Mumbai's Dr Garvit Chitkara, a leading Senior Consultant in breast surgical oncology and oncoplastic, shares his views on life after breast cancer in young women. 

Dr Garvit Chitkara states that the rise in young women with breast cancer in India may indicate a higher number of cases or that more people are seeking treatment. These young women detected with breast cancer could either be working and/or looking after homes making it difficult to cope with their responsibilities and illness. 

Breast Cancer treatment affects the health and well-being of the young women diagnosed with it. Also, they are equally disturbed about the appearance of their breasts, hair, skin and scars.

He elaborates on some of the key issues women face after breast cancer treatment.

Fertility preservation 

Despite improved survival rates due to advanced cancer treatments, women with a cancer history can experience fertility issues. Therefore, the oncologist and patient should discuss fertility preservation before beginning the treatment.  

Oncofertility is the latest branch of oncology and fertility medicine that focuses on preserving or restoring the reproductive health of young cancer patients.

Sexuality 

Treatment for young women with breast cancer is particularly complicated because they are likely to experience amenorrhea, vasomotor symptoms, infertility issues, decreased bone density, early menopause, sexual dysfunction, and cognitive disorders because of aggressive treatments and medications. As a result, these women experience a decrease in their sexual well-being and libido. Additionally, they suffer lower self-esteem, anxiety, a poorer body image and a lack of social support from their partner. 

To resolve these issues, women can seek suitable medical treatment, counselling, and emotional and physical support to regain their sexual health along with quality support from their partners. 

Physical Appearance and Cosmesis 

The treatment protocol for breast cancer includes surgery, chemotherapy, hormone/ endocrine therapy, targeted therapy, and radiation therapy.  

Surgical treatment of young women with breast cancer includes breast conservation surgery and mastectomy. The focus of the cancer specialist would be to remove the tumor and conserve/remove the rest of the breast. 

Dr Garvit specializes in breast preservation surgery, especially oncoplastic breast surgery. In oncoplastic breast surgery, he will attempt to remove the entire tumor with margins and maintain the shape and symmetry of the breast. He also performs volume displacement surgeries, volume replacement surgeries, contralateral (opposite) breast reduction, and bilateral breast reduction surgery.

In case of radiation, the patient develops a red rash in the affected area, which has a sunburnt look. The breast tissue also feels swollen or firm. The patient has to take care of their skin using gentle skin products, sunscreen, and so on. If required, they can approach a dermatologist. 

The patient can also experience lymphedema in the arms, breasts and hands, for which a unique compression sleeve and/or a set of exercises are recommended.

Genetic Screening

Dr Garvit Chitkara emphasizes that patients associated with familial cancer syndromes, especially those with a family history of BRCA1/2 gene mutations or whose family members have cancer, should go ahead with genetic testing or counseling. 

Also, single-site mutation testing in families is essential if the mutation is known, while next-generation sequencing coupled with multiplex ligation probe amplification for unknown mutilation. Upon these results, the oncologists will recommend adopting suitable surgical and lifestyle modifications to reduce breast cancer risk and manage the use of poly (ADP-ribose) polymerase inhibitors, especially in young women.

The patient experiences the after-effects of the treatment the most. Therefore, the onus of offering reasonable assistance and guidance in managing the patient post-treatment lies on the team of treating oncologists and their support system. 

About Dr Garvit Chitkara

Dr Garvit Chitkara has 15+ years of experience as a doctor and has been practicing Breast Surgical oncology for a decade. He is a Senior Consultant at Nanavati Max Institute of Cancer Care in Nanavati Max Super Specialty Hospital, Mumbai. He has received his training in breast oncology at the Tata Memorial Hospital and has worked as a Consultant Breast surgeon. He focuses on providing comprehensive breast care to all patients in a safe, reassuringly pleasant and comfortable environment. He is a patient-friendly cancer surgeon proficient in English, Hindi and Punjabi. 

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