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Breast Oncoplastic Surgery

What is Breast Cancer?

It is characterized by uncontolled growth in breast tissues which may arise from lobules which secrte milk or ducts (most common) in which milk flaws.

When “controls” in breast cells are not working properly and allows continuous growth then cancer forms. There it forms hard lump or swelling and over the time it increases in size called as localized disease-stage I or II.

Over time, cancer cells can invade nearby healthy breast tissue and make their way into the underarm lymph nodes called locoregional disease-stage III.

And finally goes to another parts of body via blood like bones,liver,lungs,brain etc, called distant disease-stage IV.

Breast Cancer Risk Factors

A “risk factor” is anything that increases your risk of developing breast cancer.

Be sure to talk with your doctor about all of your possible risk factors for breast cancer. There may be steps you can take to lower your risk of breast cancer, and your doctor can help you come up with a plan. Your doctor also needs to be aware of any other risk factors beyond your control, so that he or she has an accurate understanding of your level of breast cancer risk. This can influence recommendations about breast cancer screening — what tests to have and when to start having them.

Risk factors you can control

Weight. Being overweight is associated with increased risk of breast cancer, especially for women after menopause. Fat tissue is the body’s main source of estrogen after menopause, when the ovaries stop producing the hormone. Having more fat tissue means having higher estrogen levels, which can increase breast cancer risk.

Diet. Diet is a suspected risk factor for many types of cancer, including breast cancer, but studies have yet to show for sure which types of foods increase risk.

Some researchers believe that eating too much cholesterol and other fats are risk factors for cancer, and studies show that eating a lot of red and/or processed meats is associated with a higher risk of breast cancer. A low-fat diet rich in fruits and vegetables is generally recommended.

Exercise. Evidence is growing that exercise can reduce breast cancer risk. It is recommended that engaging in 45-60 minutes of physical exercise 5 or more days a week can reduce cancer risk.

Alcohol consumption. Studies have shown that breast cancer risk increases with the amount of alcohol a woman drinks. Alcohol can limit your liver’s ability to control blood levels of the hormone estrogen, which in turn can increase risk.

Smoking. Smoking is associated with a small increase in breast cancer risk.

Stress and anxiety. There is no clear proof that stress and anxiety can increase breast cancer risk. However, anything you can do to reduce your stress and to enhance your comfort, joy, and satisfaction can have a major effect on your quality of life. So-called “mindful measures” (such as meditation, yoga, visualization exercises, and prayer) may be valuable additions to your daily or weekly routine. It is believed that these practices can strengthen the immune system.

Risk factors you can’t control

Gender. Being a woman is the most significant risk factor for developing breast cancer. Although men can get breast cancer, too, women’s breast cells are constantly changing and growing, mainly due to the activity of the female hormones estrogen and progesterone.

Age. Simply growing older is the second biggest risk factor for breast cancer. From age 30 to 39, the risk is 1 in 227, or .44%. That jumps to 1 in 28, or just under 4%, by the time you are in your 60s.

Family history of breast cancer. If you have a first-degree relative (mother, daughter, sister) who has had breast cancer, or you have multiple relatives affected by breast or ovarian cancer (especially before they turned age 50), you could be at higher risk of getting breast cancer.

Personal history of breast cancer. If you have already been diagnosed with breast cancer, your risk of developing it again, either in the same breast or the other breast, is higher than if you never had the disease.

Race. White women are slightly more likely to develop breast cancer than are African American women. Asian, Hispanic, and Native American women have a lower risk of developing and dying from breast cancer.

Radiation therapy to the chest. Having radiation therapy to the chest area as a child or young adult as treatment for another cancer significantly increases breast cancer risk. The increase in risk seems to be highest if the radiation was given while the breasts were still developing (during the teen years).

