All About Breast Surgery

We have seen how targeted therapy benefits patients with HER2+ breast cancer. Now, we’ll take a closer look at neoadjuvant treatment and how it has changed breast surgery as a treatment for early HER2+ breast cancer. Firstly, however, let’s have a consultant breast surgeon give us an overview of breast surgery.

- Dr Ng Char Hong

“Most breast cancer cases, except Stage 4 ones, often require surgery at some stage,” explains consultant breast surgeon Dr Ng Char Hong. He adds that Stage 4 breast cancers are excluded because research has shown that surgery does not make much difference to the patient’s survival.

The purpose of such a surgery is to remove the tumour from the body.

Surgery can be offered upfront – which is to say, it is performed before other treatment options – or after the patient has undergone other treatments first.

SO, BEFORE OR AFTER?

Dr Ng points out that there is no simple answer; it depends on what the healthcare team wants to achieve in a particular case. For example, if the tumour is considered large in comparison to the size of the breast, neoadjuvant treatment may be given before surgery to shrink the size of the tumour before it is operated on. In another case, such as in someone with triple negative or HER2+ breast cancer, chemotherapy may be offered first, to determine the patient’s response to the treatment. If the patient responds well, then the outcome from the surgery will most likely be better as well.

Ultimately, it depends on the type of cancer, the stage of the cancer, the tumour size, and many other factors. The healthcare team will explore all available treatment options with the patient before any decision is agreed upon.

REMOVING THE ENTIRE BREAST

A mastectomy removes the entire breast (including the nipple).