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Early Detection. Timely Treatment. Better Outcomes. — Expert breast cancer surgery and oncoplastic reconstruction at KG Hospital, Coimbatore.
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Understanding the Disease
Breast cancer is the most common cancer in women in India and worldwide. It arises when cells in the breast tissue grow abnormally, forming a tumour that can invade surrounding tissue and spread to other parts of the body.
The good news: breast cancer is one of the most treatable cancers when detected early. Stage 0 and Stage I breast cancer have 5-year survival rates approaching 100%. Regular screening, awareness of warning signs, and prompt medical attention are the most powerful tools we have.
Dr. Prabhakaran U performs the full range of breast cancer surgeries at KG Hospital, Coimbatore — from breast-conserving surgery (lumpectomy) with oncoplastic reconstruction to mastectomy with immediate reconstruction — tailored to each patient's tumour biology, anatomy, and personal priorities.
Early Detection Saves Lives
Most breast cancers are found by women themselves or during routine screening — not by doctors. Knowing your normal breast appearance and feel is the first step to early detection.
Any new lump in the breast or underarm (axilla) that does not go away after your next period must be evaluated promptly.
Unexplained change in the size, shape, or symmetry of one breast — particularly if recent and progressive.
Redness, dimpling, puckering, or orange-peel texture (peau d'orange) of the breast skin is a warning sign requiring urgent assessment.
New nipple inversion (turning inward), change in nipple position, or any alteration in nipple appearance must be investigated.
Any spontaneous nipple discharge — particularly if blood-stained or from a single duct — requires evaluation with ultrasound and mammography.
While most breast pain is benign, new persistent or localised breast pain — particularly combined with a lump — must be assessed.
Any non-healing wound or ulcer on the breast skin — particularly overlying a lump — needs urgent evaluation.
A new lump or swelling in the armpit (axillary lymph nodes) — even without a breast lump — can be a sign of breast cancer spread.
⚠️ Act immediately: Do not wait for your next scheduled appointment if you notice any of these signs. Same-week evaluation with clinical examination, ultrasound, and mammography should be arranged. Early diagnosis changes outcomes dramatically.
Understanding Your Diagnosis
Staging determines the extent of the cancer and guides treatment decisions. Stage is the single most important predictor of outcome.
Ductal Carcinoma In Situ — cancer cells confined to the milk ducts, not yet invasive.
Small tumour (<2 cm), no lymph node spread or only microscopic involvement.
Tumour 2–5 cm or small number of lymph nodes involved. Surgery + adjuvant treatment.
Larger tumour with significant lymph node involvement or skin/chest wall extension.
Metastatic — cancer has spread to distant organs (bone, liver, lung, brain).
Surgical Expertise
Removal of the tumour with a margin of healthy tissue — preserving the breast. Modern evidence shows that BCS with radiotherapy achieves equivalent survival to mastectomy for eligible patients. Dr. Prabhakaran offers BCS as the default option wherever oncologically safe.
Oncoplastic surgery combines cancer removal with immediate plastic surgical techniques to reshape the remaining breast — achieving superior cosmetic outcomes while maintaining complete tumour clearance. This allows wider resections without deformity. A specialised technique that requires specific training.
The sentinel node is the first lymph node to which breast cancer drains. SLNB allows us to assess lymph node status by removing only 1–3 sentinel nodes — avoiding full axillary clearance in most patients. Fewer nodes removed means lower risk of lymphoedema (arm swelling).
Removal of the axillary (armpit) lymph nodes when cancer has spread beyond the sentinel node. Performed when SLNB is positive in selected patients or when sentinel node biopsy is not appropriate.
Complete removal of the breast — recommended for larger tumours, multifocal disease, inflammatory breast cancer, BRCA gene carriers, or patient preference. Includes simple mastectomy, modified radical mastectomy, and skin-sparing mastectomy (for reconstruction).
Reconstruction of the breast at the same time as mastectomy — using tissue expanders, implants, or the patient's own tissue (flap reconstruction). Immediate reconstruction gives significantly better psychological and cosmetic outcomes than delayed reconstruction.
Chemotherapy or targeted therapy given before surgery to shrink larger tumours — allowing breast conservation surgery in patients who would otherwise require mastectomy. Also allows assessment of tumour response to treatment.
For non-palpable breast lesions found only on mammography or ultrasound — image-guided biopsy using a fine needle or vacuum-assisted device to obtain tissue for diagnosis without open surgery.
Special Focus
Oncoplastic surgery is a revolutionary approach to breast cancer surgery that integrates cancer surgery (oncology) with plastic surgical techniques (reconstruction) — performed in a single operation, by a surgeon trained in both disciplines.
