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Breast Cancer - What exactly is it?
‘Breast cancer’ is a term that is used to refer to a malignant tumour, which has developed from cells present in the breast. Generally, all tumours can be divided into two categories i.e. benign and malignant and it is the malignant tumour that is responsible for causing cancer. Breast cancer generally originates in the cells the milk producing glands of the breast's or the passage, which carries milk from the glands to the lobules. Additionally, breast cancer can also originate in the stromal tissues, including the fibrous and fatty connective breast tissues.
Breast Cancer: Treatment Options
Treatment for breast cancer depends upon two things: the exact type of the cancer and how advanced the cancer is. Treatment options for breast cancer can thus be broadly divided into two categories as Local treatments and Systemic treatments.
Treatments that target the tumour without having any effect on the rest of the body are called local treatments. The following types of local treatment options are available for treating breast cancer:
- Surgery: Surgical breast cancer treatment involves removal of the malignant cancerous tumour in an operation. Smaller tumours can be removed using a surgical process referred to as ‘lumpectomy’, wherein the tumour along with a small amount of healthy tissue surrounding the tumour is removed. For larger tumours, removal of the entire breast becomes mandatory, in a surgical process known as ‘mastectomy’. Women who undergo mastectomy can choose to undergo reconstructive plastic surgery for reconstruction of the removed breast(s).
- Radiation Therapy: This basically involves using radiation to kill cancer cells present in the body. Radiation therapy is a long-drawn process that usually involves a set number of treatments administered over a long period of time. Radiation therapy is also generally the follow-up procedure after a lumpectomy, or more rarely, a mastectomy.
Treatments involving drugs that are administered via either the mouth or direct injection into the bloodstream are called systemic treatments. These include:
- Chemotherapy: This includes using drugs to destroy the cancer cells present in the body by stopping the cancer cells from growing and dividing. Chemotherapy can be administered using either an IV (intravenous) tube or via pills that can be swallowed.
- Hormone Therapy: This treatment option is used for treating tumours which have tested positive for progesterone or oestrogen receptors. Blocking hormones that fuel the tumour’s growth is the basis of this therapy.
- Targeted Therapy: This targets specific proteins and genes which contribute to growth and survival of the cancer cells. Targeted therapy is an extremely focused treatment, and is very effective in blocking the growth and division of cancer cells, as well as minimizing damage to surrounding healthy cells.
I have had a limbo sacral spine MRI. Conclusion of result is "Mild annular disc bulge with superimposed broad based posterocentral disc protrusion and annular tear at L4-L5 level is causing indentation on thecal sac. No central canal or existing foramina stenosis or nerve root compression" can anybody tell is it worrisome.
I am an advocate and have got sitting job for long hours and walking job too. I am suffer from slip disc. Any treatment?
Hi I'm from South Africa. I need to have a hysterectomy done .What are cost of hospital fees, Dr. and anesthetic ,theatre fees etc awaiting your response kind regards Mariam Patel.
1. You felt a lump in your breast and it always means you have breast cancer.
It's a small percentage of breast lumps only that will turn out to be cancer. If you discover a persistent lump in your breast or notice any changes in breast tissue, never ignore it. You must see a physician for a clinical breast examination. He or she may possibly order breast imaging studies to determine if this lump is of concern or not.
Take charge of your health by performing routine breast self-exams, establishing ongoing communication and counseling with your doctor, getting an annual clinical breast exam, and scheduling your routine screening mammograms.
2. Only women get breast cancer, men do not.
Quite the contrary, each year it is estimated that approximately 2,190 men will be diagnosed with breast cancer and 410 will die. While this percentage is still small, men should also check themselves periodically by doing a breast self-exam while in the shower and reporting any changes to their physicians.
Breast cancer in men is usually detected as a hard lump underneath the nipple and areola. Men carry a higher mortality than women do, primarily because awareness among men is less and they are less likely to assume a lump is breast cancer, which can cause a delay in seeking treatment.
Arguably one of the most fatal diseases that threaten human life, Meningitis has been the cause of a lot of recent deaths. Essentially Meningitis is triggered off by the anomalous inflammation of the protective membranes called meninges in the brain and spinal cord. Spurred by some sort of a bacterial or viral attack, this condition emanates from an infection of the fluids in the cranial chamber. Often such conditions are also stimulated by some external injury, cancerous development or even certain kinds of reaction from a given drug or the other.
Depending on the precise cause of the disease, Meningitis may be categorized as Bacterial Meningitis, Viral Meningitis or Fungal Meningitis. Other forms of Meningitis include parasitic Meningitis, Amebic Meningitis and Non-Infectious Meningitis. Meningitis could potentially be contagious. Through lengthy and proximal contact like coughing or kissing, if saliva or spit gets exchanged, Meningitis causing germs may spread from one person to the other.
