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Breast Cancer

     
     

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Breast cancer is the most common cancer in women throughout the world. Breast cancer can also occur in men but a vast majority of breast cancer cases occur in women. Breast cancer accounts for 16% of all cancers in women. According to World Health Organisation (WHO), it is estimated that 519000 women died in 2004 due to breast cancer, and although breast cancer is thought to be a disease of the developed world, a staggering majority (69%) of all breast cancer deaths occurs in developing countries.Breast cancer rates are much higher in developed nations compared to developing ones. One of the factors contributing to such a scenario is the difference in the life-expectancy among the females in developed nations when compared to developing ones. Females in the developed nations have much higher life expectancy than the females in developing nations and hence the chances of developing Breast Cancerincreases among the females from developed nationsas they get older. The different lifestyles and eating habits of females in developed, developing and poor countries might also be contributory factors.

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What is Breast Cancer?

Breast cancer is a kind of cancer that develops when breast cells starts multiplying in an uncontrolled manner to form a mass called as tumour. The tumour may be cancerous (malignant) or non-cancerous (benign). The cancerous tumour keeps growing as the cells multiply and may start spreading to other parts of the body gradually.

Breast cancer is a cancer that starts in the tissues of the breast. There are two major types of breast cancer, the Ductal carcinoma and Lobular carcinoma.

Most of the breast cancers are Ductal carcinoma. A Ductal carcinoma is a type of breast cancer that starts in the tubes (called ducts) that move milk from the breast to the nipple.

Lobular carcinoma is a type of breast cancer that starts in the parts of the breast, called lobules that produce milk.

In some rare cases, breast cancer can start in other areas of the breast also.

Further ,Breast cancer may be invasive or non-invasive. In case of Invasive Breast cancer, the cancer spreads from the place of origin (milk duct or lobule) to other tissues in the breast. Whereas, in case of a non-invasive breast cancer, the cancer has not yet spread to other breast tissues.

What are the Breast Cancer risk factors?

The causes of breast cancer are not yet fully known although a number of risk factors have been identified. Some of the major risk factors associated with breast cancer are as follows :

  • Age and gender - As you grow older, our risk of developing breast cancer increases .Most advanced breast cancer cases are found in women over age 50. This is the reason why women living in countries which have higher life expectancy have higher chances of developing breast cancer. Even though breast cancer may develop in men also but women are 100 times more likely to get breast cancer than men.

  • Family history of breast cancer - You may also have a higher risk for breast cancer if you have a close relative who has had breast, uterine, ovarian, or colon cancer. It is found that about 20 - 30% of women with breast cancer, have a family history of the disease. Hence women with family history of cancer are told by doctors to undergo breast cancer screening or check-up.

  • Genes - Some people have the defective genes that can make them more likely to develop breast cancer than other. The most common gene defects are found in the BRCA1 and BRCA2 genes. These genes normally produce proteins that protect you from cancer. This defective gene might be passed on from any of the parents to their children. If this happens then the child gets that defective gene and as it growsolder, his/her chances of developing breast cancer increases. Women with one of these defects have up to a chance of as high as 70% to 80% of getting breast cancer sometime during their life.

  • Menstrual cycle -In some cases it is found that women who got their periods early (before age 12) or went through menopause late (after age 55) have an increased risk for breast cancer.

  • Alcohol use -Drinking too much of alcohol and/or smoking leads to several health issues. In some cases it is seen that drinking more than 1 - 2 glasses of alcohol a day might increase the risk of developing breast cancer.

  • Childbirth - Women who have never had children or who had them only after age 30 have an increased risk for breast cancer. Being pregnant more than once or becoming pregnant at an early age reduces your risk of breast cancer.

  • Obesity - Some studies suggestthat obesity has been identified as a significant risk factor for many cancers and, after tobacco use, may be the single greatest modifiable cancer risk factor. But the link between obesity and breast cancer is still debated.

  • Hormone replacement therapy (HRT) -Women who have received hormone replacement therapy with estrogen for several years or more have a higher risk for breast cancer.

  • Radiation -Some studies suggest that if a person has received radiation therapy as a child or young adult to treat cancer of the chest area then he/she have a much higher risk for developing breast cancer.

What are the Symptoms of Breast Cancer?

It is very important to know the symptoms of Breast Cancer. Usually, in earlier stages the Breast Cancer does not cause symptoms. This is why regular breast exams are important. As the cancer starts growing, the symptoms may start appearing. Some of the common symptoms of breast cancer are as follows.

  • Lump in the breast and armpit that is hard

  • Change in the size, shape, or feel of the breast or nipple

  • Fluid coming from the nipple which may look like pus

  • Change in the colour of the nipple - redness, dimpling, or puckering that looks like the skin of an orange

  • Breast pain or discomfort

  • Skin ulcers

  • Swelling of one arm near to the breast with cancer

  • Weight loss

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How is Breast Cancer Diagnosed?

