The evolution of surgical treatment for breast cancer has continuously developed. Since the early days when patients were diagnosed with breast cancer, the only option at that time was to remove the entire breast and completely remove the lymph nodes in the affected armpit. Later, surgical advancements progressed to breast-conserving surgery, which means that doctors selectively remove only the breast tissue containing the cancerous tumor. This allows most of the unaffected breast tissue to be preserved, giving patients an additional treatment option besides complete breast removal.
Currently, there are numerous innovations in breast cancer surgery that have been studied, proven, and accepted as the new standard for breast surgery worldwide. These include oncoplastic breast surgery, where surgeons combine plastic surgery techniques with breast-conserving surgery to maintain the breast’s appearance as beautifully as possible. There is also breast reconstruction surgery for patients who need to have the entire breast removed. Breast cancer surgery today is more intricate and offers patients treatment options tailored to their individual needs.
Phyathai 1 Hospital recognizes the anxiety breast cancer patients face regarding their serious condition and the fear of losing their breast due to surgery. The hospital also acknowledges the advancements in modern breast cancer surgery and has developed surgical techniques that are up-to-date and highly effective in disease control, keeping pace with current innovations. The hospital has specialized breast cancer surgeons trained at leading international institutions who can effectively apply these new surgical innovations to patient care.
Current breast cancer surgery considerations are as follows:
First, we consider which surgical method to use on the breast tissue containing the tumor. There are three possible answers:
- Breast-conserving surgery as the first option, if it can be done safely.
- Complete mastectomy for patients who are not candidates for breast-conserving surgery.
- Complete mastectomy 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 surgeon will use the oncoplastic approach to achieve the best possible cosmetic outcome after surgery and radiation therapy.
Second, consideration must be given to 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 to remove these 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 it 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 found in the sentinel lymph node, full lymph node dissection is required.
Phyathai 1 Hospital performs sentinel lymph node biopsy on all breast cancer patients to minimize unnecessary axillary lymph node dissection and prevent complications from unnecessary surgery. This approach prioritizes the long-term quality of life for patients.
All of these represent the application of advanced, high-standard breast cancer surgical innovations in patient care. This not only ensures patients receive surgery with the highest standards but also achieves the best quality of life.
Additionally, Phyathai 1 Hospital is committed to quality care for all cancer patients. When breast cancer is suspected, patients are referred to breast specialists using modern medical technology for diagnosis. Once diagnosed with breast cancer, the attending physician presents the case at the MDT Cancer Committee meeting, which includes specialists in breast diseases, diagnostic radiology, radiation oncology, pathology, and medical oncology. Together, they develop a personalized treatment plan that leads to better outcomes and minimizes side effects for the patient.
