Oncoplastic Breat Surgery in Nepal

1 Oct 2019 Research

Dr. Kapendra Shekhar Amatya

Corresponding Author:
Dr. Kapendra Shekhar Amatya
Head, Department of Surgical Oncology
Nepal Cancer Hospital and Research Center
Harisiddhi, Lalitpur, Nepal

Treatment of breast Cancer has crossed many hurdles and with more understanding of Breast cancer biology and advancement of its systemic treatment; it has already been established that breast conservation surgery (BCS) is equally accepted mode of treatment. The challenges of BCS is a) tumor localization and margins and b) cosmetic challenges. Although many options have been developed to outcome above challenges, intra operative USG, wire localization & Frozen section with Oncoplastic Breast surgery and Breast reconstruction provide suitable answer.

Intra operative USG, wire localization & Frozen section has decreased the amount of breast tissue that needs to be taken out during BCS. But in a country like Nepal where resources are constrain, Breast Reconstruction with Flap or prosthesis adds to the cost and requirement of additional plastic surgery facility. Sometime Second surgery is required again adding to the cost burden of Cancer treatment.

Oncoplastic Breast Surgery provides a simple and affordable solution to the above problem. Its benefit includes a) Can be performed by same surgeon in one sitting b) acceptable cosmesis c) better tumor localization and margin clearance.
Its cons is Mild disparity in size
Conclusion: Oncoplastic Breast Surgery applies simple principle of breast cosmesis to breast cancer surgery. Complete radiographic localization and frozen section is the key to oncoplastic resection. It improves both improved cosmetic outcome and increase surgical margins of resection. It is the best option for Breast conservation with cosmetic outcome in resource-constrained country like Nepal.

Original Article
Oncoplastic surgery for breast cancer based on tumour location and a quadrant-per-quadrant atlas
K. B. Clough1,*, T. Ihrai1,2, S. Oden1, G. Kaufman1, E. Massey1 andC. Nos1

British Journal of Surgery
Volume 99, Issue 10, pages 1389–1395, October 2012

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