Breast Conserving surgery is a suitable option for early breast carcinoma in a conservative society of middle income country - early experiences

Introduction: Breast conserving surgery now a days are most common preferred surgery for breast cancer patients other then mastectomy . Oncoplastic Surgery can be a safer, more cost effective alternate to conventional BCS owing to its higher rate of negative surgical margins and better cosmetic results. In Asian countries, the rate of Breast conservation surgery is low and the cause are multifactorial such as availability and accessibility of investigation, infrastructure ,oncology and pathological support and surgeon’s choice. Aim is to elucidate the surgeons’ perspective while choosing between BCS and mastectomy, in women oncologicaly eligible for BCS. Methods: A retrospective study in Z.H.Sikder Women’s Medical College Hospital,a single Centre based study by reviewing patient’s medical records from August 2021 to July 2023 was conducted. Percentage of patient agreed for breast conservation surgery along with mean tumor size, type of cancer and different surgical procedures with postoperative complication was assessed. Results: A total of 199 patients were eligible for BCS but 75.87% patients showed unwillingness to go for BCS. 48 patients responses were included who underwent for BCS. The mean age of the participants was 43 years and of the 48 patients in the study, 46 had unilateral and 2 had bilateral BC. 74.37 % of patients tumor size was 1-2 cm . 5 patients received NACT; none achieved a complete clinical response. Majority of (73.9%) of tumor biology shows ER, PR positive and HER 2 negative. 36 patients diagnosed with IDC and second common cancer id ILC . Breast conservation surgery was the commonest surgery to remove the cancer and 27 patients had WLE and glandular repair. 21 patients required level II oncoplastic techniques. No major complications or local recurrences were observed. Conclusions: Implementing breast-conserving surgery as the standard of care breast cancer patients where appropriate. Breast-conserving surgery is not only safe, but also highly beneficial in terms of aesthetics, body image, and quality of life. Adoption of these techniques into practice can increase indications of BCT and requires a team approach for best success.