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Q. I have breast cancer. Do I need to go with complete organ removal or localized surgery?

Answered by
Dr. Arvind Guru
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 25, 2021

Hello doctor,

I have breast cancer. I have attached all the reports.

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Hi,

Welcome to icliniq.com.

I have seen your attached reports (attachments removed to protect the patient's identity), and as per the reports, it seems that there is a tumor in the left breast. This tumor has been confirmed to be cancer on one of the tests.

USG of axilla was advised but has not been attached.

MRI of the breast also has not been attached, but it may not be required depending on what surgery is planned.

The patient needs to be seen, and surgery has to be planned.

Get in touch if you need to discuss the options for surgery and the following treatments required.

It seems to be early cancer and should be completely curable in most cases.

I hope that helps.

Regards.

Hello doctor,

Thank you doctor.

I have the following questions:

1. Is a PET scan required?

2. Do we need to go with complete organ removal or localized surgery?

3. Can we eliminate chemo if we go with organ removal?

4. What are the percentage chances of recurrence, and we do not have any history of any cancer in the family?

#

Hi,

Welcome back to icliniq.com.

The answers to your questions are as follows:

1. Is PET scan required?

It depends but not required in every case.

It may be indicated if suspicious lymph nodes are present in the axilla and if the patient is symptomatic for something like bone pain or in case of abnormalities detected on CXR and USG abdomen and pelvis (as already recommended by your doctor). However, some people do it in early lesions, also like your case, but the yield is low.

2. Do we need to go with complete organ removal or localized surgery?

There are a number of factors in deciding this:

a) Mammogram in your case, as per the report, localized surgery or breast conservation surgery (BCS), as it is known, is do-able.

b) Tumor to breast ratio and location should be manageable under 2 cm size tumor.

c) There should be no clinical signs against it. In your case, your doctor's examination notes have not been attached, so I cannot comment.

d) Most importantly, patient preferences if you will not be overwhelmed with keeping the part of the organ that had cancer, then BCS can be looked into.

e) Post-operatively, radiation treatment is mandatory after BCS but may be avoided in some cases of complete breast removal.

3. Can we eliminate chemo if we go with organ removal?

No, chemo is not dependent on the extent of removal.

Chemo and its types depend on a lot of factors. The expected benefit from chemo can be calculated on the basis of some markers like Oncotype DX, but for most cases, unless the patient cannot receive it because of some serious medical problem, it is required in most cases.

4. What are the percentage chances of recurrence, and we do not have any history of any cancer in the family?

This will depend on again axillary lymph nodes and tumor characteristics like receptor status.

Regards.


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