Breast Cancer & Cosmetic Surgery | D B Ghosh

Frequently Asked Questions about Breast Surgery

What is a mammogram?

A Mammogram is a low-dose X-ray that detects breast tumours before they can be felt. It is the most effective tool for early detection of breast cancer. We recommend it for women over 50 and those at higher risk.

What are clinical breast exams?

A clinical breast exam is a a physical exam performed by a healthcare provider to feel for lumps or other changes in the breast tissue.

What is an ultrasound?

An Ultrasound is a test that uses high-frequency sound waves to create breast tissue images and detect abnormalities.

What is magnetic resonance imaging (MRI)?

An MRI is an imaging test that uses a strong magnetic field and radio waves to create detailed images of the breast tissue.

What is a biopsy?

A biopsy is the removal of a small sample of breast tissue to test for the presence of cancer cells.

What is a lumpectomy versus a mastectomy?

The most common surgical treatment for breast cancer is a lumpectomy or mastectomy. A lumpectomy is a type of breast conserving surgery which removes the cancerous tumour and some surrounding tissue, while a mastectomy removes the entire breast. In some cases, we may also remove lymph nodes in the armpit.

What is a simple and skin-sparing mastectomy?

Skin-sparing mastectomy is a surgical procedure that conserves most of the skin around the breast by removing the breast tissue through a small incision. A skin-sparing mastectomy can form part of a simple or total mastectomy or provide the skin required to accommodate an implant when reconstructing the breast following surgery. These breast surgery procedures typically remove only the skin around the nipple, areola, and the area of skin bearing the biopsy scar and consequently minimise any visual evidence of surgery following breast reconstruction.

What is chemotherapy?

Chemotherapy uses drugs to kill cancer cells throughout the body. We may use it before or after surgery, or in cases where the cancer has spread to other parts of the body.

What is radiation therapy?

Radiation therapy uses high-energy rays to kill cancer cells. We often use it after surgery to kill any remaining cancer cells.

What is hormone therapy?

Hormone therapy is used to treat breast cancers that are hormone receptor-positive. These cancers use hormones such as oestrogen and progesterone to grow. Hormone therapy may include medications that block the body’s production of these hormones, or medications that prevent the hormones from attaching to cancer cells.

What is targeted therapy?

Targeted therapy is a type of treatment that specifically targets cancer cells. We may use it in cases where the cancer has a specific genetic mutation or where other treatments have not been effective.

What is intraoperative radiation therapy (IORT)?

This is a newer technique that involves delivering a single dose of radiation therapy directly to the tumour site during surgery immediately after the tumour is removed. This can reduce the overall treatment time for patients and may be more convenient than traditional radiation therapy, which typically requires daily treatments over several weeks.

What is magnetic seed localisation?

This newer technique can help guide the surgeon to the tumour’s exact location during surgery. A tiny magnetic seed is inserted into the tumour before surgery, which can be detected using a handheld device during the procedure. Magnetic seed localisation can improve surgical accuracy and reduce the need for multiple surgeries.

What is intraoperative imaging?

This involves using specialised imaging techniques during surgery to visualise the tumour and surrounding tissue better. Intraoperative imaging can help ensure that all the cancerous tissue is removed during surgery, improving patient outcomes.

What is axillary node clearance?

Axillary node clearance is a surgical procedure involving removing the lymph nodes (also known as the lymph glands) from the armpit. It is used in the prognosis and management of invasive breast cancer, as well as to determine post-operative therapy, and is an important element of breast cancer treatment. The procedure is performed under general anaesthetic and typically requires a hospital stay of between four and seven days.

What is a sentinel lymph node biopsy?

A sentinel node biopsy is used to establish whether breast cancer has spread beyond a primary tumour into the body’s lymphatic system. It is a procedure that requires the injection of a tracer agent into the breast tissue, which enables the surgeon to identify the sentinel nodes during surgery. The sentinel nodes are then removed for clinical evaluation. If they present as free from cancer, it will typically indicate that the tumour has not spread, and the removal of further lymph nodes will not be required. If the sentinel nodes reveal the presence of cancer, further lymph nodes will be removed to determine the spread of the tumour.

What is correction of nipple inversion?

