Surgical Oncology

Understanding Breast Cancer

Breast cancer is the most prevalent cancer among women globally. In India, its incidence is rapidly increasing, with more than 50% of cases diagnosed in women under the age of 50. Early detection plays a vital role in improving cancer outcomes and significantly enhances survival rates.

When diagnosed at a localised, early stage, breast cancer has a five-year survival rate of nearly 99%. Further, early diagnosis allows for less aggressive treatments that can help preserve the natural shape and contour of the breast, as well as shorter recovery times, and long-term physical and emotional well-being.

The “Holistic Breast Centre” a state-of-the-art, multidisciplinary facility with world renowned breast cancer experts dedicated to comprehensive breast health across every stage of a woman’s life—from adolescence through adulthood. Whether addressing benign conditions, hormonal changes, or the complexities of breast cancer, our mission extends beyond clinical excellence to include restoring confidence, dignity, and aesthetics.

Our expert team delivers integrated, evidence-based care that combines advanced diagnostics, personalised treatment planning, oncoplastic breast surgery, precision oncology, and psycho-social support. All services are offered under one roof, ensuring seamless, compassionate, and high-quality care tailored to each individual.

Receiving a breast cancer diagnosis can be an overwhelming and emotionally taxing experience. Unfortunately, many patients face fragmented healthcare journeys, involving numerous appointments across different locations—often resulting in conflicting medical opinions, increased stress, and added confusion.

The Holistic Breast Centre at Sir H. N. Reliance Foundation Hospital addresses these challenges by offering a fully integrated, state-of-the-art facility where all essential services are available under one roof. This coordinated approach ensures clarity, continuity of care, and a more supportive experience for every patient.

• Multidisciplinary Expertise: Breast cancer is a complex and varied disease—there is no one-size-fits-all solution. Achieving the best outcomes requires an individualised treatment plan tailored to the specific biology of the cancer and the unique needs of each patient. At the Holistic Breast Centre, we follow a multidisciplinary approach, bringing together a team of highly trained breast cancer specialists who collaborate to deliver truly personalised care. Our expert team includes breast surgeons, radiologists, medical and radiation oncologists, plastic and reconstructive surgeons, geneticists, and pathologists. Working cohesively, they review imaging, pathology, breast characteristics, the patient’s overall health, and personal preferences to develop a unified, evidence-based treatment strategy. This integrated model ensures that every patient receives the most comprehensive, coordinated, and effective care—all under one roof.
• Integrated Care: We go beyond treating the disease—we care for the whole person. Our approach integrates personalised cancer treatment plans with complementary therapies, psycho-social support, and dedicated attention to physical, emotional, and sexual well-being. By addressing every aspect of a patient’s health and quality of life, we ensure that breast cancer is managed comprehensively, compassionately, and holistically.
• Shared Decision Making: We believe that effective cancer care is a partnership. Through a process of shared decision-making, we actively engage patients in their treatment planning—honouring their individual values, preferences, and lifestyle choices, while ensuring the highest standards of oncological safety. This collaborative approach empowers patients to make informed decisions with confidence and clarity.
• Seamless Coordination:Our integrated approach ensures a smooth and coordinated cancer journey—from initial diagnosis through all recommended treatment modalities, and ultimately into survivorship and long-term follow-up care. Every step is thoughtfully managed under one roof, providing continuity, convenience, and peace of mind.
• Emotional and Psychological Support: We understand that a cancer diagnosis can bring about significant emotional challenges, including stress and anxiety. To support our patients, we provide access to professional counselling, stress reduction techniques, and support groups, ensuring emotional well-being is prioritized alongside physical health.
• Benign Breast Condition:Many women experience breast-related symptoms, such as pain or lumpiness, at some point in their lives. Our specialists are dedicated to providing thorough evaluations for women seeking reassurance or clarification, ensuring that any serious underlying conditions are promptly identified and addressed.
• Post-Breast Surgery Issues: Women no longer need to accept suboptimal aesthetic outcomes following breast-conserving surgery or flat mastectomy scars. We specialise in onco-aesthetic partial and full breast reconstruction, offering personalised solutions that are oncologically safe. These approaches not only enhance aesthetic results but also play a key role in improving patient satisfaction and psycho-sexual well-being, helping women regain confidence and a sense of wholeness.
• Post-Axillary Surgery Issues:Lymphoedema, or swelling of the limb, is one of the most dreaded complications following any form of axillary surgery. We offer limb volume monitoring, thorough assessment, and a complete range of surgical and non-surgical solutions to both prevent and treat established lymphoedema of the upper limb.
  Lymphoedema, or limb swelling, is a common and often a most concerning complication following axillary surgery. At the Holistic Breast Centre, we provide comprehensive care that includes limb volume monitoring, thorough clinico-radiological assessments, and a full spectrum of both surgical and non-surgical solutions. Our aim is to prevent the development of lymphoedema and effectively manage any established cases of upper limb swelling, ensuring optimal outcomes and enhanced quality of life for our patients