The diagnosis of breast cancer starts with consultation. The consulting doctor will ask you about your symptoms and risk factors. Then the doctor will perform a physical exam, which includes the examination of breasts, armpits, and the neck and chest area. If the doctor finds any lump or notice any abnormal change in the breasts then he /she may prescribe certain scan tests. Such tests may include :

  • Breast MRI to identify the breast lump

  • Mammogram to evaluate an abnormal change

  • CT scan to see if the cancer has spread

  • PET scan

  • Sentinal lymph node biopsy to see if the cancer has spread

  • Breast ultrasound to know whether the lump is solid or fluid-filled

  • Breast biopsy, using methods such as needle aspiration, ultrasound-guided, stereotactic, or open

By doing the above mentioned test if the doctor finds that the patient has breast cancer then more tests will be done to see if the cancer has spread. The next step is called staging. The staging process helps to decide upon a treatment plan and follow-up. Breast cancer stages range from 0 to IV. The higher the staging number, the more advanced the cancer.

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How is Breast Cancer Treated?

In Breast Cancer treatment a multidisciplinary team will be involved. This multidisciplinary team may consists of an oncologist, radiologist, specialist cancer surgeon, specialist nurse, pathologist, radiologist, radiographer, and reconstructive surgeon. Sometimes the team may also include an occupational therapist, psychologist, dietician, and physical therapist. In some cancer hospitals this team is called as tumour board. This team develops a treatment plan and the plan is discussed with the patient or the family members. The team will take into account several factors when deciding on the best treatment for the patient. Some of the important factors are as follows.

  • Type of breast cancer

  • Whether or not the cancer cells are sensitive
    to hormones

  • Age of the patient

  • Stage and grade of the breast cancer

  • Overall health condition of the patient

  • Patient's feedback



There are many treatment options available to treatment breast cancer. Before deciding upon a treatment plan the above mentioned factors are taken into consideration. The main breast cancer treatment options may include :

  • Surgery

  • Chemotherapy

  • Hormone therapy

  • Radiation therapy

  • Biological therapy




Surgery

  • Sentinel Node Biopsy - This is generally done as a part of diagnosis in order to determine if cancer has spread beyond a primary tumor into your lymphatic system. One lymph node is surgically removed. Then the node isanalyzed in a laboratory.

  • Lumpectomy -Doctor may recommend lumpectomy if the tumour is small and it can be separated from the tissue around it. In lumpectomy the tumour and a small margin of healthy tissue around are removed. Lumpectomy is often called a breast-sparing surgery.

  • Mastectomy -In mastectomy the breast is removed surgically. There are two types of mastectomy surgeries - Simple and Radical. In a Simple mastectomy the lobules, ducts, fatty tissue, nipple, areola, and some skin are removed. In a Radical mastectomy involves removing of muscle of the chest wall and the lymph nodes in the armpit.

  • Axillary Lymph Node Dissection - If the sentinel node was found to have cancer cells, the surgeon may recommend removing several nymph nodes in the armpit. This procedure is called Axillary lymph node dissection. A traditional axillary lymph node dissection usually removes nodes in levels I and II. For women with invasive breast cancer, this procedure accompanies a mastectomy.

  • Breast Reconstruction Surgery - Breast reconstruction surgery can be done immediately after having a complete or partial breast removal (mastectomy), or at a later date. A series of surgical procedures aimed at recreating a breast so that it looks as much as possible like the other normal breast. A breast reconstruction surgery may be carried out at the same time as a mastectomy. The surgeon may use a breast implant, or tissue from another part of the patient's body.

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Radiation Therapy

Radiation therapy treats cancer by using high energy to kill tumour cells. The goal is to kill or damage cancer cells without hurting healthy cells.In radiation therapy or radiotherapy controlled doses of radiation are targeted at the tumour to destroy the cancer cells. In many cases, radiotherapy is used after surgery, as well as chemotherapy to kill off any cancer cells that may still be around. Typically, radiation therapy occurs about one month after surgery or chemotherapy. Each session lasts a few minutes. It may involve multiple sessions as decided by the doctors.The type of breast cancer the woman has will decide what type of radiation therapy she may have to undergo. In some cases, radiotherapy is not needed. Radiation Therapy may have some side effects like fatigue, lymphedema, darkening of the breast skin, and irritation of the breast skin.

Chemotherapy Thumb

Chemotherapy (chemo) is the use of medicines or drugs to treat cancer. These drugs are used to kill the cancer cells and are called cytotoxic drugs. The oncologist may recommend chemotherapy if there is a high risk of cancer recurrence, or the cancer spreading elsewhere in the body. This is called adjuvant chemotherapy. Sometimes if the tumours are large then chemotherapy drugs may be administered before surgery. The aim is to shrink the tumor, making its removal easier. This is called neo-adjuvant chemotherapy.

