Description:
Breast cancer surgery (Mastectomy / Lumpectomy) is a surgical procedure performed to remove cancerous tissue from the breast. Breast cancer is the most common malignancy among women worldwide and the second leading cause of cancer-related death in women. Surgical management is a cornerstone of breast cancer treatment and is often combined with adjuvant therapies. Indications for breast surgery include confirmed breast malignancy on biopsy, high-risk lesions (DCIS – Ductal Carcinoma In Situ, LCIS – Lobular Carcinoma In Situ), large tumors, multifocal disease, recurrent breast cancer, and in some cases, prophylactic mastectomy for high-risk patients (BRCA mutation carriers). Patients typically present with a palpable breast lump, skin changes (dimpling, redness, ulceration), nipple discharge, or abnormal findings on screening mammography.

Treatment Options:
The main treatment modalities for breast cancer include:

• Breast‑Conserving Surgery (Lumpectomy / Wide Local Excision) – removal of the tumor with a margin of surrounding healthy tissue
• Mastectomy – removal of the entire breast tissue (Simple / Total Mastectomy)
• Modified Radical Mastectomy – removal of entire breast plus axillary lymph node dissection
• Radical Mastectomy – extensive removal of breast, chest wall muscles, and lymph nodes (rarely performed today)
• Sentinel Lymph Node Biopsy (SLNB) – identification and removal of the first draining lymph node to assess spread
• Axillary Lymph Node Dissection (ALND) – removal of multiple axillary lymph nodes (if sentinel node is positive)
• Nipple‑Sparing Mastectomy – removal of breast tissue while preserving the nipple‑areolar complex (for selected cases)
• Skin‑Sparing Mastectomy – removal of breast tissue with preservation of overlying skin for better reconstruction
• Prophylactic Mastectomy – preventive removal in high‑risk individuals (BRCA1/BRCA2 mutation carriers)
• Immediate / Delayed Breast Reconstruction – using implants or autologous tissue (e.g., TRAM flap, DIEP flap)

Procedures:
Breast cancer surgery is performed under general anesthesia and typically takes 60 to 180 minutes, depending on the type of surgery, tumor size, extent of lymph node dissection, and need for reconstruction. The procedure is performed through an incision made over the tumor site (for lumpectomy) or a transverse or vertical incision across the breast (for mastectomy). In sentinel lymph node biopsy, a radioactive tracer and/or blue dye is injected to identify the sentinel node, which is then removed for pathological examination. In cases requiring axillary dissection, a separate incision in the axilla is made. For reconstructive procedures, additional incisions may be made in the abdomen or back for flap harvesting (DIEP or TRAM flaps), or implant placement is performed either immediately (during the same operation) or delayed. Intraoperative margin assessment (frozen section) may be performed to ensure clear surgical margins (negative margins). Drains are placed to prevent fluid collection (seroma), and the wound is closed in layers.

This package includes:

Preoperative consultation with breast surgeon, oncologist, anesthesiologist, and reconstructive surgeon (if needed)

Complete laboratory workup (CBC, coagulation profile, liver/kidney function, tumor markers – CA 15‑3, CEA if indicated)

Bilateral mammography and breast ultrasound (with elastography)

Breast MRI (if indicated for high‑risk or dense breasts)

Core‑needle biopsy or vacuum‑assisted biopsy (if not previously performed)

Histopathology report with hormone receptor status (ER, PR, HER2/neu, Ki‑67) and molecular subtyping

Sentinel Lymph Node Biopsy (SLNB) with radioactive tracer and/or blue dye mapping

Lumpectomy or Mastectomy (Simple, Modified Radical, Skin‑Sparing, or Nipple‑Sparing) under general anesthesia

Intraoperative frozen section (for margin assessment)

Axillary Lymph Node Dissection (ALND) if indicated

Immediate breast reconstruction (if desired and feasible) – implant or autologous flap

Three to five days hospital admission (depending on surgery extent and reconstruction)

Postoperative pain management, wound care, drain management, and physiotherapy consultation

Discharge medications (antibiotics, analgesics) and follow‑up plan

Complete histopathology report with staging and receptor status (final report within 7–10 days)

This package excludes:

• Radiotherapy (adjuvant or palliative)
• Chemotherapy (neoadjuvant or adjuvant)
• Hormonal therapy (Tamoxifen, Aromatase Inhibitors) – beyond the initial prescription
• Targeted therapy (Trastuzumab / Herceptin, Pertuzumab, etc.) – beyond the initial prescription
• Delayed breast reconstruction (if not performed immediately)
• Contralateral prophylactic mastectomy (if not pre‑arranged and approved)
• Genetic counseling and BRCA testing (if not previously performed)
• Consultation with other specialists (e.g., radiation oncologist, medical oncologist, psychologist) if additional treatment or support is required
• Extended hospital stay beyond five days due to complications (e.g., wound infection, flap necrosis, hematoma, seroma)
• Cosmetic revision or scar management procedures
• Prosthetic implants (cost of implants is separate if not covered by package)
• Physiotherapy sessions beyond the initial inpatient consultation

Instructions (Preparation):

Do not eat or drink anything (except essential medications with a small sip of water) for at least 6–8 hours prior to surgery (general anesthesia protocol).

Bring all your previous medical records, imaging reports, biopsy results (with receptor status), and any prior treatment history.

Inform your surgeon about any history of bleeding disorders, allergies, current medications (especially anticoagulants, antiplatelets, or hormonal agents), and any previous breast surgeries or radiotherapy.

If you are a smoker, stop smoking at least 2–3 weeks before surgery to improve wound healing and reduce anesthetic risks.

Discuss reconstruction options with your surgeon in advance. Decision on immediate vs. delayed reconstruction should be made before admission.

Psychological counseling is recommended and available upon request.

Arrange for a family member or caregiver to assist you during the first week after discharge.

Terms and Conditions:
All breast cancer surgeries are performed using the latest oncoplastic techniques, including intraoperative ultrasound localization, wire‑guided or radioactive seed localization for non‑palpable lesions, and advanced hemostatic devices to ensure maximum safety and precision. Oncological principles are strictly followed to achieve negative margins (R0 resection) while preserving cosmetic appearance to the greatest extent possible. Immediate reconstruction (where applicable) is performed by a specialized reconstructive surgeon using the latest implant or autologous flap techniques.

Patient Eligibility:
All procedures are conducted with state‑of‑the‑art equipment and advanced surgical methods.
Patients with a history of previous breast surgery, prior radiotherapy to the chest wall, large tumor size (≥5 cm), inflammatory breast cancer, advanced disease with skin or chest wall invasion, metastatic disease, severe comorbid conditions (cardiac, pulmonary, renal disease), uncontrolled diabetes, obesity (BMI ≥ 35), or age over 75 years are considered high‑risk and require thorough preoperative multidisciplinary assessment with medical oncology and radiation oncology involvement.

Contact:
Jam Hospital is available 24/7 for consultations, admissions, and emergency support. A dedicated breast care nurse is also available for patient education and support throughout the treatment journey.

Goals:
To provide the most effective, safe, and individualized surgical treatment with the best possible oncological and cosmetic outcomes, while preserving quality of life, ensuring psychological well‑being, and offering comprehensive multidisciplinary care (surgery, reconstruction, and adjuvant therapy coordination) for optimal long‑term survival and patient satisfaction.