Streptococcus pneumoniae and Neisseria Meningitidis are the two of the most rampant Meningitis causing bacteria. They have the potential of causing irreversible damage to several vital organs. However, with substantive progress in medical science, effective and suitable medication has been made available to the larger populace. But, immediate attention is imperative in this case.
Viral Meningitis is relatively milder than the other forms of meningitis. Enteroviruses, arboviruses and herpes virus are some of the most common sources of this kind of Meningitis. People with strong immunity are usually able to overcome this without much ado. Vaccines are available widely in the markets to cure viral meningitis.
Fungal Meningitis are caused primarily from external influences. Inhaling fungal spores from the environment is one of the most prominent factors that lead to Meningitis. People suffering from fatal diseases like cancer, diabetes or HIV are more susceptible to fungal Meningitis. While these are a few of the primary forms of meningitis, other triggers to this disease occur due to various environmental interventions. These are consequent upon interactions with various disease causing allergens. Cure to meningitis is available in the form of intravenous injections. But timely diagnosis and treatment is essential for a good outcome. If you wish to discuss about any specific problem, you can consult a pediatrician.
Breast cancer is a type of cancer, which occurs due to the development of cancerous cells in breasts. Women are usually affected by breast cancer and breast cancer is one of the most common forms of cancer after skin cancer. Usually fatal if not diagnosed in its early stage, breast cancer is a very serious medical ailment. Read on more to find all about the different symptoms, causes, preventive measures and treatment of breast cancer.
Symptoms: Breast cancer has few distinct characteristics and if you have a few or all the following symptoms you could be more likely to suffer from breast cancer.
- The formation of a lump in your breast, which is different from the surrounding tissue and usually more thickened.
- The discharge of bloody fluid material from the nipples.
- Sudden change of the size, shape and appearance of the breast.
- Certain distinct changes to the skin over the breast for example an indentation in the skin similar to that of a dimple.
- Appearance of an extra nipple which is inverted.
- If the darkened area around the nipples known as the areola is flaking or peeling off.
Causes: Studies and researches remain inconclusive on what causes breast cancer. Breast cancer occurs due to abnormal division of the cells located in the breast, which over time accumulate and form lumps. They
might spread to other parts of the body. Breast cancer is caused mainly due to a complex interaction of personal genetics, environment and lifestyle choices. Breast cancer can also be caused due to genetics as about 5% to 10% of cases are due to gene mutations which pass onto generations.
Risk factors: There are certain factors, which increase the probability of contracting breast cancer. Increasing age, personal and family history of breast cancer, obesity, radiation exposure, pregnancy at an older age, postmenopausal hormone therapy are some of the factors that increase the chances of breast cancer.
Treatment: Several forms of surgical methods exist to treat breast cancer. Depending on the condition and spread of the disease a suitable surgery is performed. These include mastectomy, lumpectomy, axillary lymph node dissection and removal of both breasts. Other forms of treatment include chemotherapy or the use of high doses of drugs to destroy cancerous cells. Radiation therapy where X-rays are used to destroy the cancer cells is also effective.
Breast cancer begins when cells in the breast(s) start to grow out of control. It is understood as being the most common cancer, seen predominantly in females, globally. It is reasonably treatable and often curable.
1. Type: Adenocarcinomas constitute more than 95% of breast cancers with infiltrating ductal carcinoma (IDC) being the most common form of invasive breast cancer.
Frequently occurring breast cancers present as one of the following types mainly
1. Ductal Carcinoma In Situ (DCIS): Is the most common type of non-invasive breast cancer and is confined to the milk ducts of the breast. There is no invasion in the basement membrane. Pure DCIS metastasizes rarely. Non comedo cribrioform carcinoma is the most common DCIS found which, when compared to the comedo type, is mostly non-aggressive.
2. Infiltrating Ductal Carcinoma (IDC): Represents majority (about 3/4th) of the breast cancers, and is known to metastasize commonly to bones, lungs and liver.
3. Lobular Carcinoma In Situ (LCIS): Develops in multiple lobules of the breast (bilaterally). LCIS is less commonly seen, compared to DCIS.
4. Infiltrating Lobular Carcinoma (ILC): Represent about a tenth of all breast cancers and tends to metastasize to other regions of the body.
Less commonly occurring breast cancers such as
5. Inflammatory Breast Cancer: Is relatively uncommon and are caused probably owing to viral infections. The breast is warm, red and swollen.
6. Paget’s disease of the nipple: Is a rare form of breast cancer. It begins in the milk ducts and spreads to the nipple and areola.
7. Medullary Carcinoma
8. Mutinous Carcinoma
9. Tubular Carcinoma
10. Phylloides tumor etc all.
2. Gender: Affects the female populace predominantly. However, a small percentage of breast cancer is attributable to the male populace as well.
