First of all, we will discuss the types of surgery done for breast cancer.
Breast cancer Surgery can either be a breast conservation surgery or modified radical mastectomy.
First we come to breast conservation surgery.
In early stage disease, when the tumor size is small and it can be removed with adequate margins, without removing the whole breast, it is called breast conservative surgery.
Its advantage is that, it helps preserve breast tissue and results in better cosmesis.
For advanced stage disease with larger tumor size, breast conservation surgery may be tried.
In this, we first have to shrink the tumor size by giving neoadjuvant chemotherapy, and later reassess the tumor for breast conservation surgery, depending upon the response to chemotherapy.
If after neo-adjuvant chemotherapy, there is shrinkage of tumor to a size when it can be removed with adequate margins without removing the whole breast, breast conservation surgery may be done.
Where as when the tumor size is very large and breast conservation surgery is not possible, we do the modified radical mastectomy or MRM.
As you can see, the complete breast tissue is removed in MRM, along with the axillary lymph nodes.
In early-stage disease also, MRM may be done in place of BCS in certain cases, such as when the patient is apprehensive and does not give consent for BCS or when there are contraindications against BCS
But the final decision is taken after discussing with the patient and discussion in the tumor board on an individual patient basis.
Yes, I was given an option between BCS and MRM by my oncologist and I choose breast conservation.
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