Two women undergo robot-assisted Breast Preservation Surgery at CK Birla Hospital

New Delhi: In a landmark medical advancement, CK Birla Hospital®, Delhi has successfully treated two women suffering from complex and advanced breast cancer with the help of robotic-assisted breast preservation surgery. This is one of the first in India case where this unique technique has been used to preserve full breasts and nipple sensation. The team of doctors led by Dr. Mandeep Singh Malhotra, Director of Surgical Oncology at CK Birla Hospital®, Delhi performed robot-assisted functional breast preservation surgery (RAFBPS), which is a minimally invasive surgical technique performed using Da-Vinci Robot. 

A 27-year-old woman was presented at 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 with Neo Adjuvant Chemotherapy, which allows for optimal removal of residual tumor, along with targeted medicine and she responded exceptionally well to this systemic treatment. The patient underwent RAFBPS without complications and experienced a swift recovery. Despite her initial fear of losing her breasts, RAFBPS not only preserved her breasts, but also provided her with functional, sensate, and similar breasts like her original ones. 

In another case, a woman in her late 50s was diagnosed with early-stage of breast cancer but the cancer was multifocal i.e. she had 3 breast lumps. The patient was in a lot of distress due to the expected loss of breasts and the morbidity it would cause. Identified as a candidate for immediate surgical intervention, she underwent RAFBPS. This surgical procedure utilized robotic arms to remove the cancerous tissue and simultaneously harvesting tissue from the back to reconstruct the breast; with a single lateral mammary incision. Following the successful surgery, the woman recovered well and now enjoys a healthy and fulfilling life.

Dr Mandeep Singh Malhotra, Director of Surgical Oncology at CK Birla Hospital®, Delhi, said, “One of the first in India, where Robot-assisted functional breast preservation surgery with Latissimus flap reconstruction has been conducted at our hospital. This surgery offers more precise visualization and smaller incisions. In these types of surgeries, 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. 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. Loss of breast is morbid for women of any age and should be equally evaluated for the option of breast preservation. This procedure is recommended for women having early-stage breast cancer without involvement of overlying skin/nipple and those women who have responded very well to Neo Adjuvant Chemotherapy/ Systemic Therapy.”

Breast cancer is now the most common cancer affecting women in India. It constitutes 14% of female cancers, posing a significant challenge. For every two women diagnosed, one sadly succumbs to the disease. In 2020, 178,361 new cases were reported, with urban women facing a higher risk (1 in 22) than rural women (1 in 60). While cancer-specific mortality (death rate) of ovarian cancer is more than breast cancer, the overall mortality of breast cancer is higher.