International Women’s Day 2017

Women are truly the real architects of society – I am fortunate to know so many courageous women, who continue to fulfil their personal & professional responsibilities despite battling breast cancer. Hats off to their fighting spirit!! Wishing all these beautiful women a very happy International Women’s Day

 

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Interesting Mammogram #4 

47 year old lady with complaints of bilateral breast pain since 3 months. Pain was non cyclical and relieved by oral paracetamol. She had a hysterectomy 6 years back and she was a known asthmatic.

On examination, she has multiple tender nodules in both the breasts, localised in the peri-areolar region. 

Mammogram revealed multiple, well defined, rounded densities in both the breasts with a rim of calcification around them (refer to figures). 

Multiple round densities in the breast


Ultrasound done revealed dense fibroglandular tissue with multiple sub-centimetric cysts in the breasts. 

Differential – 1. Multiple oil cysts with calcification 

2. Cysts secondary to fibroadenosis

Case managed by:

Dr Rohan Khandelwal

Consultant, Department of Breast Diseases and Cancer Care

W Pratiksha Hospital, Gurgaon  

Breast Conservation Surgery for Early Breast Cancer

Breast Cancer Surgery has undergone a lot of change in the last few years. Earlier, mastectomy (full breast removal) was the norm for breast cancer management, but nowadays if the cancer is detected early, Breast Conservation Surgery (BCS) can be carried out.

In breast conservation surgery (BCS), only the cancerous lump and some portion of normal breast tissue around it is removed, preserving the rest of the breast, thereby leading to a better cosmetic outcome for the patient. BCS is also psychological and physically better for a patient suffering from breast cancer. The overall survival, whether the patient undergoes BCS or mastectomy for breast cancer treatment, remains the same.

 

Breast conservation surgery should be carried out by a trained breast cancer surgeon (breast onco-surgeon). A frozen section analysis should be done at the time of surgery to confirm that the tumor has been adequately removed.

 

 

 

Information provided by:

Dr. Rohan Khandelwal

W Pratiksha Hospital

Gurgaon

 

Free Breast Cancer OPD – Early detection is the best protection!!

 

 

Early detection is your Best Protection!!

 

breast cancer

 

 

Initiative by:

Dr. Rohan Khandelwal

Department of Breast Diseases & Cancer Care

W Pratiksha Hospital, Gurgaon

Seroma formation – a common complication of axillary surgery

A seroma is accumulation of clear fluid in the body after surgery. It is a common complication which can occur in the underarm area (axilla) after breast or axillary surgery. In fact, axillary seromas have been seen even after axillary lymph node biopsy or sentinel lymph node biopsy for breast cancer

To prevent seroma formation, surgeons insert drains after breast and axillary surgery ( both cancerous and non cancerous). Drains are usually removed once the output falls below 40 cc for two consecutive days. Early removal of drains is a common cause which can predispose to seroma formation after breast cancer surgery. 

Patients usually develop fluid collections within 5-7 days after surgery and they present with pain and swelling in the axillary region. Diagnosis of a seroma can be made by your breast cancer surgeon and in case of any doubt, an axillary ultrasound can confirm the diagnosis (image)

Axillary Seroma

Axillary Seroma

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Management of an axillary seroma is relatively simple. They can be aspirated under local anaesthesia. Patients might require 2-3 aspirations before the seroma subsides.

Sometimes fluid collections can become infected and can give rise to pus formation in the axillary region. These situations can be avoided if seromas are detected and aspirated in time.

 

 

Information provided by:

Dr. Rohan Khandelwal

Consultant, Breast Surgeon

W Pratiksha Hospital, Gurgaon

Fat Grafting – a novel technique for breast augmentation

Autologous fat grafting (fat transfer) is a technique in which fat is harvested from the patient using liposuction and after centrifuging, this fat is introduced in the sub-dermal and retro-glandular portions of the breast to augment the breast.

This technique has also been used to fill up post lumpectomy defects following breast conservation surgery for breast cancer.

Advantages of the procedure:

  1. No foreign material or implant is used
  2. Double benefit of liposuction from the donor site
  3. Relatively cheap as compared to an implant based reconstruction
  4. Day care procedure
  5. Natural feel & contour of the breast

 

Potential Drawbacks:

  1. Only 70-80% of fat cells transferred by this technique survive, therefore, there is some amount of volume reduction after the procedure. In some cases, multiple sittings might be required to achieve the desired results.
  2. As these fat cells die, they can sometimes give rise to calcifications, which can be confused for malignant/benign lesions on a mammogram
  3. Haematomas & bruising in the immediate post-op period

 

The following video demonstrates a case of primary breast augmentation using fat grafting: