A 37-year-old woman, who was diagnosed with early stage breast cancer and a BRCA1 mutation, underwent a robotic nipple-sparing mastectomy and prophylactic oophorectomy at Apollo Cancer Centre (ACC).
Venkat P., senior consultant, surgical oncology, ACC, said the patient was diagnosed with cancer of the right breast (stage II). A biopsy revealed that she had triple negative disease, an aggressive type of breast cancer. She received eight cycles of neoadjuvant chemotherapy, while genetic testing found a BRCA1 pathogenic mutation.
“She required prophylactic mastectomy of the other breast as well and risk reducing removal of the ovaries. We performed the bilateral mastectomy robotically, preserving the nipple, with immediate reconstruction. Her ovaries and fallopian tubes were removed,” he told reporters on Tuesday. The surgery was performed in December 2023.
The robotic surgery has the advantages of preservation of nipple, skin, and sensation of the breast, 10 times magnification, smaller incision, rapid recovery, lesser pain, better cosmesis, no blood loss, and better psychological outcomes, he added.
Dr. Venkat added that so far, they had performed 16 such surgeries. “Why is all this important? The reasons include a growing population of younger patients, better quality of life, psychosocial outcomes, and confidence,” he said.
Noting that the patient had no family history of breast cancer, he said there were clear cut guidelines for genetic testing in the case of younger patients.
Priya Kapoor, consultant, surgical oncology, ACC, said that breast cancer was the most common cancer with a high death rate affecting women in the country. Speaking on breast cancers in younger women and genetics, she observed that they were seeing patients aged in their 20s and 30s, posing a different set of challenges.
“There are heightened concerns of body image, issues of sexuality, fertility, pregnancy and early menopause, and more aggressive cancers,” she said. Noting that 30% to 35% of breast cancers can be associated with genetic effect, she said, “When we see young patients with breast cancer, genetic testing becomes a must and addressing the quality of life is also a must.”
A brochure on robotic breast surgery was released on the occasion. Sheelaketan, Chief Executive Officer, ACC, and Mukta Mahajan, consultant, radiology, ACC, were present.