Breast cancer is a highly heterogeneous disease, encompassing a variety of cell subtypes, each of which demands a tailored and specialized treatment approach. The treatment plan for each patient is carefully crafted to address the unique characteristics of their cancer, and may include, though not necessarily in this order:

• Surgery (Breast-conserving surgery or mastectomy)
• Immediate or delayed partial and whole breast reconstruction
• Chemotherapy, Targeted Therapies and Immunotherapy
• Radiation Therapy
• Hormonal Manipulation
• Genetic Testing
• Fertility Preservation
• Counselling

A multidisciplinary approach significantly improves the chances of successful breast cancer treatment by bringing together expertise from various medical disciplines. This collaborative model ensures holistic support and that each patient receives the most comprehensive and effective care. Research has shown that this approach not only enhances patient satisfaction but also leads to improved cancer-specific outcomes.

A personalized breast screening strategy customizes the approach to breast cancer detection, taking into account individual risk factors and breast density, rather than relying on a one-size-fits-all method. This tailored approach helps identify women at higher risk and offers screening options that are better suited to their specific needs. By focusing on early detection, it can lead to improved outcomes and a more efficient use of healthcare resources. A personalized screening plan considers various factors, including

• Age
• Family History
• Breast Density
• Lifestyle and Reproductive History
• Prior Breast Biopsy Results
• Genetic Alterations
• Previous Breast Surgery and/or Radiation
• Breast Augmentation with Silicone Prosthesis

State-of-the-art imaging techniques like 3D mammography in conjunction with AI-assisted diagnostics, breast and axilla ultrasound, and whole breast MRI help in early detection. Accurate diagnosis and appropriate follow-up care are ensured by a team of experienced surgeons, specialist breast radiologists, and expert breast pathologists.

Modern breast cancer surgeries emphasize the principle of “less is more.” Advanced surgical options include:

• Breast-Conserving Surgery (Lumpectomy): Breast conservation surgery involves removing all the tumour tissue along with a margin of healthy breast tissue all around it , while carefully preserving the shape, contour, and symmetry of both breasts. In most cases, following breast conserving surgery, radiation to the breast is required to ensure optimal outcomes. Research has shown that the cancer outcomes following breast conservation surgery are comparable to, or even better than, those achieved with more invasive mastectomies, while also maintaining a more natural and feminine appearance.
• Mastectomy: The total removal of the breast is performed only when medically necessary for oncological reasons or based on the patient’s personal preference. It does not offer any oncological advantages over breast-conserving surgery. At our centre, advanced oncoplastic breast surgical techniques enable successful breast conservation, even in cases of larger breast cancers, ensuring that patients have the option of preserving breast tissue while achieving optimal oncological outcomes.
• Breast Reconstruction:We offer both partial and full breast reconstruction options to minimize any treatment-related changes in breast shape, contour, and symmetry. These advanced techniques not only ensure long-term, aesthetically favourable outcomes but also play a crucial role in enhancing quality of life and boosting patient confidence.
• Immediate Reconstruction: Most women with breast cancer are candidates for advanced breast reconstruction techniques. Unfortunately, in India, less than 1% of women who undergo mastectomy receive immediate breast reconstruction. Today, skin- and nipple-sparing mastectomies are safely practiced, offering not only improved cosmetic results but also comparable recurrence rates and survival outcomes.
  There are two primary techniques for immediate whole breast reconstruction: one involves the use of modern, safe silicone breast implants, while the other utilizes the patient’s own fat (without muscle) in an autologous fat transplant. Both options aim to restore the natural appearance of the breast while enhancing overall emotional and physical well-being
• De-escalation of Axillary Surgery: Axillary lymph node surgery, while critical in breast cancer treatment, can lead to side effects such as changes in limb volume, lymphoedema, sensory changes, and limitations in shoulder mobility. The principle of "less is more" is especially important in axillary surgery. At our centre, we offer a range of tailored, oncologically safe alternatives to the traditional approach of removing all axillary nodes. From sentinel lymph node biopsy to advanced targeted axillary dissection techniques, we prioritise minimizing side effects while ensuring effective cancer management.

