Cancer incidences worldwide are increasing alarmingly and India is no exception. Added to this burden, is the increasing incidence of breast cancers in younger women, which can have devastating physical, mental, social & ﬁnancial consequences. Our DBCCU consists of highly trained specialists and is well equipped to manage all such breast cancer patients comprehensively. Our unit provides all the services required for cancer screening, diagnosis, treatment and supportive rehabilitation under one roof, with special emphasis on enabling our patients to return to their normal lives as quickly as possible.
Not all lumps are cancerous. However, a systematic evaluation is required to rule out breast cancer. Breast diseases are broadly classiﬁed as benign (non-cancerous) & malignant (cancerous).
Benign breast diseases:
Breast cysts, Fibroadenomas, Fibroadenosis, Mastalgia (cyclical / non-cyclical) & Mastitis.
Malignant breast diseases:
Malignant cancers are further classiﬁed as: Non-invasive (In-situ cancers) & Invasive (Inﬁltrating cancers). Treatment is based upon the type of cancer, the physical condition of the patient and the stage at presentation. Accordingly, breast cancer may present as early invasive/ non invasive, locally advanced or metastatic breast cancer.
Breast cancer mainly affects women, but it can happen in men as well. The chances of developing cancer increases with age, but no age is exempt.
Certain risk factors have been identiﬁed :
The presence of a risk factor does not necessarily mean that a woman will always develop breast cancer. However, women with risk factors should undergo regular health checks with a specialist.
The symptoms are initially quite subtle and often missed. However, as the disease progresses, certain signs and symptoms arise:
Any unusual changes in the breast should not be ignored and brought to the notice of your doctor as soon as possible.
- A healthy lifestyle & a well balanced diet can help prevent most diseases and cancer is no exception.
- A screening mammogram is recommended in all women above the age of 40 years.
- In women with a family history of breast or ovarian cancer, screening is recommended 10years prior to the age at which the relative was diagnosed.
- High risk screening in the form of breast ultrasound, MRI is required in younger women.
- BRCA 1 & 2 gene testing is advised after adequate pre-test counseling in women with a strong family history.
- Breast self-examination should be practiced every month, along with a clinical breast examination at least once a year.
- No. But all breast complaints need to be evaluated by a specialist before to rule out cancer.
- A breast lump is evaluated by performing a mammogram and ultrasound.
- Additionally, Breast MRI may be advised for further characterization.
- Diagnosis is conﬁrmed with a core biopsy.
- A PET - CT is advised to rule out metastases.
- Pre- operative investigations are carried out to assess ﬁtness for surgery.
Treatment is based on the type of the disease & stage at presentation. Broadly, treatment of breast cancer includes any or all of these modalities:
Modiﬁed Radical Mastectomy with/ without immediate/ delayed breast reconstruction or Oncoplastic Breast Conserving Surgery. The choice of breast conservation or reconstruction after mastectomy is discussed with the patient and planned accordingly. Post surgery, the histopathology report is discussed in detail with the patient and adjuvant treatment in the form of chemotherapy, radiation and hormone therapy are planned accordingly. Surgery for benign breast conditions are also carried out based on the symptomatology.
Either before (neo- adjuvant chemotherapy) or after surgery, with/ without the use of a chemoport to facilitate chemotherapy administration. This is carried out under the supervision of a Medical Oncologist.
Radiotherapy is carried out to the operated breast after breast conserving surgery or to the chest wall after a mastectomy, based on the ﬁndings in the pathology report. Radiation is carried out under the supervision of a radiation oncologist.
4. Hormone Therapy:
In the form of tablets or injectable drugs, Hormone therapy is given based on the histopathology report. In elderly, in ﬁrm patients, it may also be used as neo-adjuvant hormone therapy.
Your prognosis is completely dependent on the type of disease, the extent of spread at the time of diagnosis & the response to treatment. Most breast cancers generally respond well to treatment. Non- invasive and early invasive cancers have the best prognosis. However, all breast cancer patients require regular follow- up to assess their well- being and rule out recurrence if any.
A signiﬁcant number of young women develop amenorrhoea (cessation of menstruation) post chemotherapy. However, it may or may not lead to early menopause. Pregnancy can be planned post treatment completion in selected patients (generally 2 - 3 years post treatment). Oocyte preservation can be planned after careful consideration of the disease status for future use. Pregnancy in such patients is safe and does not increase the risk of recurrence.
There is an increasing trend worldwide towards development of site speciﬁc oncology units, as it enables caregivers to provide highly specialized treatment using the latest techniques. AIMS hospital is an NABH & ISO accredited tertiary care institution with state-of-the-art Laminar air-ﬂow operating theatres, Intensive Care Units (ICUs), Linear Accelerator for providing radiation, day- care chemotherapy suites and in-house radiology, pathology, physiotherapy, nutrition services to cater to all your treatment needs.