How Urgent is Breast Cancer Surgery? Dr Garvit Chitkara clarifies this most asked question

Most patients are bewildered and wonder what is next after a breast cancer diagnosis. And as they accept the diagnosis, they ask their oncologist ‘How urgent is breast cancer surgery?

Dr Garvit Chitkara, a leading breast cancer doctor in Mumbai, gives an exhaustive overview of this most asked query. Dr Garvit Chitkara is committed to treating breast cancer through in-depth clinical diagnosis and personalized care. Currently, he is a Senior Consultant in Breast Surgical Oncology at Nanavati Max Super Specialty Hospital and regularly deals with breast cancer patients and their queries.

Most breast cancer patients want to know more about the treatment protocols and the possibility of totally recovering from cancer. They also wish to know for how long they can delay their treatment, which could be a combination of surgery, chemotherapy, radiation therapy, hormone therapy or targeted therapy. These apprehensions are best sorted out by having an in-depth consultation with the oncologist and his team while the patient has to take a carefully planned decision based on following factors: Facilities and Medical Equipment at the hospital and cost of surgery.

No cancer is the same; hence, treatment varies from patient to patient. After an evidence-based diagnosis, the doctor can state the stage of the breast cancer and the path forward. The doctor may reassure the patient to take time to seek treatment (unless it is stage 4 cancer or the presence of a tumor theatning a vital body part).

Various studies reveal that survival rates are directly linked with the delay in the commencement of cancer treatment. Therefore, urgent initiation of breast cancer directed therapy are recommended to improve the patient’s survival.

Any delays in surgery could significantly lower the survival rate, especially of more than six months can lead to death. Also, merely observing the breast lumps and not seeking diagnosis and treatment can be disastrous. Hence, it is essential to understand its cause.

The patient’s age is yet another critical determining factor in the need for urgent breast cancer surgery Studies reveal that delay in surgery of stage I and II breast cancer patients lowers their overall survival rate in the age group of 65 and above. Therefore, it is recommended that patients in this age group should opt for early surgery, i.e., within 30 days of diagnosis.

Younger women aged 15 to 39 should proceed with the recommended surgery within six weeks of diagnosis. These limits should not be used as excuse for procrastinating the delays in starting treatment are due logistic reasons. Once diagnoised it should be treated on an urgent basis. Cancer is rarely an emergency but is an urgency.

The tumor type and its growth rate is yet another factor that needs attention. Various tumors grow at their own pace, and delay in surgery implies their further growth, leading to more complications. For example, Triples Negative tumors or HER2 positive tumors grow much faster, which could also mean progression to the next stage of cancer. Hence, patients detected with these tumors must undergo urgent breast cancer treatment.

Nevertheless, the logical reasons for scheduling the treatment later include time taken to understand the diagnosis, seeking a second opinion and searching for the best onco-surgeon for treatment.

The patient needs time to understand the reason and type of oncosurgery recommended, especially mastectomy or lumpectomy, its outcome and the need for further surgeries relating to breast or nipple reconstruction surgery.

Chemotherapy, if recommended, causes infertility, so patients should seek a fertility consultation if they wish to preserve their fertility to become a parent later. Also, quitting smoking before surgery greatly reduces the risk of complications. Blood pressure, sugar levels, and other vital parameters must be stable.

Preparations for assistance during the post-recovery period or childcare arrangement during the hospitalization period or after the surgery are likely to cause a delay in scheduling the surgery.

Dr Garvit Chitkara states that advancement in breast cancer treatment, including surgery, has made it possible to increase the gap between the diagnosis and the surgery in the past decades. However, there is no specific consensus regarding the length of the waiting period. Still, playing safe and seeking the recommended and urgent breast cancer surgery is preferred to avoid further complications.