Traditional lumpectomy removes the tumour but can leave the breast deformed — particularly for larger tumours or tumours in certain locations. Oncoplastic surgery solves this by immediately reshaping the remaining breast tissue after tumour removal, often achieving a better breast shape than before surgery.
Volume displacement techniques rearrange remaining breast tissue to fill the defect — suitable for medium to large breasts with adequate volume remaining after tumour removal.
Volume replacement techniques use tissue transferred from elsewhere (usually the back or side of the chest) to replace removed volume — suitable for smaller breasts where insufficient tissue remains after resection.
Important: Oncoplastic breast surgery requires specific training in both oncological and plastic surgical principles. Not all cancer surgeons offer this service. At KG Hospital, Coimbatore, Dr. Prabhakaran provides oncoplastic surgery as part of a comprehensive breast cancer service.
Women with strong family history or young-onset breast cancer may carry BRCA1 or BRCA2 gene mutations — significantly increasing lifetime breast and ovarian cancer risk. Dr. Prabhakaran advises genetic testing in appropriate patients and counsels on risk-reducing surgery options (risk-reducing mastectomy, salpingo-oophorectomy).
Who is at Risk
Being female is the biggest risk factor. Risk increases with age — most cases occur after 40. However, Indian women develop breast cancer at younger ages than Western women.
First-degree relatives with breast cancer approximately double the risk. BRCA1/BRCA2 mutations carry lifetime risks of 50–85%.
Previous breast cancer, DCIS, LCIS, atypical ductal hyperplasia — all increase future cancer risk.
Early first period, late menopause, no pregnancies, older age at first childbirth — prolonged oestrogen exposure increases risk.
Long-term combined HRT (oestrogen + progesterone) modestly increases breast cancer risk.
Alcohol consumption increases breast cancer risk proportionally. Obesity — especially post-menopause — increases risk through higher oestrogen levels from fat tissue.
Radiotherapy to the chest before age 30 (e.g. for lymphoma) significantly increases long-term breast cancer risk.
Breastfeeding is protective. Women who breastfeed for a total of more than 1 year have a lower risk of breast cancer.
Regular Screening Can Save Lives
All women over 20 should perform a monthly breast self-examination — 7–10 days after the start of the period (when breasts are least tender). Know what is normal for you. Report any new changes to your doctor promptly.
A clinical breast examination by a doctor should be performed every 1–3 years for women aged 20–39, and annually for women aged 40 and above.
Recommended for high-risk women (BRCA carriers, strong family history, previous chest radiation) — usually alternating with mammography every 6 months.
Comprehensive Breast Cancer Care
Before surgery (neoadjuvant — to shrink tumours) or after surgery (adjuvant — to reduce recurrence risk). Regimens vary by tumour subtype.
Trastuzumab (Herceptin) and other anti-HER2 agents for HER2-positive breast cancer — dramatically improve survival in this subtype.
Tamoxifen or aromatase inhibitors for hormone receptor-positive (ER/PR-positive) breast cancer — typically given for 5–10 years after surgery.
Radiation after BCS or mastectomy to destroy any remaining cancer cells and reduce local recurrence risk. Usually 3–6 weeks of treatment.
Pembrolizumab for triple-negative breast cancer — an aggressive subtype that does not respond to hormone therapy. Increasingly used in combination with chemotherapy.
Oncotype DX, MammaPrint — gene expression tests that help determine which patients truly benefit from chemotherapy and which can safely avoid it.
Your Breast Cancer Journey
You notice a lump, skin change, or nipple discharge. Do not wait — book an appointment within 1 week. Bring any previous mammogram or ultrasound reports.
Clinical breast examination by Dr. Prabhakaran, followed by breast ultrasound and mammogram. Most diagnoses begin here. Results usually same day or next day.
If imaging shows a suspicious lesion, a core needle biopsy or vacuum-assisted biopsy is performed under local anaesthesia to obtain tissue for diagnosis. Results in 5–7 days.
CT scan chest-abdomen-pelvis, bone scan or PET-CT, blood tests. Determines if cancer has spread beyond the breast and guides treatment planning.
Your case is reviewed at a multidisciplinary tumour board — surgical oncologist, medical oncologist, radiation oncologist, radiologist, and pathologist all contribute. Treatment is never decided by one doctor alone.
Breast conservation surgery with oncoplasty, or mastectomy with reconstruction — chosen based on tumour characteristics, your anatomy, and your preferences. Hospital stay 2–5 days depending on procedure.
Chemotherapy, radiotherapy, hormone therapy, or targeted therapy as recommended by the tumour board — to reduce recurrence risk and improve long-term survival.
Regular clinical reviews, annual mammograms, bone density monitoring if on hormone therapy. Focus on quality of life, lymphoedema management, and emotional wellbeing. Stronger Together.
Common Questions