What is Breast Cancer Surgery: Purpose, Procedure, Results, Preparation & Costs in India

Breast cancer is a significant health concern for women in India, and early detection and effective treatment are crucial for improving outcomes. Surgery is often a key component of breast cancer treatment, aimed at removing cancerous tissue and preventing the spread of the disease. This comprehensive guide provides detailed information about breast cancer surgery in the Indian context, covering its purpose, different types, the surgical procedure, preparation, expected results, potential risks, and costs involved. We aim to empower you with knowledge so you can make informed decisions about your health and treatment options.

What is Breast Cancer Surgery?

Breast cancer surgery refers to various surgical procedures performed to remove cancerous tissue from the breast and, in some cases, surrounding areas like lymph nodes. The specific type of surgery recommended depends on several factors, including the stage and size of the tumor, the type of breast cancer, and whether the cancer has spread to other parts of the body. The primary goal of breast cancer surgery is to eliminate the cancer and reduce the risk of recurrence, while also considering the patient's quality of life and cosmetic outcomes.

Why is Breast Cancer Surgery Performed?

The primary purpose of breast cancer surgery is to remove cancerous tissue from the breast. This can involve:

Removing the tumor: This is the core objective, ensuring that the cancerous cells are physically removed from the body.
Breast Conservation: In the early stages of breast cancer, surgery often aims to conserve as much breast tissue as possible, leading to better cosmetic results and improved body image.
Determining the Extent of Cancer: The type of surgery performed is directly related to how widespread the cancer is. Smaller, localized tumors might be treated with less invasive procedures, while more advanced cancers may require more extensive surgery.
Lymph Node Removal: Surgeons often remove affected lymph nodes during the surgery to check for cancer spread. This is crucial for determining the stage of the cancer and guiding further treatment decisions.
Mastectomy (Removal of the Entire Breast): If the cancer cells are widespread or if other factors make breast conservation unsuitable, a mastectomy (removal of the entire breast) is recommended.
Reducing the Risk of Recurrence: By removing the cancerous tissue, surgery significantly reduces the risk of the cancer returning in the same location.

Who Needs Breast Cancer Surgery?

Breast cancer surgery is typically recommended for individuals diagnosed with breast cancer. The specific type of surgery and the necessity for it depend on a variety of factors assessed by an oncologist and a surgical team. These factors include:

Stage of the Cancer: Early-stage breast cancers are often treated with breast-conserving surgery (BCS) followed by radiation therapy. More advanced stages may require a mastectomy.
Tumor Size and Location: The size and location of the tumor within the breast will influence the surgical approach.
Type of Breast Cancer: Different types of breast cancer (e.g., ductal carcinoma, lobular carcinoma) may respond differently to various treatments, influencing the surgical decision.
Patient Preference: The patient's personal preferences and concerns are also taken into consideration when deciding on the surgical approach.
Genetic Predisposition: Individuals with a strong family history of breast cancer or carrying certain genetic mutations (e.g., BRCA1, BRCA2) may opt for more aggressive surgical options, such as a prophylactic mastectomy, to reduce their risk of developing breast cancer.
Overall Health: The patient's overall health and ability to tolerate surgery are also assessed.

Preparation for Breast Cancer Surgery (India-Specific Tips)

Preparing for breast cancer surgery involves several steps to ensure the best possible outcome. Here's a guide tailored for the Indian context:

