We offer comprehensive surgical management of breast cancer, benign breast conditions, and reconstructive surgery in a caring and supportive environment. Our approach combines clinical skill with compassion, recognising that every patient’s experience is unique.
Nipple discharge is another common problem women are confronted by and thankfully most cases of discharge are caused by benign conditions such as intraductal papilloma (benign growth) or Duct ectasia ( widening of a milk duct). Dr Kowsi will take a through history and risk assessment and will advise you if you need further investigations and/or surgery to identify the cause. If surgery is required then Dr Kowsi will guide you through the options.
Microdochectomy is a surgical procedure to remove a single milk duct from which the discharge is happening. The procedure is used to both diagnose and treat the cause of persistent nipple discharge.
Central duct excision is a surgical procedure to remove all the major milk ducts located behind the nipple surface which is performed when there is multiple ducts discharging or recurrent periductal mastitis.
Dr Kowsi will take a through history including all relevant family history and risk factors for Breast cancer and then will use appropriate Breast cancer risk calculators to quantify individualized Breast cancer risk. Based on this risk assessment she will recommend personalized screening and discuss with you the various risk reducing strategies including surgery if appropriate.
From the very beginning, you'll be supported by a dedicated team who will guide you with care, clarity, and compassion.
Your journey usually begins with meeting Dr Kowsi. She will take the time to explain your diagnosis in a way that’s easy to understand and answer any questions you may have. You’ll work together to create a treatment plan that is tailored to your specific type of breast cancer taking into consideration of your individual needs, preferences, and circumstances.
Your care is managed by a team of experienced professionals who work closely together with Dr Kowsi. She will coordinate this team which consists of Medical Oncologists, Radiation Oncologist, and a breast care nurse.
Breast cancer is not a single disease and there are various treatment options and sequences of treatment based on the type of breast cancer you have. Dr Kowsi will guide you through all these options and the treatment can involve combination of Surgery, radiation therapy, chemotherapy and hormone ( Endocrine) Therapy. Every patient with Breast cancer is discussed in a Multidisciplinary Breast cancer meeting at the Wesley Hospital or the St. Vincent’s Northside Hospital by Dr Kowsi. She will then convey the teams recommendation to you so that you feel well informed of the options and make informed decision and then she will coordinate the treatment accordingly for you.
You will have access to ongoing support throughout your treatment. Breast care nurses are often a key point of contact, providing guidance, practical help, and emotional support.
After your surgical treatment is complete, Dr Kowsi will continue to monitor you on a yearly basis with clinical review and radiological surveillance program to ensure long-term wellbeing and cancer free survival.
The most suitable surgical approach depends on your individual circumstances. Dr Kowsi will discuss every option in detail so you can make a fully informed decision.
Breast Conservation Surgery
Also called lumpectomy, wide local excision (WLEx), or partial mastectomy. This involves removing the breast cancer with a rim of healthy breast tissue around it. When the tumour size is relatively small compared to the size of the breast, conservation surgery is possible and Dr Kowsi will discuss this in detail.
Oncoplastic Breast Surgery
Every breast conservation surgery is performed with careful consideration of breast type, shape, and tumour location to choose the best surgical scar placement and remodelling of the breast. Sometimes local flaps — using adjacent fatty tissue from under or beside the breast — are used to fill and reshape. Dr Kowsi will take you through all options available so you are well informed to decide.
Mastectomy
Dr Kowsi understands that a mastectomy can be emotionally overwhelming and will go through your indications carefully and with empathy.
Common reasons include:
Flat closure
Mastectomy without reconstruction — sometimes called “flat closure” — may be the right choice for some women. Dr Kowsi will provide full information on this surgery and the recovery process. Some women may wish to consider reconstruction at a later time and prefer to preserve skin that could be used for future reconstruction.
For many women, breast reconstruction is an important part of their recovery. Choosing whether to have reconstruction is a very personal decision. There is no "right" choice — only what feels right for you.
“Dr Murugappan will guide you through every consideration and support you in making a decision that feels right.”
Uses a breast implant to recreate the breast shape. May be done in one or two stages using a tissue expander and silicone implant.
Uses tissue from another part of your body — commonly the abdomen, back, or thighs. Dr Kowsi will refer you to excellent plastic surgeons to discuss further.
This is a significant decision and it's important to take the time you need. Dr Murugappan will guide you through all considerations, answer your questions, and support you every step of the way.
Dr Kowsi will advise which axillary surgery is indicated for your situation and will clearly explain the risks and recovery for each procedure.
A minimally invasive surgical procedure used to find out whether breast cancer has spread to the lymph nodes. The sentinel lymph node is the very first lymph node — or group of nodes — that drains fluid from the area where your cancer is located, usually found in your armpit (axilla).
If cancer cells were going to spread from your breast, the sentinel lymph node would be the first place they would travel to. By removing and examining this node, your surgeon can determine whether the cancer has spread — without removing all of the lymph nodes in your armpit.
Also called axillary lymph node dissection — an operation to remove a group of lymph nodes from your armpit (axilla). This surgery is performed when multiple lymph nodes are involved with cancer, to ensure all affected nodes are removed.
Dr Kowsi will advise you which of these axillary surgeries is indicated and will clearly explain the risks and recovery for each procedure so you feel confident and fully prepared before proceeding.
Every patient's situation is unique. Dr Kowsi takes the time to understand your circumstances and tailor a treatment plan to help you make confident decisions and support you through your journey.
