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Successful Breast Conservation Surgery in a 64-Year-Old Female with Carcinoma of the Right Breast

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PACE Hospitals Oncology team successfully performed a Breast conservation surgery – Quadrantectomy with axillary lump nodal excision for a 64-year-old female patient with of the carcinoma right breast (T2N0M0)


A 64-year-old woman patient with chief complaints of right breast pain and swelling for the last three months presented to the consultant surgical oncologist, Dr. Ramesh Parimi, at PACE Hospitals, Hitech City, Hyderabad.

Medical History

Delving deeper, it was understood that the patient had pain in the right breast for the past three months along with swelling which led to her admission to the PACE Hospitals for additional care and management. She is a known case of diabetes mellitus and hypertension and is on medications. She also has a history of spondylitis for the past 15 years.

Diagnosis

Upon being admitted to PACE Hospitals her general condition was examined, and her vitals were stable. On a detailed physical examination, a lump was identified which was movable and non-tender in the right breast located at the lower outer quadrant region and a blackish discoloration of skin was found. Necessary investigations were done before the surgery procedure. 


Upon evaluating the diagnostic investigations, the patient was diagnosed with carcinoma of the right breast (T2N0M0). The tumor is located in the lower outer quadrant of the right breast measuring 3 cm by 3.5 cm. 


Carcinoma of the right breast is a type cancer that develops in the tissues of the right breast. It usually starts in the cells that line the ducts or lobules and can spread to other tissues or other areas of the body if not treated.

Treatment

After consultations with the consultant surgical oncologist, Dr. Ramesh Parimi, along with a consultant endocrinologist along with Dr. Tripti Sharma, it was determined that breast conservation surgery – quadrantectomy with axillary lump nodal excision was the effective method for treating the patient.


Breast conservation surgery is a procedure for removing cancer while leaving as much normal breast as possible. Generally, some surrounding healthy tissue and lymph nodes are also removed based on the spread of cancer. It is sometimes called lumpectomy, quadrantectomy or partial mastectomy based on how much tissue is removed.


As the patient was diagnosed with carcinoma of the right breast, with necessary investigations done & clearances obtained which included a pre-anesthesia checkup, the patient underwent a breast conservation surgery with axillary node excision. The procedure was supervised by the consultant surgical oncologist, Dr. Ramesh Parimi, and it was accomplished devoid of any complications.


During the procedure, the patient was positioned in a supine position in the operating theatre under general anesthesia. A circum areolar incision was made of 3.5cm in length, the tumor was exposed and excised with liberal margins. Short superior and long lateral markers were kept in respective margins. The lymph nodes in the right axilla at level 1 was excised.

Aftermath

Endocrinologist Dr. Tripti, has provided comprehensive care for her diabetes management. The post-operative period was uneventful. The patient was discharged when she was hemodynamically stable and was prescribed antibiotics, antipyretics, proton pump inhibitors, antifibrinolytics, antihyperglycemic agents, calcium channel blockers and vitamin D capsules. The patient was instructed to take care of the drain as advised by Dr. Ramesh Parimi. The patient was informed to contact PACE Hospitals in case of fever, abdominal pain, or vomiting.

Review notes

The patient was asked to get a review by Dr. Ramesh Parimi with a prior appointment after 1 week.

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