Tests: Mammograms and Biopsies: These are essential for diagnosing breast cancer. Ensure you get these tests done at a reputable diagnostic center. In India, many hospitals offer comprehensive breast cancer screening packages.
Consultation with Your Surgeon: Discuss all surgical options with your surgeon. Ask questions about the procedure, potential risks and benefits, recovery process, and expected cosmetic outcomes. Don't hesitate to seek a second opinion if you feel unsure. Ensure the surgeon is experienced in breast cancer surgery and, if possible, breast reconstruction.
Physical Examination: Your surgeon will conduct a thorough physical examination to assess your overall health and evaluate the tumor.
Medical History: Provide a complete medical history to your surgeon, including any pre-existing medical conditions, allergies, and medications you are taking.
Pre-operative Blood Tests and Imaging: You will likely need to undergo blood tests, ECG, and chest X-ray to assess your fitness for surgery.
Dietary Considerations: Maintain a healthy diet leading up to the surgery. Focus on nutrient-rich foods and avoid processed foods, sugary drinks, and excessive caffeine. If you have any specific dietary restrictions or preferences (e.g., vegetarian, vegan), inform your healthcare team.
Medication Review: Discuss all medications you are currently taking with your surgeon, including prescription medications, over-the-counter drugs, and herbal supplements. Some medications, such as blood thinners, may need to be stopped before surgery.
Smoking and Alcohol: If you smoke, it is crucial to quit smoking before surgery, as smoking can impair healing and increase the risk of complications. Similarly, limit or avoid alcohol consumption.
Arrange for Support: Enlist the help of family members or friends to support you during the recovery period. You may need assistance with daily tasks, transportation to and from appointments, and emotional support.
Financial Planning: Understand the estimated costs of the surgery, hospitalization, and follow-up care. Check with your health insurance provider to determine the extent of coverage. Explore options for financial assistance, such as government schemes or charitable organizations.
Mental Preparation: Surgery can be a stressful experience. Practice relaxation techniques, such as deep breathing or meditation, to manage anxiety. Talk to a therapist or counselor if you need additional support.
Hospital Bag: Pack a bag with essentials for your hospital stay, including comfortable clothing, toiletries, books, and any personal items that will make you feel more comfortable.
Choose a Hospital Wisely: Select a hospital with experienced surgeons and comprehensive breast cancer care facilities. Consider factors such as location, cost, and reputation. Many hospitals in India now offer specialized breast cancer centers with multidisciplinary teams of experts.
Discuss Pain Management: Talk to your surgeon about pain management options after surgery. Understand the types of pain medication you will be given and how to manage any side effects.
Post-operative Care Instructions: Make sure you fully understand the post-operative care instructions provided by your surgeon. This includes wound care, medication schedules, and follow-up appointments.

Breast Cancer Surgery Procedure: A Step-by-Step Guide

The breast cancer surgery procedure varies depending on the type of surgery being performed. Here's a general overview of the steps involved:

Pre-Surgery:
- Physical Examination: The surgeon will conduct a physical examination to assess the tumor and overall health.
- Mammogram: A mammogram helps to visualize the breast tissue and identify any suspicious areas.
- Biopsy: A biopsy is performed to confirm the diagnosis of breast cancer and determine the type of cancer.
- Discussion of Surgical Options with the Patient: The surgeon will discuss the various surgical options with the patient, explaining the risks and benefits of each approach.
During Surgery:
- Anesthesia: You will receive general anesthesia to ensure you are comfortable and pain-free during the procedure.
- Incision: The surgeon will make an incision in the skin, the location and size of which will depend on the type of surgery being performed.
- Removal of Cancerous Tissue: The surgeon will carefully remove the cancerous tissue, ensuring that a margin of healthy tissue is also removed to reduce the risk of recurrence.
- Lymph Node Removal (if necessary): If there is concern that the cancer may have spread to the lymph nodes, the surgeon will remove one or more lymph nodes for examination. This may involve a sentinel lymph node biopsy or an axillary lymph node dissection.
- Closure: The incision will be closed with sutures or staples. A drain may be placed to remove excess fluid from the surgical site.
Post-Surgery:
- Recovery Room: You will be taken to a recovery room where you will be closely monitored as you wake up from anesthesia.
- Hospital Stay: The length of your hospital stay will depend on the type of surgery you had and your overall health. It can range from a few days to a week.
- Pain Management: You will receive pain medication to manage any discomfort after surgery.
- Wound Care: You will be given instructions on how to care for your incision site to prevent infection.
- Follow-up Appointments: You will need to attend regular follow-up appointments with your surgeon to monitor your progress and address any concerns.
- Discussion of Results and Further Treatment: The surgeon will discuss the results of the surgery and any further treatment that may be needed, such as radiation therapy, chemotherapy, or hormonal therapy.

