cancer patient has a high chance of getting cancer in her other breast

 

Note: Breast cancer is more prevalent in females (19-34%), and rare in men (1%).

Prevention of Modifiable factors: STAY WELL & GET WELL

  • Avoid obesity
  • Abstain from alcohol consumption
  • Exercise regularly
  • Eat a more plant-based diet
  • Avoid the consumption of saturated fat
  • Breastfeed your baby
  • Plan your family earlier in life (early pregnancy)
  • Consult your doctor early if a lump is detected
  • Use oral contraceptive with the supervision of your doctor

 

Prevention of Non-Modifiable factors

  • Early detection:
    • Conduct regular breast self-examination
    • Prioritise health education.
    • Radiological screening – MMG (for females 45 years old and above)
  • Early Mastectomy for IN SITU cancer;

Types Of Breast Surgery Available For Cancer

Surgery is one of the primary mode of therapy in all stages as per presentation. A primary biopsy will be needed to diagnose the disease

 

Types Of Breast Surgery For Cancer

  1. Total Mastectomy-
    • Skin Sparing mastectomy (Video Assisted Mastectomy).
    • Classical Modified Mastectomy.
    • Bilateral Mastectomy
  2. Limited Mastectomy (Breast Conservative Surgery)
    • This type of surgery will be conducted if a tumor is less than 4cm and is non-aggressive The procedure is called Wide Exicision/Quadrantectomy, which is the removal of a small area of diseased or problematic tissue with a margin of normal tissue
  3. Axillary Lymph node and Node Biopsy
    • Conducted for surgical clearance.
  4. Breast Reconstructive surgery (BRS)
  5. Chest Wall Exision and Reconstruction.
  6. Surgery for Isolated Metastasis in other parts of the body.
  7. Surgery for lung complications such as Pleorodesis, etc.

These surgeries may be needed at any stage, whereby the desired outcome is to acheive freedom from disease, a local cure or a local control of the disease and its complications.

 

Symbol Of Femininity

While the main function of the breasts is to produce milk to nurture one’s baby, the breasts are also a sign of femininity and sexual indentification. Breast recontruction will help restore a woman’s feminine identity in this regard. However, a poor prognosis and/or progressive/uncontrollable disease will prevent breast reconsturction surgery. An alternative to breast reconstruction surgery would be the use of extrenal prosthesis.


Dr. Anantha Kumar Chinnaswamy
Sri Kota Specialist Medical Centre, Klang

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