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Dr. Jayanti Thumsi is a trailblazer in the field of breast cancer surgery, known for her expertise and compassion. As India’s 1st lady surgeon trained in Robotic breast surgery, she has revolutionized the field with her commitment to excellence and patient-centered care, particularly through her pioneering work in performing Robotic Nipple Sparing Mastectomy (RNSM) in Karnataka.
What is Robotic Nipple Sparing Mastectomy (RNSM)?
RNSM is a minimally invasive surgical procedure that removes breast tissue while preserving the healthy nipple, areola, and skin. This approach aims to improve cosmetic outcomes and reduce the risk of nipple necrosis, setting a new benchmark in breast cancer surgery.
Why Robotic Nipple Sparing Mastectomy (RNSM)?
Historically mastectomy procedures entailed the complete removal of breast tissue, often resulting in significant physical and psychological impacts on patients. Recognizing the need for a more holistic approach, RNSM was introduced to preserve the natural appearance of the breast, including the nipple.
The Procedure
- Infra Axillary Incision: An incision is made under the armpit to facilitate sentinel lymph node or Axillary lymph node dissection.
- Insertion of Robotic Arm: The breast tissues are separated from the skin, and a robotic arm is inserted through the incision.
- Breast Tissue Dissection: Using the da Vinci SP Robotic Surgical System, Robotic Surgical System, the breast tissue is separated from the chest muscle.
- Tissue Removal: The breast tissue is then removed through the incision.
- Reconstruction: The breast is reconstructed, avoiding nerve damage that can result in desensitization.
Clinical Outcomes, Benefits, and Advantages
- Lower Rate of Complications: RNSM has been associated with a lower incidence of post-operative complications and nipple necrosis compared to traditional mastectomy procedures.
- Locoregional Recurrence-Free Survival:Patients undergoing RNSM have shown favorable locoregional recurrence-free survival rates, indicating the effectiveness of the procedure in controlling cancer recurrence.
- Reduced Intraoperative Blood Loss: RNSM is linked to a significant reduction in intraoperative blood loss, minimizing the need for blood transfusions and associated risks.
- Minimally Invasive Nature: RNSM’s minimally invasive approach results in smaller incisions (3-5 cm) and minimal scarring, enhancing cosmetic results and patient satisfaction.
- Comparable 5-Year Disease-Free Survival: The 5-year disease-free survival rate following RNSM is comparable to that of traditional open mastectomy, highlighting its efficacy in treating breast cancer.
- Positive Influence on Body Image: Preservation of the nipple-areolar complex through RNSM positively impacts body image and aids in psychological adjustment, addressing emotional aspects of recovery.
- Robotic Technology Advantages: The use of robotic technology in RNSM allows for meticulous dissection and tissue preservation, minimizing trauma and optimizing aesthetic outcomes.
- Shorter Hospital Stay: Patients undergoing RNSM typically experience shorter hospital stays compared to traditional mastectomy, facilitating faster recovery and early return to normal activities.
Here are few cases, demonstrate the success of RNSM in different age groups and conditions, highlighting its effectiveness in providing favorable outcomes and preserving patient quality of life.
Case 1: 28-year-old Woman
– Background: Employed in the IT sector, married for a year with no children.
-Initial Diagnosis: Lump in the left breast, initially diagnosed as a fibroadenoma.
-Further Diagnosis:Revealed ductal carcinoma in situ (DCIS), a precancerous breast disease.
-Treatment: Timely intervention with RNSM and implant reconstruction.
-Outcome: Avoided the need for chemotherapy and radiation therapy, resulting in a good cosmetic outcome.
Case 2: 43-year-old Woman
-Background: Working in an MNC, newly diagnosed with breast cancer.
-Diagnosis: Detected through FAMP(Fastest and Most Precise) Breast Cancer screening services (24 hours for diagnosis) at Apollo Hospital.
-Condition:Multiple lumps in all the quadrants of her breast.
-Treatment: RNSM performed with reverse mapping using robotic assistance for axillary clearance.
-Outcome: Doing well, pain-free and recovering
Case 3: 52-year-old Woman
-Background: Diagnosed with aggressive triple-negative breast cancer (TNBC).
-Presentation: One large lump and additional multiple tiny lumps in the entire breast (Multicentric disease).
-Treatment:Immunotherapy and Chemotherapy (NACT) X 8 cycles followed by RNSM with implant reconstruction.
-Outcome: Wound has healed well, patient is pain-free and satisfied with the surgical outcome, further scheduled for radiation therapy
outcome, further scheduled for radiation therapy
In conclusion, Robotic Nipple Sparing Mastectomy is a groundbreaking procedure that offers patients a chance at comprehensive healing with minimal physical and emotional scars. Dr. Jayanti Thumsi’s pioneering work exemplifies the commitment of healthcare professionals to continuously push boundaries, ensuring that every patient receives the best care possible.
Additional read: –
Fastest and Most Precises Breast Cancer Screening
