Introduction

Breast cancer is the most common cancer diagnosed in India and is the most common cancer in women. The recent advances in breast cancer treatment had led to excellent survival and cure rates. The surgical treatment of breast cancer initially involved Mastectomy (removal of whole breast), but now the treatment of choice is Breast Conservation Therapy (removal of only the tumour with preservation of normal breast), wherever feasible. Both options have their merits and drawbacks, and the choice should be guided by individual circumstances and preferences.

Understanding the Options

Breast Conservation Therapy (BCT):

BCT, also known as lumpectomy or partial mastectomy, involves surgically removing only the cancer tissue within the breast while preserving as much of the healthy breast as possible. This approach is usually followed by radiation therapy.

Advantages of Breast Conservation:

• Preserves the natural appearance of the breast, hence providing better patient satisfaction and improved quality of life. 
• It has a shorter recovery period compared to mastectomy.
• Provides similar survival / cure rates when compared to mastectomy

Considerations for Breast Conservation:

• May not be suitable for larger tumours or advanced stage cancers.
• Requires radiation therapy, which can have side effects.

Mastectomy:

A mastectomy involves the complete removal of the breast tissue irrespective of the tumour size and stage,

Advantages of Mastectomy:

• Reduces the risk of cancer recurrence in the breast, but no added advantage on the survival / cure rates.
• Recommended for patients with advanced or extensive disease
• Eliminates the need for radiation therapy in few cases.

Considerations for Mastectomy:

• Loss of the breast, which can impact body image and self-esteem.
• Longer recovery period and potential complications associated with surgery.

Making the Decision

The choice between breast conservation and mastectomy should be a shared and informed decision involving the patient and the oncology team. A Surgical Oncologist (Cancer Surgeon) should be adequately trained in performing both the kind of operations in order to offer the options to the patient.

Conclusion

The decision to undergo breast conservation therapy or a mastectomy is deeply personal and should be based on a careful assessment of individual factors. It’s crucial to have open and honest discussions with healthcare providers to make an informed choice considering both the medical needs and personal preferences.

Breast cancer treatment has made significant advancements in recent years, offering more options with improved survival rates. Ultimately, the goal of breast cancer treatment is not only to treat the disease but also to support the patient’s physical and emotional well-being i.e., quality of life.

References

Agarwal S, Pappas L, Neumayer L, Kokeny K, Agarwal J. Effect of Breast Conservation Therapy vs Mastectomy on Disease-Specific Survival for Early-Stage Breast Cancer. JAMA Surg. 2014;149(3):267–274. doi:10.1001/jamasurg.2013.3049

Chatterjee, S. Is India Overdoing Mastectomy?. Indian J Surg 83 (Suppl 2), 275–277 (2021). https://doi.org/10.1007/s12262-020-02402-9

Fisher, Bernard et al. “Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer.” The New England journal of medicine vol. 347,16 (2002): 1233-41. doi:10.1056/NEJMoa022152

Veronesi, Umberto et al. “Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer.” The New England journal of medicine vol. 347,16 (2002): 1227-32. doi:10.1056/NEJMoa020989

Introduction

Your smile is a powerful tool. It can convey happiness, confidence, and joy. But what if your smile is under threat from a silent killer like oral cancer? Oral cancer is a serious health condition that affects lakhs of people, especially in India. The World’s ¼ total Oral Cancer cases are diagnosed in India. The good news is that there are steps one can take to reduce your risk. In this blog, we’ll discuss the prevention of oral cancer and the importance of early detection.

Understanding Oral Cancer

Oral cancer refers to cancers that develop in the mouth, including the lips, tongue, gums, and the inner lining of the cheeks. The leading causes of oral cancer are tobacco use, alcohol consumption, poor oral hygiene, weak immune system and viral infections.

Prevention Tips

Say No to Tobacco: Smoking cigarettes and using smokeless tobacco products significantly increase your risk of oral cancer. 80% of total Oral Cancer are caused by the use of Tobacco. Smoking cigarettes, bidi and using smokeless tobacco products puts oneself on the risk of developing an oral Cancer. Quitting smoking and avoiding tobacco altogether is one of the most effective way to prevent oral cancer. A visit to your Oncologist / Cancer Specialist can help you in quitting tobacco and thereby preventing Oral Cancer altogether.

Avoid Alcohol Consumption: Alcohol consumption is another major risk factor for oral cancer. It has a synergistic effect along with tobacco in causing Oral Cancer. There are medicine and various non-medicinal options to help you avoid alcohol.

Maintain Good Oral Hygiene: Good oral hygiene is essential for overall oral health and cancer prevention. Brush your teeth at least twice a day, floss daily, and visit your doctor regularly for check-ups and cleanings. Pay attention to any unusual changes in your mouth, such as sores that don’t heal, white or red patches, or swelling.

Eat a Healthy Diet: A diet rich in fruits and vegetables provides essential vitamins and antioxidants that can help protect against oral cancer. Include a variety of colorful fruits and vegetables in your meals to ensure you’re getting a wide range of nutrients.

Regular Screenings: Regular oral cancer screenings by a cancer specialist is important. They can detect early signs of oral cancer when it’s most treatable. Be active in scheduling these screenings, especially if you have risk factors like smoking. The screening can detect cancer at an early stage, where cure rates are very high

Conclusion

Preventing oral cancer requires a combination of lifestyle choices, regular screenings, and awareness. Remember, early detection is key to successful treatment, so don’t neglect regular check-ups with your healthcare provider or dentist. Your smile is worth protecting, and with these prevention tips, you can do just that.

References

Bouvard V, Nethan ST, Singh D, Warnakulasuriya S, Mehrotra R, Chaturvedi AK, Chen TH, Ayo-Yusuf OA, Gupta PC, Kerr AR, Tilakaratne WM. IARC perspective on oral cancer prevention. New England Journal of Medicine. 2022 Nov 24;387(21):1999-2005.

Mangalath, Ummar et al. “Recent trends in prevention of oral cancer.” Journal of International Society of Preventive & Community Dentistry vol. 4,Suppl 3 (2014): S131-8. doi:10.4103/2231-0762.149018

Sankaranarayanan R, Ramadas K, Amarasinghe H, et al. Oral Cancer: Prevention, Early Detection, and Treatment. In: Gelband H, Jha P, Sankaranarayanan R, et al., editors. Cancer: Disease Control Priorities, Third Edition (Volume 3). Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2015 Nov 1. Chapter 5. Available from: https://www.ncbi.nlm.nih.gov/books/NBK343649/ doi: 10.1596/978-1-4648-0349-9_ch5