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What is A female presents with ductal ca in situ of breast with diffuse microcalcifications on mammography. She also gives family history of breast ca. What is best possible management and explain in detail?
.* Total (simple) mastectomy: Along with the tumour, entire breast, areola, nipple, skin over the breast, including axillary tail are removed. There is no axillary dissection. Often the patient is subjected to radiotherapy later (External) to axilla. * Conservative breast surgeries: Tumour is removed with a rim of 1 cm of normal tissue. It may be a. Wide excision. b. Quadrantectomy as pa of therapy -- QUA (VERONESI): Entire segment of the involved breast is removed along with axillary dissection (done through a separate incision in the axilla, level I and II removal) and radiotherapy. There is a higher rate of local recurrence after conservative QUA therapy especially in younger patient and in high grade tumours. ref:SRB&;s manual of surgery,ed 3,pg no 484