3. Etiology: No definite cause is known. However, diet, lifestyle, environment, hormonal/ reproductive factors, personal or family history of breast cancer especially in first degree relatives and also any benign breast disease history etc all are known to increase the risk of breast cancers. Specifically, excessive fatty diet, obesity, type 2 diabetes mellitus, benign breast disease, heredity/ inheritance of mutated breast cancer genes 1 (BRCA1) and 2 (BRCA2), smoking, alcohol intake, infertility, estrogen therapy/ hormone replacement therapy (long term) in post menopausal women, delayed age at first pregnancy, nulliparity (not having child), early menstruation, delayed onset of menopause, lactating mothers not breast feeding, exposure to ionizing radiation, sedentary lifestyle, depression, exposure to MMTV virus etc all can potentially increase the risk for breast cancer.
4. Features: Signs & symptoms, of breast cancer, manifest majorly in the following ways
Lump/ nodule in the breast that gets attached to the skin of the breast over time. The lump / nodule could be hard and painless with irregular edges or it could also be soft, rounded, tender and painful.
Enlarged lymph nodes in the axilla which are palpable.
Swelling of whole or a part of a breast. This is even if there is no distinct lump felt.
Retraction or thickening of the nipple(s).
Pain in the breast or nipple.
Discharge from nipple other than breast milk.
Irritation/ scaliness of skin over the breast.
Redness of nipples
Rarely, red, swollen and tender breast.
5. Screening: Is generally recommended for asymptomatic populations goal of which, as usual, is to be able to detect & diagnose breast cancer at an early stage which is potentially curable. It is mostly radiologic with mammography/ USG being instrumental in raising suspicions for further diagnostics (i.e. biopsy) that help detect breast cancer, if any, early.
6. Diagnosis: A self-examination/ clinical exam of the breast(s)/ axilla that reveals a palpable mass prompts the following diagnostics. Abnormal blood test results may be indicative of malignancy, but a follow up imaging/ biopsy is always the gold standard for accurate diagnosis.
- Blood: ER/ PR/ HER2/neu, uPA, PAI-1, CA15-3, CA27.29 etc all tumor markers are helpful.
- Imaging: Mammography/ USG Scan usually, as relevant. Again, CT Scan of abdomen & pelvis and chest, PET CT scan, bone scan etc all help detect metastasis, if any, for cancers in stage III & above.
- Biopsy: either excisional, incisional, fine needle aspiration (FNA) or core biopsy technique, as contextually appropriate, is frequently employed and a histopathological examination (HPE) thereof clinches the diagnosis and the nature of the disease.
7. Treatment: Conventional treatment includes surgery, radiotherapy, hormone therapy/ chemotherapy as deems appropriate. Simultaneously, an adjunctive or integrative naturopathic treatment with suitable complementary & alternative medicines (CAM) too can help improve clinical outcomes and facilitate recovery as would be feasible contextually.
8. Prognosis: Preventive measures, earlier diagnosis and right early treatment is key for an effective therapeutic management & better prognosis. Like most other cancers, the chances of cure for an early stage breast cancer are more. The cure/ recovery chances are influenced by the type, grade, stage of cancer, recurrence and the patient’s general health & vitality etc all. Above-mentioned apart, age, menopause status, lymph node status, ER/ PR/ HER-2/ neu status, size & extent of breast cancer etc all also influence the treatment outlook in breast cancer. The five year survival rate is strongly correlated with the stage of breast cancer.
9. Prevention: Rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an increased focus on protective factors and avoidance of the risk factors can be of help. An adherence to a Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising (for at least 30 minutes daily), de-stressing and relaxation is highly recommended for reducing the risks of breast cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. It is advisable to limit milk/ dairy, preferably of low fat content, to 1 to 2 servings max daily. Although alcohol is optional and is not for everyone, the consumption of the same, if any, has to be strictly in moderation, and is best avoided. Smoking is to be avoided as well. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly or are best avoided too. Limiting dosage/ duration of hormone therapy, if any, especially to counteract post menopausal symptoms and also avoiding exposure to radiation and environmental pollution can help reduce the risks of breast cancer. Apart from the above-mentioned, for high risk cases, a prophylactic oophorectomy, prophylactic radical mastectomy, long term hormone therapy etc all can help reduce the chances/ risks of developing breast cancer significantly. Breastfeeding is known to confer protection against breast cancer risk too.
I am 38 years old man having back pain lasting for 20 days from mild to severe in left hip side. In consultation to orthopedic surgeon and after MRI one doctor told me the disease sciatica and another its slip disc. MRI of LS SPINE report says the result of AP diameter L1-L2=15, L2-L3=08, L3-L4=15, L4-L5=10 , L5-S1=09 Impression: 1) Degenerative DISC DISEASE with generalised disc bulge at L3-L4. Please tell.