These techniques prioritize both cancer eradication and aesthetic restoration, while also maintaining function.

A dedicated Holistic Breast Centre addresses the full spectrum of breast health needs across a woman’s lifetime and offers continuing support to women beyond the completion of their active cancer treatment.

Services at our centre include:

• Lifestyle Guidance: Our approach focuses on improving and maintaining quality of life while reducing the risk of cancer recurrence. This involves evaluating each individual’s lifestyle preferences and providing personalized guidance on nutrition, physical activity, stress management, and the use of alcohol and tobacco. By making informed lifestyle choices, women can positively influence modifiable risk factors, effectively lowering their lifetime risk of a new breast cancer diagnosis and reducing the likelihood of recurrence in survivors.
• Family History Assessment: Our consultations thoroughly evaluate the family history of patients to assess the risk of developing breast or ovarian cancer, for both those affected and unaffected by a previous cancer diagnosis. Utilizing specialized risk algorithms, we identify women who may benefit from genetic testing, allowing for a more tailored approach to their care. This includes personalized breast imaging protocols and in-depth discussions on risk management and cancer prevention strategies. Additionally, this process supports shared decision-making for women already affected by cancer, empowering them to make informed choices about their treatment and care plans.
• Counselling and Support: Counselling plays a vital role in the holistic care of women with breast cancer, addressing the emotional, psychological, and social challenges that often accompany a cancer diagnosis. This support helps women navigate the physical, emotional, and social impacts of their condition, while also managing the complexities of treatment, healing, and recovery. Effective counselling is essential in enhancing quality of life, supporting mental health, and promoting overall well-being during treatment and, perhaps even more importantly, after recovery. We also recognize that family members often face similar emotional challenges and can greatly benefit from these supportive services.
• Preventive Care: Preventive care for breast cancer involves a multifaceted approach, combining lifestyle changes, regular screenings, medical interventions, and genetic testing and counselling. While not all breast cancers can be prevented, these strategies can significantly reduce risk, facilitate early detection, and improve overall outcomes.

Genetic mutations such as BRCA1, BRCA2, and PALB2 are known to significantly increase the lifetime risk of breast cancer. Genetic counselling offers personalized guidance to help individuals make informed decisions regarding their health. This process includes:

• Risk Assessment: Risk assessment for breast cancer involves evaluating an individual’s likelihood of developing the disease by considering a wide range of factors. This essential component of early detection and prevention strategies takes into account genetic predisposition, family history, pre-existing high-risk lesions such as atypias, lifestyle habits, and prior exposure to radiation. By identifying those at elevated risk, we can offer tailored surveillance, preventive measures, and timely interventions to improve outcomes.
• Surveillance Plans: Imaging strategies for breast cancer surveillance are tailored to an individual’s lifetime risk, age, and breast density. In consultation with each patient, we offer a range of options—from advanced 3D mammography enhanced with AI diagnostics to contrast-enhanced mammograms and specialised breast MRI scans. While surveillance does not prevent breast cancer or eliminate the need for treatment, it plays a critical role in early detection, which can significantly improve outcomes and help preserve overall life expectancy.
• Preventive Strategies: Risk-reduction strategies range from simple lifestyle modifications to detailed consultations about medical options aimed at lowering lifetime breast cancer risk. For individuals identified as high-risk—typically with a lifetime risk exceeding 30%—further measures may include chemoprophylaxis (preventive medication), risk-reducing breast surgeries, and immediate whole breast reconstruction. These proactive approaches are tailored to each individual’s risk profile and personal preferences, with the goal of significantly reducing the likelihood of developing breast cancer while supporting long-term health and well-being.
• Emotional Support: In many smaller centres, the emotional impact of learning about one’s lifetime risk of breast cancer is often overlooked. Knowing one's risk as a concrete percentage can lead to significant stress, anxiety, and emotional distress, which may present in various ways. That’s why it is essential to pair risk assessment with dedicated counselling and psychological support. This helps individuals process the information, cope effectively, and make informed, confident decisions about their health.

At our Comprehensive Breast Care Centre, we are committed to delivering the highest standard of care with compassion and dignity. Our team of experienced specialists harnesses the latest advancements in technology and evidence-based treatments to ensure personalized, effective, and holistic care—aimed at achieving the best possible outcomes for every patient.

Early detection saves lives. Prioritize your health. Schedule your breast screening today.