Chemotherapy may also be administered if the cancer has spread to other parts of the body (metastasis). Like radiation therapy, chemotherapy also has some side effects which may include nausea, vomiting, loss of appetite, fatigue, sore mouth, hair loss, and a slightly higher susceptibility to infections. Many of these side effects subside over a period of time and can be controlled with medications which are prescribed by the doctor. There are chances that women over 40 years of age may enter early menopause.

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Hormone Therapy

There are certain hormones that can attach to breast cancer cells and affect their ability to multiply. The purpose of hormone therapy is to add, block, or remove hormones. Hormone therapy is used for breast cancers that are sensitive to hormones. These types of breast cancers are often referred to as ER positive (estrogen receptor positive) and PR positive (progesterone receptor positive) cancers. The aim is to prevent cancer recurrence. Hormone therapy is usually used after surgery, but may sometimes be used beforehand to shrink the tumour. In some cases for health reasons, the patient cannot undergo surgery, chemotherapy or radiotherapy, hormone therapy may be the only treatment she receives.

Life after Breast Cancer TreatmentThumb

It is found that women who have been diagnosed and treated for early breast cancer have an increased risk of breast cancer coming back or developing in the other breast. Hence when the treatment ends, the doctors will still want to watch the patient closely. It is very important not to miss any follow-up appointments. During these visits, the doctors will ask questions about any problems or issuesthat the patient may have and may do exams and lab tests or x-rays and scans to look for signs of cancer or treatment side effects.Regular follow-up means that if breast cancer does come back or if a new breast cancer develops, it can be treated promptly. Follow-up also allows doctors to check for any side effects from treatment and to monitor any long-term treatments such as hormonal therapies. It also provides an opportunity for women to talk about how they are feeling.

Prevention of Breast Cancer

The exact cause of Breast cancer is still unknown. However some lifestyle changes that can help significantly reduce the risk of developing breast cancer.

  • Alcohol consumption -Alcohol consumption should be done in moderation or stopped completely. Moderation means no more than one alcoholic drink per day. Some studies suggest that women who drink in moderation, or do not drink alcohol at all, are less likely to develop breast cancer compared to those who drink large amounts regularly.

  • Physical exercise -Some studies suggest that women who engaged in 10 to 19 hours of at least mild exercise per week from their reproductive years on had about a 30 percent lower risk of developing breast cancer.

  • Healthy Diet - Healthy diet may help you lower the risk of many diseases. Some experts say that women who follow a healthy and a well-balanced diet may reduce their risk of developing breast cancer in later stages of life.

  • Postmenopausal hormone therapy - Limiting hormone therapy may help reduce the risk of developing breast cancer. Before undergoing hormone therapy, it is important for the patient to discuss and understand the benefits and drawbacks thoroughly with her doctor.

  • Managing Bodyweight -Some studies suggest women who have a healthy bodyweight have a considerably lower chance of developing breast cancer compared to obese and overweight females. But this aspect is still debatable.

  • Breast cancer screening - Patients should discuss with their doctor when to start breast cancer screening exams and tests.

  • Breastfeeding - Some studies suggest that the longer the women had breastfed during their lifetime, the less likely they were to get breast cancer. That means women who breastfeed run a lower risk of developing breast cancer compared to other women.

Breast Cancer treatment in India

The cost of Breast cancer treatment at our network cancer hospitals in India depends upon the hospital and the location you choose. There are many good cancer hospitals across various cities in India that have done a great work in the field of Breast cancer treatment. In cancer treatment a multi-disciplinary approach is used. It is not a single doctor or specialist who will decide upon a treatment plan but a team of doctors from various specialities come together and discuss the case and the treatment plan. Right from diagnosis to surgery to radiotherapy, our network cancer hospitals in India have the latest technology and equipment which helps in quicker diagnosis, staging and treatment of Breast cancer.

Apart from helping patients to avail high quality cancer treatment and excellent service, we also focus in making cancer treatment more and more affordable. The cost of cancer treatment differs from hospital to hospital and from one room category to another. We try our best to give options to patients which helps them to choose. For more information you can write to us or call us anytime.

How to get started?

If you know anybody suffering from Breast cancer and is willing to travel to India for treatment then it is very simple to get started. Just scan the following documents and send it to us by mail to info@mentorsethicare.com.

  • Recent Medical Reports.

  • Scan images and Reports (if available) and

  • Age of the patient

Once we get the medical reports, one of our patient service associates will contact you and guide you through the entire process step by step.

For more information on high quality and low cost Breast cancer treatment in India, you can write to us at info@mentorsethicare.com. or call us anytime at 0091 9611 231 188

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