I have been suffering from disk problem since 7 months. I have consulted a doctor. I took x-Ray as per his advice. He said disk has been narrowed. He prescribed some painkillers and vitamin tablets. Could anyone please prescribe some medicine for me. I am really unable to sit without any support.
I am a 38 year old married lady with 2 kids. I have herniated disc of l5 s1 with mild detention as detected in mri. What is the treatment? I am really scared. Is it dangerous?
Brain surgery involves several medical procedures, which incorporate fixing issues with the brain, including changes in the tissues of the brain, cerebrospinal fluid and brain blood flow. Brain surgery is quite a complicated method of surgery and the type of surgery to be conducted depends on the underlying conditions.
Reasons for Brain Surgery:
Brain surgery is performed for the correction of physical brain abnormalities. These abnormalities could occur because of diseases, birth defects and injuries. A brain surgery is required when the following conditions arise in the brain:
- Abnormal blood vessels
- Blood clots in the brain
- When the protective tissue or dura is damaged
- Due to nerve damage
- Parkinson's disease
- Any kind of pressure after an injury
- Skull fractures
- In case of stroke and tumors
A surgery may not be required for all the above mentioned conditions, but in case of many, a brain surgery is very important as the conditions may worsen health problems.
Types of brain surgeries:
- Craniotomy: During this open brain surgery, an incision is made in the scalp, and a hole is created in the skull, near the area, which is being treated. After this process is complete, the hole or bone flap is secured in its place using plates or wires.
- Biopsy: This form of brain surgery helps in the removal of a small amount of brain tissues or tumors. After removal, the tissues or tumors are examined under a microscope. The creation of a small incision and a hole in the skull is indicated as a part of this process.
- Minimally invasive endonasal endoscopic surgery: This form of brain surgery enables the removal or lesions and tumors via the nose and sinuses. Private parts of the brain can be accessed without creating an incision. An endoscope is utilized in the process which is used to examine tumors all across the brain.
- Minimally Invasive neuroendoscopy: This process is similar to the minimally invasive endonasal endoscopic surgery. This method also involves the use of an endoscope for removal of brain tumors. Small, dime sized holes may be made in the skull to access some brain parts.
Brain surgeries may be associated with several risks. They may be:
- Allergic reactions to anesthesia
- Blood clot formations
- Swelling of the brain
- A state of coma
- Impairment in speech, coordination and vision.
- Problems in memory
- Strokes and seizures
- Infections in the brain
A brain surgery is a serious and very complex surgery. There are different kinds of brain surgeries, which are conducted depending on the condition and severity of the disease. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.
I am a man of 50 years and have no complications except slip disc between l4-l5 which is ok if I take proper precaution. From last few months I feel considerable pain in my both knee after sitting on a chair for few hours constantly and then trying to move. When I am keep walking pain is not there. I have to sit in front of computer whole day long. Kindly advise.
Dear doctor, One of my relative suffered due to minor brain stroke She gave birth to baby by cesarean just a week before the stroke. Is there any relation between delivery and stroke. Kindly let me know. Note She is 30 years old female.
What are the alternatives to avoid surgery for my brother aged 47 identified with Listhesis with foot drop and disc extrusion. In fact I had disc bulge (L3 L4 L5) at the age of 41 in 2013 and took oil massage in Kerala for 15 days and I am doing good now.
I am suffering from sciatica for the last 6 months. Tried back exercises and muscle relaxants. The condition is due to L4/L5 disc herniation. Kindly advice.
The uterus is a muscular structure held in place inside your pelvis with the help of muscles, ligaments, and tissues. These muscles weaken in women due to pregnancy, childbirth or delivery complications and can lead to severe complications. One such complication is a uterine prolapse. Uterine prolapse occurs when the uterus sags or slips from its normal position into the vaginal canal.
The causes of uterine prolapse are varied and include:
- Delivering a large baby
- Difficulty in labor and delivery
- Reduction in estrogen levels post menopause
- Traumatic childbirth
- Loss or weakening of the pelvic muscle
- Conditions which lead to increased pressure in the abdominal area such as a chronic cough, straining, pelvic tumors or accumulation of fluid in the abdomen
- Loss of external support due to major surgery in pelvic area
Uterine prolapse can be complete or incomplete depending on how far the uterus sags into the vagina. Women who have minor uterine prolapse may not have any visible symptoms. However, if the condition worsens, it manifests itself in visible signs.
Symptoms of moderate or severe prolapse are:
1. A feeling of fullness or pressure in your pelvis when you sit
2. Seeing the uterus or cervix coming out of the vagina
3. Vaginal bleeding or increased discharge
4. Painful sexual intercourse
5. Recurrent bladder infections
6. Continuing back pain with difficulty in walking, urinating and moving your bowels
Without proper attention, the condition can cause impairments in the bowel, and can also affect bladder and sexual function. If you wish to discuss about any specific problem, you can consult a Gynaecologist.