Robotic surgery offers hope to 2 women with advanced breast cancer

New Delhi: Two women with advanced breast cancer have successfully undergone robotic mastectomy, a unique procedure to preserve full breast and nipple sensation, said doctors here on Thursday.

The two cases -- a 27-year-old woman and another in her late 50s -- are one of the first cases in India where the robot-assisted functional breast preservation surgery (RAFBPS), which is a minimally invasive surgical technique performed using Da-Vinci Robot, has been done, said doctors at CK Birla Hospital, Delhi.

“One of the first in India where robot-assisted functional breast preservation surgery with Latissimus flap reconstruction has been conducted, this surgery offers more precise visualisation and smaller incisions,” said Dr Mandeep Singh Malhotra, Director of Surgical Oncology at the hospital.

"In these types of surgeries, a robot is used to enter the breast from the armpit to remove tissue and reconstruct the breast, preserving the breast skin as well as nipple, if possible, thus preserving the breast sensation," he added.

The 27-year-old woman came to the hospital with a breast lump, a few months after her baby was born. Due to her denial and masking of symptoms associated with changes in the breast during pregnancy and lactation, the cancer progressed to an advanced stage.

The woman was administered neo-adjuvant chemotherapy, which allows for optimal removal of residual tumour, along with targeted medicine and she responded exceptionally well to this systemic treatment.

The patient underwent RAFBPS without complications and experienced a swift recovery.

The woman in her late 50s was diagnosed with early-stage breast cancer but the cancer was multifocal, that is, she had three breast lumps. RAFBPS utilised robotic arms to remove the cancerous tissue and simultaneously harvest tissue from the back to reconstruct the breast; with a single lateral mammary incision.

“This procedure provides remarkably natural-looking outcomes while preserving full breast sensation. By retaining the original breast skin and nipple, the breast sensation remains intact, hence the breast looks as well as feels like the original breast and the robot makes this surgery simpler with better aesthetics,” Dr Mandeep said.

“Loss of breast is morbid for women of any age and should be equally evaluated for the option of breast preservation," he said.

Further, the doctor recommended the procedure to women with early-stage breast cancer, "without the involvement of overlying skin/nipple and those women who have responded very well to neo-adjuvant chemotherapy/systemic therapy."