Phyllodes Surgery With Robot-Assisted Technology
Background
A 36-year-old woman with a 6 cm lump in her breast presented at the CK Birla Hospital Gurgoan. A biopsy revealed that it was a phyllodes tumour. Unlike breast cancer that starts in the breast ducts, phyllodes tumours originate from the connective tissue in the breast. This type of tumour is classified as a sarcoma, differing from the more common breast carcinoma.
Investigation & Analysis
Upon careful examination and subsequent investigative tests, it was confirmed to be a sarcoma. The treatment for a phyllodes tumour involves surgical excision with clear margins, meaning the tumour is removed along with some healthy tissue around it.
The patient, being young, was very concerned about losing her breast and how it would look afterward. This psychological concern is common among patients who fear the disfigurement of their breast. During the examination, it was found that the tumour was in the upper part of the breast and extended to the nipple, but the overlying breast skin and nipple were not involved in the disease.
Treatment & Management
Dr Mandeep S. Malhotra and his team at the CK Birla Hospital, Gurgaon, performed a robot-assisted functional breast preservation surgery in the following steps to completely eliminate the tumour:
A circumareolar incision (a small cut around the areola) was made Robotic arms were used to reach the upper part of the breast and mobilize the tissue, including the tumour.
The tumour was then removed with ample margin space, ensuring enough healthy tissue around it. Latissimus tissue from the back was harvested using the precision of robotic arms. The tissue from the back was moved with the robot, without making any cuts in the back, to fill the space where the tumour was removed.
Post Operative Care
We supported the patient with subsequent dressing and precautionary measures post-surgery, helping her resume her quality of life with a speedy recovery. Based on the response from her follow-up visits, the patient is very satisfied and happy to have retained her aesthetic feminine form With robotic surgery, we can perform fine precision-based surgery on delicate malignant tumours that are dangerous unless completely removed. Upon recovery, the patient’s breast is similar to its original state with the same functionality and sensation.