Understanding Breast Cancer Surgery Results

After the surgery, the removed tissue and lymph nodes are sent to a pathologist for examination. The pathology report provides crucial information about the cancer, including:

Type of Cancer: Identifies the specific type of breast cancer (e.g., ductal carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma).
Grade of Cancer: Indicates how aggressive the cancer cells are.
Stage of Cancer: Describes the extent of the cancer, including the size of the tumor and whether it has spread to lymph nodes or other parts of the body.
Margin Status: Indicates whether the edges of the removed tissue are free of cancer cells (clear margins) or contain cancer cells (positive margins).
Lymph Node Involvement: Determines whether cancer cells are present in the lymph nodes.
Hormone Receptor Status: Indicates whether the cancer cells have receptors for estrogen and progesterone. This information helps to determine whether hormonal therapy may be effective.
HER2 Status: Indicates whether the cancer cells have an excess of the HER2 protein. This information helps to determine whether targeted therapy with drugs like trastuzumab (Herceptin) may be effective.

Based on the pathology report, your oncologist will develop a personalized treatment plan that may include additional therapies, such as radiation therapy, chemotherapy, hormonal therapy, or targeted therapy.

Breast Conservation Surgery (BCS): When followed by radiotherapy, survival rates are equivalent to mastectomy. BCS aims to be less disfiguring and more cosmetically acceptable. This is an increasingly common and effective option for early-stage breast cancer in India.

Oncoplastic surgery: Slowly becoming the standard of care in India for early breast cancer. This approach combines breast conservation surgery with plastic surgery techniques to improve cosmetic outcomes, resulting in a more natural-looking breast shape.

Risks and Potential Complications of Breast Cancer Surgery

As with any surgical procedure, breast cancer surgery carries some risks and potential complications, including:

Infection: Infections can occur at the incision site or in the surrounding tissue. Antibiotics are typically used to treat infections.
Bleeding: Excessive bleeding can occur during or after surgery. In rare cases, a blood transfusion may be necessary.
Pain and Stiffness: Pain and stiffness around the breast area are common after surgery. Pain medication and physical therapy can help to manage these symptoms.
Swelling (Lymphedema): Swelling of the arm or hand can occur if lymph nodes are removed during surgery. Lymphedema can be managed with physical therapy and compression garments.
Change in Breast Shape: Breast surgery can alter the shape and appearance of the breast. Breast reconstruction can help to restore the breast's shape.
Reactions to Anesthesia: Allergic reactions or other complications can occur in response to anesthesia.
Damage to Nerves or Blood Vessels: Nerves or blood vessels in the breast or armpit can be damaged during surgery, leading to numbness, pain, or other problems.
Seroma: A collection of fluid can accumulate under the skin at the surgical site, forming a seroma. Seromas can be drained with a needle.
Hematoma: A collection of blood can accumulate under the skin at the surgical site, forming a hematoma. Hematomas may need to be drained surgically.
Wound Healing Problems: The incision site may not heal properly, leading to wound dehiscence (separation of the wound edges).
Nipple or Skin Necrosis: In rare cases, the nipple or skin around the incision site may die due to a lack of blood supply.
Phantom Breast Pain: Some women experience pain in the breast area even after a mastectomy. This is known as phantom breast pain.
Psychological Distress: Breast cancer surgery can be emotionally challenging. Some women may experience anxiety, depression, or body image issues.

It is important to discuss these risks and potential complications with your surgeon before undergoing breast cancer surgery.

Breast Cancer Surgery Costs in India (₹)

The cost of breast cancer surgery in India can vary significantly depending on several factors, including:

Type of Surgery: The type of surgery performed will have a major impact on the cost. More complex procedures, such as mastectomy with reconstruction, will generally be more expensive than simpler procedures, such as lumpectomy.
Stage of Cancer: The stage of the cancer can also affect the cost of surgery. More advanced stages may require more extensive surgery and additional treatments.
Hospital Choice (Private vs. Government): Private hospitals generally charge higher fees than government hospitals. However, private hospitals may offer more amenities and shorter waiting times.
Number of Chemotherapy or Radiation Cycles Needed: If chemotherapy or radiation therapy is needed in addition to surgery, this will add to the overall cost of treatment.
Surgeon's Fees: Surgeon's fees can vary depending on their experience and expertise.

