By Dr.Supakorn Rojananin, Breast surgeon, Wattanosoth Hospital, Bangkok Cancer Hospital
Pink ribbon is an international symbol for breast cancer awareness. In Thailand, there are several campaigns to increase awareness of this disease. Breast cancer screening can reduce deaths through early detection. With technological advancement, an innovative new surgical device, PEAK PlasmaBlade, offers precise control of the surgery while minimizing damage to surrounding tissues. This reduces recovery time and complications.
Understanding breast cancer
Breast cancer occurs when some breast cells begin to grow abnormally. These cells grow uncontrollably and have the potential to spread to other parts of the body. Researchers have identified that hormonal, lifestyle and environmental factors may increase the risk of breast cancer. It’s not clear why some people who have no risk factors develop cancer, yet other people with risk factors never do. With modern treatment options, survival rate is generally very good for breast cancer and is continuing to improve.
The average age of first diagnosis of breast cancer is 40 years and older. Like a lot of cancers, breast cancer grows by simple cell division. It begins as one malignant cell, which then divides itself and becomes two bad cells. With most breast cancers, each division takes one to two months, as a result by the time you can feel a cancerous lump, the cancer has been in your body for many years.
Breast cancer symptoms
If you have the below symptoms, see your doctor without delay.
- Breast pain or discomfort
- A lump or swelling at breast, clavicle, or armpit
- Changes to the nipple, such as a change in shape, crusting, sores or ulcers, redness, a clear or bloody discharge, or a nipple that turns in (inverted) when it used to stick out
Who should be screened for breast cancer?
Women who have no symptoms should be screened for breast cancer by screening mammography as below.
- Women aged 40 years and older should be screened annually
- Women who are in the high risk group
– have first degree relatives with breast or ovarian cancer
– have BRCA1, 2 gene mutation
– have first degree relatives with BRCA1, 2 gene mutation
– beginning your period at a younger age and beginning menopause at an older age
– has taken long term hormonal therapy
- Receive radiation treatments to your chest as a child or young adult (10-30 years old) – recommended to begin the screening early at the age of 30-35 years old
Breast cancer screening
Breast cancer screening involves a mammography exam and breast ultrasound. It can find cancer early, when it is small and easier to treat. When the diagnosis is done early enough, the chances for successful treatment increases.
2D digital mammography is the gold standard for early detection of breast cancer. It is a safe, low dose x-ray examination of the breasts, which produces high quality images while significantly reducing examination time. There is also a 3D digital mammography that makes suspicious areas of tissues easier to detect and characterize. It is especially beneficial for women with dense breasts. This increases accuracy in detecting small abnormal structures or calcifications.
Ultrasound imaging of the breast uses high frequency sound waves to produce pictures of the internal structures of the breast. It can help determine if an abnormality is solid (which may be a non-cancerous lump of tissue or a cancerous tumor) or fluid-filled (such as a benign cyst) or both cystic and solid.
Breast cancer screening consists of both mammography and breast ultrasound in order to increase the accuracy in detecting abnormality of the breast. This also helps the doctor to choose the best treatment options. Moreover, there are other investigations that can be done such as contrast enhanced spectral mammography (CESM) and breast MRI. These could help the doctor better understand the extent of disease and plan an effective course of treatment. For the patient with a suspicious mammographic abnormality or a palpable breast lump, the obligatory diagnostic next step is a breast biopsy.
Breast cancer treatment
In patients with Stage 0 breast cancer (the atypical cells have not spread outside of the ducts or lobules into the surrounding breast tissue), the cure rate is almost 100%. For stage 1 breast cancer (tumor is less than 1 2 centimeter), surgical removal of the tumor provides around 90% cure rate. If the patient is able to detect breast cancer in the early stage, there are 2 options for surgery. Surgery to remove the whole breast, called a mastectomy, or to remove just the tumor and tissues around it, called a lumpectomy or breast-conserving surgery. If the patient chooses the breast-conserving surgery, radiotherapy is required after the surgery. However, if the patient chooses to remove the whole breast, radiotherapy is not necessary. With these surgical treatments, the cure rate is almost 100%. For breast cancer stage 1B and more, the treatment includes surgery, chemotherapy, and hormonal therapy.
Plasmablade – an innovative device that improves the treatment of breast cancer
A new surgical device called the PEAK PlasmaBlade provides important benefits for patients, including reduced tissue damage and improved incision healing compared to traditional electrosurgical devices. Although it has the precision of a scalpel, the PEAK PlasmaBlade uses radiofrequency (RF) energy delivered across a very small surface area, giving surgeons the ability to control bleeding while cutting. This tool also makes it possible to save the nipples of women who undergo mastectomy after being diagnosed with breast cancer, as for many women, they lose a sense of sexuality after a traditional mastectomy because their nipple is removed.
In addition, it improves surgical incision healing with reduced scarring and inflammation. Compared to traditional devices, PlasmaBlade produces minimal thermal damage to the surrounding tissue. This reduces post-operative complications and recovery time.
Breast Center at Wattanosoth Hospital is internationally certified by the Joint Commission International (JCI), USA. We received clinical care program certificate for breast cancer from the JCI. The Breast Center is dedicated to breast health, and to the care and treatment of breast cancer. Breast cancer specialists work as a team to ensure the highest quality of care. Each patient’s case is discussed by breast radiologists, surgeons, medical oncologists, radiation oncologists, pathologists, pain medicine specialists, oncology nurses and other specialists who make up the multidisciplinary team. Together, our experts explore all possible treatment options to recommend the ideal breast treatment plan.
Whether you need additional mammograms, a biopsy or treatment for breast cancer, our team is here to provide information and support. We help our patients get to the right doctor, receive the right treatment at the right time, and help guide each patient on their journey, no matter how simple or complex the case is. Our goal is to make sure this experience produces the least possible anxiety in patients.
We also help breast cancer patients and their families by supporting the whole process during breast cancer treatment and into the recovery process. Our support teams and programs help patients and their families manage both the medical and the many non-medical aspects of dealing with breast cancer treatment.
For more information: Breast Center, 3rd Floor Wattanosoth Hospital || Call 1719 || Bangkok Hospital
Dr.Supakorn Rojananin, Breast surgeon
1997 Certificate a Course Practical Microsurgery, The Canniesburn Regional Plastic Surgery Unit Edinburgh UK
1988-1989 Certificate in Observer-ship in Head & Neck Surgical Oncology, M.D. Anderson Cancer Center, University of Texas at Houston USA
1982 Diploma Thai Board of Surgery, Siriraj Hospital
1982 Certificate of Medical Science (Surgery), Siriraj Hospital
1977 Medical Doctor, Siriraj Hospital
2014 Emeritus Professor of Surgery
2006 Professor of Surgery
1997 Associate Professor of Surgery
1991 Assistant Professor of Surgery
1985 Lecturer, Division of Head-Neck & Breast Surgery,Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University
Director of Breast Center, Wattanosoth Hospital, Bangkok Dusit Medical Service (BDMS)