Our Treatment Services

SURGERY - DHRC offers full range of the latest surgical techniques and procedures to treat patients with breast cancer. Surgeons provide individualized information and work with patients to help determine the appropriate treatment and provide timely surgical care. Surgical options for breast cancer treatment include:

Breast Conservative Surgery (BCS)

BCS is offered to patients to remove the cancer but not the breast. The following BCS procedures are being done at Dharamshila Hospital And Research Centre.

Lumpectomy – Removal of the lump along with the margins of the surrounding normal breast tissue.

Partial Mastectomy – A segment of the breast which has cancer along with surrounding normal breast tissue is removed.

Other Types of Breast Surgeries

Mastectomy- is the surgical removal of a breast. Breast reconstruction is possible in many patients after the mastectomy.

Simple or total mastectomy - removal of the breast, with its skin and nipple, but no lymph nodes. In some cases, a separate sentinel node biopsy is performed to remove only the first level one to three axillary (armpit) lymph nodes.

Modified Radical mastectomy - removal of the complete affected breast with nipple/areolar region and lymph nodes.

Breast reconstruction

Breast reconstruction after cancer surgery is an option for most women undergoing mastectomy. Surgical options offered at DHRC include reconstruction with implants and autologous flap reconstruction (using the patient′s own tissue), including:

• TRAM surgery
• DIEP surgery
• SIEA surgery
• Reconstruction of the nipple and areola

Axillary Node Dissection

Axillary node dissection, the surgical removal of the axillary (armpit) lymph nodes, is usually performed on patients with invasive cancers. A radical mastectomy, modified radical mastectomy, or lumpectomy operation often include removal of axiliary lymph nodes.

Localization

Localization may be used to pinpoint the location of a breast tumor that appears on a mammogram but cannot be felt. In localization, a radiologist uses either mammography or ultrasound to insert a fine wire into the tumor site. The surgeon then follows the wire to locate and remove the targeted area.

As an alternative, a radioactive seed (a metal capsule that contains a small amount of radioactive material) the size of a grain of rice may be placed at the tumor site. The seed may be placed a day or more before the operation. The surgeon locates the seed with a handheld Geiger counter and removes the targeted area.

Frozen section analysis

Breast Cancer Specialists may use frozen section evaluation and intra-operative pathology consultations during breast cancer surgery to determine whether all of the cancer has been removed. Frozen sections ensure adequate clear margins during tumour resections. Frozen sections also provide an intra-operative histological diagnosis where pre-operative evaluation may not have been done. Thus second surgeries with the attendant risks of anaesthesia are totally avoided and we are able to provide our patients with the best Surgical Oncology Services.

Evaluation of lymph nodes

If breast cancer is invasive (spreading into surrounding healthy tissue), it usually spreads first to the axillary lymph nodes in the axilla (armpit). When an invasive cancer is found in the breast, the surgeons remove axillary lymph nodes to confirm whether the cancer has spread.

Surgeons at DHRC use several procedures to evaluate lymph nodes:

• Fine-needle aspiration (removal of body tissue through a thin, hollow needle), which may be performed before surgery if lymph nodes appear abnormal on ultrasound
• Sentinel lymph node biopsy is done for the majority of our patients with breast cancer, who are unlikely to have cancer in the lymph nodes
• Dissection (surgical removal) of the axillary lymph nodes is performed when the cancer is known to have spread to the lymph nodes