From Diagnosis to recovery: The Breast Centre Pathway & Advances in Oncoplastic Breast Surgery in Bangladesh
Authors: Dr Ali Nafisa
Institution: Labaid Cancer Hospital & Super Speciality Centre
Introduction
Breast cancer care is evolving in Bangladesh, with increasing emphasis on early diagnosis, breast conservation, oncoplastic surgical techniques, and patient-centred multidisciplinary management. Dedicated breast units can facilitate coordinated care from initial assessment and diagnostic investigations to definitive treatment and follow-up. To describe the clinical pathway, surgical experience, and evolving breast-conserving and oncoplastic surgical practices at a dedicated breast unit in Bangladesh.
Methods
This abstract presents clinical experience and service data reported by the Breast Centre at Apollo JMI Clinic, including diagnostic pathways, image-guided localisation of non-palpable breast lesions, breast-conserving surgery (BCS), sentinel node biopsy (SNB), and oncoplastic breast surgery. The presentation also reports experience with 747 patients with non-palpable breast lumps evaluated between December 2018 and June 2023, alongside selected cases of minimal-access breast surgery and level II oncoplastic procedures.
Results
The reported experience demonstrates the feasibility of integrating image-guided diagnosis, wire-guided and ultrasound-guided wide local excision, therapeutic mammoplasty, and immediate implant-based reconstruction into breast cancer care. Among 747 patients evaluated for non-palpable breast lumps, 512 underwent core biopsy, and 152 malignant cases were reported. In a series of 19 patients undergoing level II oncoplastic breast surgery, all patients had clear surgical margins, and satisfactory cosmetic outcomes were reported. The presentation also describes the use of BCS with SNB in clinically node-negative patients. These approaches support a shift towards less extensive surgery where clinically appropriate, while maintaining oncological principles.
Conclusion
A dedicated breast unit can strengthen the delivery of coordinated, evidence-based breast cancer care in Bangladesh. Breast-conserving surgery and sentinel node biopsy are important components of less extensive surgical management for appropriately selected patients. With increasing public awareness, earlier presentation, improved diagnostic access, and greater availability of trained breast surgeons and specialised services, the use of BCS and SNB is expected to expand further. Continued development of multidisciplinary breast units may improve access to appropriate surgical options and support better functional and cosmetic outcomes for patients.
