Apollo Proton Cancer Centre Performs Rare High-Risk Breast Cancer Surgery on Patient with Severe Pulmonary Hypertension !

 

Apollo Proton Cancer Centre Performs Rare High-Risk Breast Cancer Surgery on Patient with Severe Pulmonary Hypertension

Chennai, June 29, 2026: In a remarkable demonstration of multidisciplinary coordination and advanced surgical planning, a high-risk breast cancer surgery was successfully performed at Apollo Proton Cancer Centre, Chennai, by Breast Surgical Oncologist, Dr. Manjula Rao, and her team, on a young woman with severe pulmonary arterial hypertension, a condition that significantly increases the risk of anaesthesia and surgery.

The patient, who was a known case of Systemic Lupus Erythematosus, had previously begun chemotherapy elsewhere but experienced a life-threatening collapse following her first cycle of treatment. Upon referral to APCC, she was found to have pulmonary arterial pressures approaching 140 mmHg (normal value: less than 20 mmHg), placing her at extreme perioperative risk. Additionally, her platelet counts continued to decline even 1.5 months after completion of chemotherapy, further complicating her cancer treatment pathway and placing her at significant risk of becoming unfit for curative surgery.

However, the multidisciplinary team led by Dr. Manjula Rao remained committed to pursuing a curative treatment strategy, recognizing that the patient was under 40 years of age and had early-stage, potentially curable breast cancer.

The surgical team assembled a multidisciplinary team comprising specialists in anaesthesia, rheumatology, hematology, and cardiology, who worked collaboratively to stabilize her pulmonary pressures, improve her blood counts, and optimize her overall medical condition.

Through meticulous monitoring and coordinated medical management, the team was able to safely perform the breast cancer surgery, thereby enabling treatment with curative intent and significantly improving her prognosis.

Given the high anaesthetic risk associated with general anaesthesia in patients with severe pulmonary hypertension, the surgical team devised a carefully structured plan. The procedure was conducted under a high thoracic epidural block without sedation or muscle relaxants, allowing the surgery to be completed safely while minimising cardiopulmonary strain.

Despite the significant challenges, the surgery was completed successfully within a carefully optimised time frame. The patient recovered well and was discharged home within 24 hours, fully mobile and stable. Today, nearly six months after completion of treatment, the patient remains disease-free, is enjoying a good quality of life, and has returned to her family and daily activities.

"High-risk cancer surgery is never about a single individual - it is about meticulous preparation, transparent patient counselling, multidisciplinary collaboration, and precision medicine. This case demonstrates that with careful planning and coordinated expertise, even patients with extremely high-risk medical profiles can safely undergo potentially curative cancer treatment," said Dr. Manjula Rao, Consultant - Breast Oncoplastic Surgery, Apollo Proton Cancer Centre.

Severe pulmonary hypertension remains one of the most formidable risk factors in perioperative medicine, often deterring elective surgery due to the potential for cardiovascular collapse under anaesthesia. Cases such as this highlight the importance of individualised surgical planning and multidisciplinary cancer care in tertiary centres equipped to handle complex comorbidities.

This case underscores the evolving capabilities of advanced breast cancer management in India, where high-risk patients can now access comprehensive, evidence-based, and carefully coordinated treatment strategies.