Breast cellular changes. Unusual changes in breast cells found during a breast biopsy (removal of suspicious tissue for examination under a microscope) can be a risk factor for developing breast cancer. These changes include overgrowth of cells (called hyperplasia) or abnormal (atypical) appearance.

Factors related to menstruation. Because the female hormone estrogen stimulates breast cell growth, exposure to estrogen over long periods of time, without any breaks, can increase the risk of breast cancer. Some of these risk factors are not under your control, such as:
• starting menstruation (monthly periods) at a young age (before age 12)
• going through menopause (end of monthly cycles) at a late age (after 55)

Pregnancy and breastfeeding. Pregnancy and breastfeeding reduce the overall number of menstrual cycles in a woman’s lifetime, and this appears to reduce future breast cancer risk. Women who have never had a full-term pregnancy, or had their first full-term pregnancy after age 30, have an increased risk of breast cancer. For women who do have children, breastfeeding may slightly lower their breast cancer risk, especially if they continue breastfeeding for 1 1/2 to 2 years. For many women, however, breastfeeding for this long is neither possible nor practical.



Screening & Symptoms of Breast Cancer

Initially, breast cancer may not cause any symptoms. A lump may be too small for you to feel or to cause any unusual changes you can notice on your own. Often, an abnormal area turns up on a screening mammogram (X-ray of the breast), which leads to further testing.

So Breast Self Examination(BSE) should be the part of screening programme for every women more than 30 years evry 3 monthly along with physical examination by clinician yearly.

In addition Digital Mammogram should be part of examination for every women more than 40 years on yearly basis.

Any of the following unusual changes in the breast can be a symptom of breast cancer:
• swelling of all or part of the breast
• skin irritation or dimpling
• breast pain
• nipple pain or the nipple turning inward
• redness, scaliness, or thickening of the nipple or breast skin
• a nipple discharge other than breast milk
• a lump in the underarm area

These changes also can be signs of less serious conditions in around 90% of cases such as an infection or a cyst.However, it’s important to get any breast changes checked out promptly by a doctor.



Evaluation & Treatment

Once Cancer has been confirmed, staging work up will be done in form of chest, abdominal and bone imaging to to decide further paln of treatment.

Usually Locoregional disease that is not gone to other areas of body will be treated by cocktails of different modalities like Surgery, Chemotherapy,Radiotherapy and targeted therapy and hormonal therapy depending on stage and naure of your disease.
• Know your stage of the disease.
• Know your nature of disease.
• Finalize your treatment plan.
• Take second opinion.



Surgery

Surgery is usually the first line of attack against breast cancer in localized disease and will be done after initial chemotherapy in loclly advanced disease. This section explains the different types of breast cancer surgery.

Decisions about surgery depend on many factors. You and your doctor will determine the kind of surgery that’s most appropriate for you based on the stage of the cancer, the "personality" of the cancer, and what is acceptable to you in terms of your long-term peace of mind.
Explore your surgery options:

What to Expect With Any Surgery :Mastectomy vs. Lumpectomy
Lumpectomy, also known as breast-conserving surgery, is the removal of only the tumor and a small amount of surrounding tissue.
Mastectomy is the removal of all of the breast tissue. Mastectomy is more refined and less intrusive than it used to be because in most cases, the muscles under the breast are no longer removed.
Lymph node removal, or axillary lymph node dissection, can take place during lumpectomy and mastectomy if the biopsy shows that breast cancer has spread outside the milk duct. Some people qualify for the less-invasive sentinel lymph node dissection.
Breast reconstruction is the rebuilding of the breast after mastectomy and sometimes lumpectomy. Reconstruction can take place at the same time as cancer-removing surgery, or months to years later. Some women decide not to have reconstruction or opt for a prosthesis instead.
Prophylactic mastectomy is preventive removal of the breast to lower the risk of breast cancer in high-risk people.
Prophylactic ovary removal is a preventive surgery that lowers the amount of estrogen in the body, making it harder for estrogen to stimulate the development of breast cancer.