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Dr. Sabeena Toppa

Radiologist, Bangalore

Dr. Sabeena Toppa Radiologist, Bangalore
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I pride myself in attending local and statewide seminars to stay current with the latest techniques, and treatment planning....more
I pride myself in attending local and statewide seminars to stay current with the latest techniques, and treatment planning.
More about Dr. Sabeena Toppa
Dr. Sabeena Toppa is one of the best Radiologists in Vijayanagar, Bangalore. You can meet Dr. Sabeena Toppa personally at Padmashree Diagnostic in Vijayanagar, Bangalore. Book an appointment online with Dr. Sabeena Toppa on Lybrate.com.

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I am suffering from severe backache problem. From last three days. Like slip disk. What should I do? suggest please.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
I am suffering from severe backache problem. From last three days. Like slip disk. What should I do? suggest please.
Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful use no pillow under the head. Do hot fomantation. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck back knee & general exercises. It may have to be further investigated. Make sure you are not allergic to any of the medicines you are going to take. For emergency treatment contact your nearest hospital or family doctor. If it does not give relief in 4-5days, contact me again. You may have to use a spinal belt for some time.
1 person found this helpful
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Hi sir my mother 72 year old she is suffering slip disk problem mri report conclusion/impression- Mr. Imaging reveal degenerative changes affecting lumbar spine with disc bulge-herniation at l1-2, l3-4, l4-5 and l5-si levels, more at l2-3, l3-4, l4-5 and l4-s1 level (protrusion), together with ligamentum flavum hypertrophy and facetal arthropathy are producing secondary canal stenosis with narrowing of bilateral neural foraming. Canal stenosis is most sever at l4-5 level.

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. It is good that you have actually mentioned mri report of your mother which shows degenerative changes in spine with degenerative discs at multiple levels and ligamentum hypertrophy. But since we have to treat the patient and not mri, please elaborate her problem as to a detailed discussion of back pain which means duration of pain and mode of onset. I would also like to ask you if it is associated with any leg pain or any other neurological symptoms like numbness, paraesthesias (electrical shock like abnormal sensations) or any weakness in limbs. Please also tell me about any associated symptoms like fever, weight loss etc. What medications she generally takes and what has been her treatment history till now for existing problem. Do not hesitate to contact me if you need any further assistance.
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Mri report- mild diffuse disc bulge at l4-l5 level causing the cal sac indentation and bilateral mild neural formalin narrowing (l> r). Please advice.

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. These are mri findings which you have suggested, but actually it is better if you mention your clinical condition so that if significant we can correlate them with your mri findings. So please mention your back pain duration, any associated leg pain, numbness, parestheisas, weakness etc in legs. Do not hesitate to contact me if you need any further assistance. Thanks & regards Dr. Akshay kumar saxena Consultant orthopaedics fortis hospital, new delhi.
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I am 46 year old I have slip discs problem in l-4, l-5 it is curebel? and what should I do to get my self cure in this regards.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Kindly show me digital x rays of ls spine. Not all patients of backache need surgery. Most of them can be managed without operation. Rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful use no pillow under the head. Do hot fomantation. Ibuprofen 200mg od & sos x 5days bio d3 max 1tab od x10 do neck, back & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. Do reply back for detailed treatment plan. Do not ignore. It could be beginning of a serious problem.
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I have severe lower back pain for last 18 years which increases during periods. I'm 32 years old and unmarried. It's constant, it always pains. Is it slip disc or what Please help.

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
I have severe lower back pain for last 18 years which increases during periods. I'm 32 years old and unmarried. It's ...
For confirmation x-ray and mri must so tk heat fermentation twice a day avoid toward bending and long standing or sitting.
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Brain Stroke - Things You Must Know!

MBBS, MD - Internal Medicine, Fellow in Pain Management, DM - Neurology
Neurologist, Delhi
Brain Stroke - Things You Must Know!

A brain stroke can affect anyone at any point of time when the supply of blood to the brain is interrupted. It can threaten major physical functions and can prove to be fatally dangerous at times. The brain stem which is placed right above the spinal cord controls the breathing, heartbeat and levels of blood pressure. It is also in charge of controlling some elementary functions such as swallowing, hearing, speech and eye movements

What are the different types of strokes?
There are three main kinds of stroke: ischemic strokes, hemorrhagic strokes and transient ischemic attacks. The The most common type of brain stroke is the ischemic stroke is caused by narrowing or blocking of arteries to the brain, which prevents the proper supplyof of blood to the brain. Sometimes it so happens that the blood clot that has formed elsewhere in the body have travelled via the blood vessels and has been trapped in the blood vessel which provides blood to the brain. When the supply of blood to a part of the brain is hindered, the tissue in that area dies off owing to lack of oxygen. The other variant of brain stroke is termed as hemorrhagic stroke is caused when the blood vessels in and around the brain burstor or leak. Strokes need to be diagnosed and treated as quickly as possible in order to minimize brain damage.

What are the common symptoms of a brain stroke?
The symptoms of the brain stroke are largely dependent on the area of the brain that has been affected. It can interfere with normal functioning, such as breathing and talking and other functions which human beings can perform without thinking such as eye movements or swallowing. Since all the signals from the brain as well as other parts of the body traverse through the brain stem, the interruption of blood flow often leads to numbness or paralysis in different parts of the body.