Nipple inversion (nipples that point inwards) is a common condition that is readily corrected by this type of breast surgery. It is caused by the shortening of the milk ducts as they enter the nipple and can affect breastfeeding. The treatment of inverted nipples depends upon the severity of the condition. According to the degree of inversion, correction can be brought about with a suction device in minor cases, and surgery will be unnecessary. The surgical procedure involves drawing the nipple out via an incision so that it points in the correct direction. The process is usually performed under local anaesthetic.

What is breast augmentation (enlargement)?

Also known as mammoplasty, breast enlargement, and breast enhancement, breast augmentation surgery is a popular surgical procedure that uses a breast implant to augment the size and shape of a woman’s breasts. Followed by breast augmentation recovery treatments, The process of breast enlargement surgery involves the insertion of specially designed breast implants behind the breasts, giving them a fuller and more rounded shape. As well as enhancing appearance, breast enhancement can also have a positive impact on a woman’s confidence and self-image.

What is breast reduction?

Breast reduction is a frequently performed and highly effective surgical procedure that is used to reduce the size of large or heavy breasts. Excessively large breasts are a common cause of shoulder, neck and back pain and can also result in posture problems and skin inflammation. As well as alleviating physical pain and discomfort, breast reduction surgery can also help with problems of low self-esteem and psychological issues resulting from poor body image.

What is breast symmetrisation?

It is perfectly normal for breasts to be slightly different in size, and in most cases, it is hardly noticeable. But when one breast is noticeably larger than the other (asymmetrical), it can result in needless anxiety and self-consciousness. Surgery for asymmetrical breasts is effective in matching breast size. It may involve enlarging one breast to bring it in line with the other; alternatively, it can be more appropriate to reduce the size of a breast to match its smaller counterpart. Needs vary from person to person, and your surgeon can advise you on the best solution for your circumstances.

What is oncoplastic surgery and breast remodelling

Oncoplastic breast surgery (sometimes known as breast conservation surgery) combines the aesthetic techniques of plastic surgery with conventional cancer surgery to treat breast tumours that a straightforward mastectomy would have previously managed. It allows for wide excision of a tumour and its outer margins while rebuilding the breast to prevent unsightly scarring and deformation. Oncoplastic breast surgery is typically performed on breasts with adequate volume and on lumpectomies no larger than one quadrant of the area of the breast.

What is risk-reducing breast surgery?

Risk-reducing breast surgery is recommended when it is deemed there is an abnormally increased risk of a woman developing breast cancer. The operation entails the complete removal of both breasts, as well as when indicated, the skin and nipples. The lymph nodes and underlying breast muscles are left intact. Risk-reducing mastectomy involves a major surgical procedure and is performed using a general anaesthetic.

What is therapeutic mammoplasty?

A therapeutic mammoplasty is a surgical technique that combines the removal of a breast tumour (lumpectomy) with an element of breast reduction while, in most cases, avoiding a total mastectomy. As the procedure results in reduced breast size, it is most suitable for women with larger breasts. The advantage of a therapeutic mammoplasty is that it enables the surgeon to remove larger tumours than conventional surgery while leaving a smaller, well-shaped breast in place.

What is breast conservation surgery?

Breast conservation surgery (sometimes called Oncoplastic surgery or lumpectomy) removes cancerous tissue while preserving healthy breast tissue.

By using oncoplastic surgery techniques such as round block mammoplasty, therapeutic mammoplasty, chest wall perforator flaps, and fat grafting, the goal is to achieve optimal cancer removal while preserving as much of the breast tissue as possible and, therefore, trying to maintain the breast’s natural appearance.

Oncoplastic surgery techniques are beneficial for many seeking breast conservation, as breast shape and symmetry are maintained, cosmetic outcomes are improved, and risk recurrence is reduced. Breast conservation surgery is less invasive than a mastectomy and minimises the need for extensive reconstructive surgery.

The benefits are psychological, too. Preserving the breast and achieving satisfactory cosmetic outcomes positively impacts a patient’s self-esteem and overall well-being, reducing the emotional distress associated with more invasive breast cancer treatments.

Suitability for oncoplastic surgery depends on factors like tumour size, location, and patient preferences.

What is SAVI SCOUT®️?

SAVI SCOUT is a medical device used for wire-free localisation of breast tumours during surgery. It helps surgeons precisely locate and remove tumours, improving accuracy and reducing the need for repeat surgeries. Mr D B Ghosh has been one of the first surgeons to use the device during breast surgeries.