Many people may not know that breast cancer is currently the number one cancer causing the most deaths among Thai women every year. Breast cancer screening is very important and beneficial because it helps detect breast cancer at an early stage, increasing the chances of a complete cure through surgery.
However, fear of breast cancer surgery is another factor that causes patients to hesitate, leading to disease progression and worsening over time. In reality, breast cancer surgery is not as frightening as imagined. With today’s advanced medical technology, breast cancer patients now have several surgical options that better meet their individual needs.
How many types of breast cancer surgery are there?
What are the advantages of each option?
Currently, breast cancer surgery can be divided into 3 main options as follows:
1. Total mastectomy
This type of surgery involves removing all breast tissue, some skin, the areola, and the nipple. It is the most extensive surgery to remove all breast tissue and then close the wound. After surgery, the skin will lie flat over the front ribs. Patients who undergo this surgery will have no breast remaining on that side.
Advantages: Total mastectomy has the lowest chance of cancer recurrence in the same breast area because all breast tissue is removed. However, the downside is that the patient loses one breast and must live with only one breast, which may affect their confidence in their femininity.
2. Breast-conserving surgery
Breast-conserving surgery involves preserving the breast shape. The surgeon removes the tumor and some surrounding healthy tissue. To maintain the breast’s original shape, the surgeon repositions the breast tissue from the side to fill the cavity and then closes the skin wound, allowing the breast to be preserved.
Advantages: Patients still have a breast that looks similar to the original, with sensation close to normal. The surgical wound is smaller than total mastectomy, leading to faster recovery. The treatment outcome and chance of cure are comparable to the standard total mastectomy.
However, breast-conserving surgery has limitations and conditions. After surgery, all patients must receive radiation therapy to the remaining breast. There is a higher chance of recurrence in the preserved breast compared to total mastectomy. Also, patients who are pregnant, have had prior chest radiation, have very small breasts, or have large tumors may not be suitable for breast-conserving surgery.
3. Immediate breast reconstruction surgery
This is the most modern surgery, where the entire breast is removed and a new breast is reconstructed immediately during the same operation. The surgical technique for the new breast uses either Skin-sparing Mastectomy, which removes all breast tissue while preserving as much skin as possible, or Nipple-sparing Mastectomy, which removes all breast tissue but preserves the nipple, areola, and skin for reconstruction.
Breast reconstruction can be done in two ways: by transferring muscle and fat tissue from the back or abdomen to replace the removed breast, or by using implants or silicone bags to replace the removed breast.
Advantages: Immediate breast reconstruction allows patients to have beautiful breasts on both sides. The chance of recurrence is low because all breast tissue is removed. However, the cost is higher than other surgeries, and there may be complications such as infection at the surgical site, infection where tissue was taken from the abdomen or back, scar tissue formation from silicone implants, and longer surgery time.
Special techniques to increase confidence
For simultaneous breast reconstruction surgery
in one operation
Currently, immediate breast reconstruction surgery is the most beneficial surgical option for patients because it reduces the chance of recurrence and preserves the patient’s aesthetic appearance perfectly. However, silicone implant reconstruction places the implant under the chest muscle, which can cause the lower part of the implant to protrude. This protrusion risks implant displacement, and the skin covering the implant is thin, making the breast feel less natural.
This problem can be solved by transferring some back muscle to cover the implant, but this increases surgery time and causes pain at the back wound. Nowadays, special techniques use synthetic materials to support the breast, such as acellular dermal matrix (ADM) or titanium mesh, to cover the implant. The surgeon creates a pocket to hold the implant securely, preventing displacement, and thickens the skin layer covering the implant, resulting in a more natural feel, improved breast appearance, and reduced post-surgical pain.
Advantages: Replaces tissue, increases thickness, no need to dissect skin or muscle from the back, improving breast shape.
Disadvantages: High cost, possible post-surgical complications, and increased risk of infection.
Understanding breast cancer treatment
Providing consultation and treatment planning
tailored to patient needs
We understand that every breast cancer patient has concerns about treatment, and there are various surgical options with different advantages and effectiveness. Each patient’s symptoms and physical condition are also unique. At Phyathai 3 Hospital, we prioritize consultation and treatment planning before surgery to build understanding and ease patient concerns. This allows patients to choose the treatment method that best suits their needs and physical condition. Specialized breast cancer surgeons closely monitor and provide consultation daily. Patients can make appointments or walk in for advice 24 hours a day.
Although breast cancer is a serious disease, early detection offers many curative treatment options. Immediate breast reconstruction is a new treatment option that truly understands women because after surgery, patients can confidently and happily return to their lives with a good quality of life. Anyone diagnosed with breast cancer or who has a loved one suffering from this disease and feeling worried or afraid of surgery should seek consultation from specialized doctors. This is the first step to easing worries, seeing new hope, and finding the best treatment option that fits their needs.
Dr. Withu Klinuan
Head and Neck and Breast Surgeon
Breast Center, Phyathai 3 Hospital