Here's an approximate cost breakdown:

Lumpectomy with reconstruction: Rs 2-3 lakhs
Mastectomy: Rs 1-2 lakhs
Chemotherapy (per cycle): Rs 1-4 lakhs
Radiation therapy: Rs 1-3 lakhs
Mammograms: Rs 2,000 to 4,000
Ultrasounds: Rs 5,000 to 10,000
Biopsies: Rs 10,000 to 12,000
Genetic testing: Can be quite expensive

Overall Treatment Cost: The total cost of breast cancer treatment in India can range from INR 1 lakh to INR 10-15 lakhs or more, depending on the stage of the cancer and the treatments required. Some sources suggest that the average cost of breast cancer treatment in India is around INR 7,00,000 but can go up to INR 16,50,000 in some cases.

Important Considerations for Indian Patients:

Health Insurance: Check with your health insurance provider to determine the extent of coverage for breast cancer surgery and other treatments.
Government Schemes: Explore government schemes that provide financial assistance for cancer treatment.
Charitable Organizations: Many charitable organizations offer financial assistance to cancer patients.
Negotiate Costs: Don't hesitate to negotiate costs with the hospital and surgeon.
Compare Prices: Get quotes from multiple hospitals and surgeons to compare prices.
Consider Medical Tourism: If you are unable to afford treatment in your city, consider medical tourism to other cities in India where costs may be lower.

Remember that these are just approximate costs, and the actual cost of your treatment may vary. It is important to discuss the costs with your healthcare provider and explore all available financial assistance options.

How Ayu Helps

Ayu is dedicated to supporting you through your healthcare journey. While we don't directly provide medical treatments or financial assistance, Ayu can help you:

Organize and manage your medical records: Keep all your mammograms, biopsy reports, and other important documents in one secure place. This makes it easier to share information with your healthcare team.
Connect with trusted healthcare providers: Find and connect with reputable oncologists and surgeons in your area.
Track your medications and appointments: Stay on top of your treatment plan with reminders and notifications.
Access reliable information about breast cancer and its treatment: Empower yourself with knowledge to make informed decisions about your health.

Frequently Asked Questions (FAQs) about Breast Cancer Surgery

Here are some frequently asked questions about breast cancer surgery:

1. What are the different types of breast cancer surgery?

The main types of breast cancer surgery are lumpectomy, mastectomy (including partial, total, and radical), sentinel lymph node biopsy, axillary lymph node dissection, and breast reconstruction. Oncoplastic surgery is also gaining popularity.

2. What is the difference between a lumpectomy and a mastectomy?

A lumpectomy involves removing only the tumor and a small amount of surrounding tissue, while a mastectomy involves removing the entire breast.

3. How long does it take to recover from breast cancer surgery?

Recovery time varies depending on the type of surgery and individual factors. Generally, recovery from a lumpectomy takes a few weeks, while recovery from a mastectomy can take several weeks to months.

4. Will I need chemotherapy or radiation therapy after surgery?

The need for additional treatment depends on the stage and type of cancer, as well as other factors. Your oncologist will develop a personalized treatment plan based on your individual needs.

5. Will I lose my hair if I have chemotherapy?

Hair loss is a common side effect of chemotherapy, but it is usually temporary. Your hair will typically grow back after you complete chemotherapy.

6. Can I have breast reconstruction after a mastectomy?

Yes, breast reconstruction is an option for many women who have undergone a mastectomy. Reconstruction can be done at the same time as the mastectomy or at a later date.

7. Will breast cancer surgery affect my ability to breastfeed?

Breast cancer surgery can affect your ability to breastfeed, especially if you have had a mastectomy. Discuss this with your surgeon and lactation consultant.

8. What are the long-term side effects of breast cancer surgery?

Long-term side effects can include pain, stiffness, swelling, and changes in breast shape. Some women may also experience psychological distress.

9. Is breast conservation surgery as effective as mastectomy?

For early-stage breast cancer, breast conservation surgery followed by radiation therapy is as effective as mastectomy in terms of survival rates.

10. Where can I find support for breast cancer patients in India?

There are many support groups and organizations in India that provide support for breast cancer patients and their families. Ask your healthcare provider for recommendations.

This guide provides a comprehensive overview of breast cancer surgery in India. Remember that this information is not a substitute for professional medical advice. Always consult with your healthcare provider to discuss your individual needs and treatment options. Early detection and appropriate treatment can significantly improve outcomes for women with breast cancer in India.

What is Breast cancer surgery: Complete Guide for India