Early detection and treatment of breast abnormalities increase the chances of recovery with minimal disruption to the breast tissue. It’s important to examine your breasts regularly for signs of change and report any abnormal findings to your doctor for an accurate diagnosis and follow-up treatment.
Your doctor will probably order a mammogram or ultrasound and may recommend a minimally invasive surgery (MIS) procedure to obtain a sample of the affected breast tissue (a biopsy) to be sent to the lab for testing and diagnosis.
Although it’s a natural worry, this does not necessarily mean you have breast cancer. Around 80 – 85% of breast lumps are noncancerous, and if you have had a recent mammogram with a negative result, the odds are that the lump is benign (not cancerous). Lumps can be the result of cysts caused by hormonal changes during your monthly cycle, plugged milk ducts, infection, benign tumours called fibroadenoma (often linked to the use of birth control pills) or injury to the breast that damages fatty breast tissue. However, your doctor will want to establish the reason for the lump and put you on the right course of treatment. MIS is a useful procedure to obtain an accurate lab diagnosis with minimal discomfort to you.
What is MIS?
Unlike open surgery where the surgeon makes a large cut to access directly the part of the body being operated on, MIS involves small incisions or just one small incision through which the surgeon operates using small tools, cameras and lights. The benefit of this type of surgery is less scarring and a quicker, less painful recovery time.
MIS for breast biopsy
Your surgeon may use any of the following day-surgery options when taking a biopsy of your breast so you can return to normal activities the following day.
This procedure is done under local anaesthesia and takes about 10 – 15 minutes. Your surgeon will insert a fine needle to withdraw a sample of the affected tissue to be sent to the lab for analysis. This can be done with the assistance of imaging technology for abnormalities that can’t be felt to the touch.
Vacuum-assisted needle biopsy
If you have already been diagnosed with a noncancerous tumour, this procedure, also performed under local anaesthesia, allows your surgeon to remove all the affected tissue so you don’t need to undergo a second surgery. Using a cutting mechanism and assisted imaging technology, your surgeon will cut up the tissue and draw it through the opening of the needle using a vacuum. This procedure usually takes around 20 minutes and is commonly used to remove fibroadenoma.
MIS to treat breast cancer
If the biopsy tests come back with a diagnosis of breast cancer, your surgeon will look to the least invasive procedure necessary to treat the cancer with the aim of saving the breast where it is feasible to do so. The advances in modern MIS make this increasingly possible for early stage breast cancer. Your surgeon may recommend any of the following:
Instead of removing the whole breast (mastectomy), your surgeon uses MIS to remove just the lump while conserving the rest of the breast.
Integrated plastic surgery approach
Your surgeon may recommend an integrated approach which is aimed at performing the lumpectomy with the aim of minimising scarring and reconstructing the breast after the lump removal by using breast tissue flaps or surrounding fat or muscle. This procedure takes about an hour longer than a normal lumpectomy but aims to reshape your breast for a more cosmetically pleasing result.
Is MIS always the answer?
While treatments for breast cancer are aimed at saving the breast where possible, obviously the ultimate goal is total removal of the cancer and giving you your best chances of recovery.
Often MIS is just as effective at removing some cancers as open surgery, but it may not always be the best solution. Your surgeon will always recommend the most effective treatment for your particular case. If this is a total mastectomy – removal of the entire breast – ask your surgeon about breast reconstruction options as part of your treatment process. This will involve invasive surgery under general anaesthesia and a longer recovery process. Your surgeon may also recommend radiotherapy or chemotherapy depending on the stage of your cancer and the likelihood of it recurring.
Article reviewed by Dr Chong Chee Keong, breast surgeon at Parkway East Hospital
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