Major workload
(approximate numbers)
OPD patients 10000/yr
Patients having surgery 1000/yr
Mastectomies 550/yr
Breast conserving surgeries 400/yr
Reconstructions 200/yr
Wire guided resections 150/yr
Mammograms 3000/yr
Department of Breast Oncosurgery
About the Department
The department of breast oncosurgery is a state of art dedicated breast cancer department, and is one of the few centres in India which is part of Global Breast Cancer Network, an international consortium of hospitals which offer advanced breast cancer services. The surgical team works closely with other cancer services including Medical Oncology, Radiotherapy, Palliative Care and others, to provide comprehensive care for patients with breast cancer.
The department focuses on a minimal surgical approach, offering Breast Conserving Surgery as widely as possible, using Oncoplastic and Reconstructive techniques for the best cosmetic outcomes. We also have a minimalist approach to the axilla, offering Sentinel Lymph Node Biopsy in many clinical situations. Apart from these specialist procedures, we also offer routine breast surgery such as mastectomy, axillary dissection and management of benign disease.
Following completion of treatment, our support group, ‘Padakkep’, provides activities, fellowship and encouragement to help our patients on their journey beyond cancer, back to their normal life.
We are a training centre, offering a fellowship programme for speciality training in breast surgery. Alongside clinical services we have also contributed to breast cancer research in India with severa peer reviewed publications and presentations, both national and international.
This unit provides comprehensive breast cancer services to a large number of patients, including international patients from neighbouring countries of Bangladesh, Nepal and Bhutan.
Our breast diagnostic services include high quality digital mammography, MRI with specialist breast coils, and PET-CT scans. We offer stereotactic biopsy for impalpable lesions. Our pathology department provides the full range of services including immunohistochemistry, frozen section, and in situ hybridisation.
Breast conserving surgery is offered to all suitable patients, using intraoperative ultrasound guidance or hook wire localisation, to give a very precise outcome. Patients who need mastectomy and wish to have whole breast reconstruction have a choice of all reconstruction options, from Implants to Flaps – both immediate and delayed. All eligible patients are offered Sentinel Lymph Node Biopsy, thus avoiding axillary dissection and its complications in many patients.
As many of our patients present with advanced breast cancers we offer comprehensive neoadjuvant chemotherapy services – an approach where chemotherapy reduces the tumour size and subsequent surgery is guided by placement of markers – allowing us to preserve the breast in many more women who would otherwise have needed mastectomy.
Our OPD for new and follow up patients runs from Monday to Friday, with a separate clinic for genetic counselling and testing for women with hereditary breast cancer. The breast surgical team is well supported by the medical oncology and radiotherapy units to provide comprehensive treatment. We also have dedicated breast care nurses, who support our patients in the management of cancer related problems such as lymphoedema of the arm, breast prosthetic fitting and rehabilitation to normal life.
Special Procedures / Operations :
In terms of numbers of patients undergoing breast conserving surgery, we are one of the largest centres in the country. Using precise intraoperative USG guidance we have achieved re-surgery rates exceeding international standards. Along with our plastic surgery department we are able to offer the full range of reconstructive procedures for the breast. We specialise in the use of perforator flaps for partial breast reconstruction, and recently published one of the largest series of this procedure in a reputed journal.
We specialise in use of ICG for sentinel node biopsy (ICG- guided SLNB), a comparatively new and advanced technique, using infra red light for sentinel node biopsy, avoiding the use of harmful radioactive material. Our experience with this technique has been published in a reputed peer reviewed journal.
Teaching Programmes
We have 2 dedicated fellowship posts each year for surgeons aiming for a career in breast surgery. We also have provision for international candidates interested in training in breast surgery. In association with the other surgical units, we participate in a rotating fellowship programme in surgical oncology, of two years duration.
We run the annual Tata Clinical Research Methodology course, in collaboration with department of psycho-oncology.
We are a centre for ESSO Breast Surgery Qualification examination.
Anything else specific to dept :
We have led efforts to popularise and use ICG dye based sentinel lymph node biopsy. This is a novel solution for a developing country like India where radioactive material is tightly regulated and hence not available at many centres.
