With the burgeoning incidence of cancer all across the globe, the management of cancer patients is also witnessing rapid change. The emphasis on clinical and laboratory research has led to a scenario where oncologists all over the world are trying to make patients not only live longer but also live better.
Surgery for breast cancer patients has evolved with focus on improving cosmetic outcomes with oncoplasty and whole breast reconstruction. The availability of a wide range of oncoplasty techniques including local perforator flaps, reduction mammaplasty, free flaps and implants has changed the outcomes of breast cancer surgery from morbid to aesthetically desirable results. De-escalation of axillary surgery with sentinel node biopsy even in certain post chemotherapy cases has led to a reduction in lymphedema and arm morbidity rates. Robotic surgery is also making a steady mark especially in patients undergoing prophylactic mastectomy with immediate reconstruction.
With the advent of better diagnostic tools like 3D mammograms, MR Mammograms, vacuum assisted biopsy etc. the ability to detect non palpable cancers has shown a steady increase. It has enabled clinicians to screen patients more accurately and has aided in the workup of not only malignant but benign breast conditions as well.
Systemic therapy in breast cancer has perhaps seen the largest amount of growth with the development of newer targeted therapies, immunotherapy and tools like next generation sequencing. Although the newer agents have changed the outcomes of a number of patients with metastatic disease, they are gradually being tested in neoadjuvant and adjuvant areas as well and perhaps in a few years, entire treatment plans would be designed by molecular tumour boards.
Embracing newer radiation techniques such as accelerated partial breast irradiation (APBI) and deep inspiration breath hold (DIBH) has allowed radiation oncologists to deliver best oncological outcomes with minimal side effects.
This is just a glimpse of the fast growing world of oncology and it is indeed an exciting time to work in this field. Team work and organ specific approach are the two main pillars supporting our work at Max Institute of Cancer Care as we strive daily in our fight with cancer and aim to consolidate our position as one of the premier oncology centres in Asia.