The evolution of surgical treatment for breast cancer has continuously developed. Since the early era when patients were diagnosed with breast cancer, the only option at that time was to remove the entire breast and the lymph nodes in the affected armpit completely. Later, surgical advancements progressed to breast-conserving surgery, which means that doctors would choose to remove only the breast tissue containing the cancerous tumor, allowing most of the unaffected breast tissue to be preserved. This provided patients with an additional treatment option besides complete breast removal.
Currently, there are numerous innovations in breast cancer surgery that have been studied and proven, becoming the new standard for breast surgery worldwide. These include oncoplastic breast cancer surgery where surgeons combine plastic surgery techniques with breast-conserving surgery to maintain the breast’s appearance as beautifully as possible, as well as breast reconstruction surgery for patients who require complete breast removal. Thus, modern breast cancer surgery is more intricate and offers patients treatment options tailored to their individual needs.
Phyathai Hospital 1 recognizes the concerns of breast cancer patients who worry about the disease and the possibility of losing their breast due to surgery. Aware of the advancements in modern breast cancer surgery, the hospital has developed surgical techniques that are up-to-date and highly effective in disease control, keeping pace with current innovations and standards. The hospital has specialized breast cancer surgeons trained at leading international institutions who skillfully apply these new surgical innovations to patient care.
Currently, breast cancer surgery is considered according to the following details:
First, we consider which surgical method to use on the breast area containing the tumor? There are three possible answers:
- Use breast-conserving surgery as the first option if it can be done safely.
- Use total mastectomy for patients who cannot undergo breast-conserving surgery.
- Use total mastectomy combined with breast reconstruction for patients who cannot undergo breast-conserving surgery and wish to have a new breast to reduce anxiety or maintain their original breast appearance.
If the patient is eligible for breast-conserving surgery, the doctor will perform breast-conserving surgery using the oncoplastic approach to achieve the best possible cosmetic outcome after surgery and radiation therapy.
Second, we consider how to manage the axillary lymph nodes?
Since cancer can spread to the lymph nodes in the armpit on the same side as the breast cancer, doctors must plan treatment by removing the axillary lymph nodes along with the breast surgery.
In the past, it was common to remove all axillary lymph nodes during breast surgery, which significantly affected patients, causing arm swelling, numbness due to nerve damage, and chronic arm pain.
Nowadays, sentinel lymph node biopsy has replaced full axillary lymph node dissection to avoid these complications. The sentinel lymph node biopsy involves removing the first lymph node(s) to which cancer is likely to spread and examining them for cancer cells. If no cancer cells are found, it means the cancer has not spread to the lymph nodes, and full lymph node removal is unnecessary. However, if cancer cells are detected in these nodes, full lymph node dissection is required.
Phyathai Hospital 1 performs sentinel lymph node biopsy for all breast cancer patients to minimize unnecessary axillary lymph node removal and prevent complications, thereby ensuring the best long-term quality of life for patients.
All of these represent the application of advanced, high-standard surgical innovations in breast cancer treatment, not only to provide patients with high-standard surgical care but also to ensure the best quality of life.
Additionally, Phyathai Hospital 1 recognizes the importance of quality care for all cancer patients. In cases suspected of breast cancer, patients are referred to breast specialists for diagnosis using modern medical technology. Once diagnosed with breast cancer, the attending physician presents the diagnostic results at the MDT Cancer meeting, a multidisciplinary team comprising breast specialists, diagnostic radiologists, radiation oncologists, pathologists, and medical oncologists. Together, they develop personalized treatment plans that improve patient outcomes and minimize treatment side effects.
Pol. Lt. Col. Dr. Hasan Muhammad
Specialist in Surgical Oncology
Breast Care Center, Phyathai Hospital 1
