Dr. Mandar Nadkarni

AREA(S) OF INTEREST:

Breast Oncology & G I Oncology

TREATMENTS/PROCEDURES OFFERED:

10 years at TMH where he held the position of consultant breast cancer surgeon and professor of surgical oncology with over 6000 surgeries for breast cancer done varying from breast conservation to modified radical mastectomy to oncoplastic surgeries like reduction mastopexy, symmetrisation procedures, and therapeutic mammaplasty. His expertise includes conservative surgery for axillary lymph nodes like sentinel node biopsy using radiocolloid and isosulfan blue dye (for early breast cancers) and 4 node axillary sampling (anatomic) that Tata Memorial Hospital pioneered for the country.

KDAH Experience

In 2009 he moved to Kokilaben Hospital and till date has performed over 2500 breast surgeries. At Kokilaben Hospital he has an extensive experience in the following

Oncoplastic breast conservation - roundblock, hemi roundblock, single incision therapeutic mammaplasties and E3 grissoti flap oncoplastic surgery for central quadrant tumours.

Skin sparing and nipple areola complex preserving Mastectomies (where the disease doesn't allow breast conservation) with whole breast reconstructions using LD flaps with or without implants/expanders and free Deep Inferior Epigastric Perforator Artery flaps (best suited for Indian women)

Bilateral prophylactic mastectomies with whole breast reconstructions in BRCA 1 and 2 positive patients.

Practice of breast conservation surgery with intraoperative radiation implants (HDR Brachytherapy) that allows completion of RT (accelerated partial breast irradiation) in a week

Sentinel node biopsy using the radioactive isotope and blue dye techniques to avoid unnecessary surgery of the axillary lymph nodes in patients with no involvement of the axillary lymph nodes. This prevents lymphedema in a vast majority of patients.

Microdochectomy/ Hadfields procedures that are diagnostic/therapeutic procedures in the management of patients with blood stained nipple discharge. Cosmetic approaches to treating benign lumps of the breast.

Academics/Research/Awards

Visiting observership to Centre Oscar Lambret where he trained himself in oncoplastic surgery and implant reconstructions

Invited faculty for the Breast Health Global Initiative (BHGI is run by the Fred Hutchinson Research Centre, Washington) as an invited representative from India to brainstorm and formulate guidelines for breast cancer management in the developing world.

World Health Organisation panel - In 2007 he coordinated the Indian panel for development of guidelines for treatment of breast cancer in India depending upon different levels of available infrastructure at different oncology centres across the country.

Over 21 publications

Landmark publications

• Breast conservation surgery without pre-operative mammography–A definite feasibility (published in Breast 2006)
  - The original paper attracted an editorial by Dr Benjamin Anderson - The results is the paper were included as a guideline to increase breast conservation in developing countries worldwide (in Cancer 2008 and World Journal of Surgery 2010)
• Single-Injection Depot Progesterone Before Surgery and Survival in Women With Operable Breast Cancer: A Randomized Controlled Trial
  - A simple inexpensive intervention in selected patients to reduce risks of recurrence after breast cancer treatment.
• Influence of surgical technique on axillary seroma formation: a randomized study. ANZ Journal of surgery 2007
  - Original research paper to reduce the incidence of postoperative seroma formation

Conferences

• Organisation of the Tata Memorial Hospital-Women's Cancer Initiative conference on breast cancer
• Coordination and Organization of the World Health Organization panel for development of treatment guidelines for early and advanced breast cancer in India
• Invited for surgical demonstration including
• National Surgical Conferences- Oncosurg at Tata Memorial
• Surgical faculty for the onco plastic masterclass at Pune in 2015
• NorthEast chapter of ASI conference on common cancers
• Regional surgical conferences - MASICON conferences (Asso. of surgeons, Maharashtra Chapter)