Who is likely to have a stroke?
Anyone is at a risk of developing brain stroke although ageing is directly proportional to the risk of having a stroke. Not only that an individual with a family history of brain stroke or transient ischemic attack is at a higher risk of developing stroke. People who have aged over 65 accounts for about 33 percent of all brain strokes. It is important to point here that individuals with high blood pressure, high blood sugar, cholesterol, cancer, autoimmune diseases and some blood disorders are at a higher risk of developing brain stroke.

There are a few factors which can increase the risk of developing stroke beyond any control. But there are certain lifestyle choices as well which aids in controlling the chances of being affected by stroke. It is crucial to refrain from long-term hormone replacement therapies as well as birth control pills, smoking, lack of physical activity, excessive use of alcohol and drug addiction. A brain stroke is a life-threatening medical condition, and when an individual has symptoms that resemble that of stroke, it is crucial to seek immediate medical help.

Treatment for stroke:

  • Treatment depends on the type of stroke.
  • Ischemic strokes can be treated with 'clot-busting' drugs.
  • Hemorrhagic strokes can be treated with surgery to repair or block blood vessel weaknesses.
  • The most effective way to prevent strokes is through maintaining a healthy lifestyle.

What is TPA?
TPA is a thrombolytic or a “Clot Buster” drug. This clot buster is used to break-up the clot that is causing a blockage or disruption in the flow of blood to the brain and helps restore the blood flow to the area of the brain. It is given by intravenous (IV). This can be given only within 45.5 hrs of the onset of symptoms

Time is brain

Remember Every second Loss means brain cells die.

Rush to the nearest Stroke Centre whenever you experience such symptoms.

You can save the brain cells dying if you reach within 45.5 hrs by the CLOT BUSTER. 

Endovascular procedures:
Another treatment option is an endovascular procedure called mechanical thrombectomy, strongly recommended, in whichtrained  trained doctors try  removing a large blood clot bysending sending a wired-caged device called a stent retriever, to the site of the blocked blood vessel in the brain

Stroke prevention:
The good news is that 80 percent of all strokes are preventable. It startswith with managing keyrisk risk factors, including 

  • High blood pressure,
  • Cigarette smoking,
  • Diabetes Atrial fibrillation and
  • Physical inactivity.

More than half of all strokes are caused by uncontrolled hypertension or high blood pressure, making it the most important risk factor to control. 

Rehabilitation:
The best way to get better after a stroke is to start stroke rehabilitation ("rehab"). In stroke rehab, a team of health professionals works with you to regain skills you lost as the result of a stroke. If you wish to discuss about any specific problem, you can consult a neurologist.

2363 people found this helpful

I have L4, L5 disc bulging problem , some time it pains me that I am unable to move also , How to recover from this. Please help me out.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
I have L4, L5 disc bulging problem , some time it pains me that I am unable to move also , How to recover from this. ...
Spine physiotherapy, posture care and pain killer as and when needed. If persistent problem, please visit.
1 person found this helpful
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I am 33 years old, I have backache from last 1 year, x ray indicate there is borderline slip disk, what kind of precaution can I take for future?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Sleep on a hard bed with soft bedding on it. SPRING BEDS, FOLDING BEDS OR THICK MATRESS ARE HARMFUL Use no pillow under the head. DO HOT FOMANTATION. Paracetamol 250mg OD & SOS x 5days. Caldikind plus 1tab OD x10. Do neck, back & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. If it does not give relief in 4-5days, contact me again.. Do not ignore .It could be beginning of a serious problem.
1 person found this helpful
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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?

Diploma in Radio-Diagnosis
Radiologist, Shimla
-nothing to worry -no jerky movements -avoid long standing, sitting posture. -hard bed rest. -no pillow -take Ms. Relaxant, analgesic. -click on private questions for further treatment.
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Breast Cancer - Signs That Help You Spot It!

MBBS, DNB - Surgery, Fellowship in Breast Surgical Oncology
Oncologist, Gurgaon
Breast Cancer - Signs That Help You Spot It!

Breast cancer is an abnormal growth of cells in the tissues of the breast. Mainly it occurs in females but less than 1% of all the breast cancer cases develop in males. The majority of breast cancers start in the milk ducts. A small number start in the milk sacs or lobules. It can spread to the lymph nodes and to the other parts of the body such as bones, liver, lungs and to the brain.

With more reliable early detection methods as well as the trend towards less invasive surgery, there is hope that even more women with breast cancer will be treated successfully and will go on to resume their normal lives.

Signs & Symptoms 
It is painless, especially, during the early stage. Watch out for the following changes in the breast:

  1. A persistent lump or thickening in the breast or in the axilla. 
  2. A change in the size or shape of the breast. 
  3. A change in the colour or appearance of the skin of the breast such as redness, puckering or dimpling. 
  4. Bloody discharge from the nipple. 
  5. A change in the nipple or areola such as scaliness, persistent rash or nipple retraction (nipple pulled into the breast).

Consult a doctor immediately if you notice any of these changes.

Risk Factors 
Being a woman puts you at risk of getting breast cancer. There are certain factors that increase the risk of breast cancer. Some of them have been listed below:

  1. The risk increases with age; most cases of breast cancer develop after the age of 50 
  2. Genetic alterations in certain genes such as BRCA1 and BRCA2 
  3. Family history of breast cancer 
  4. Being overweight 
  5. Early menarche (onset of menstruation before the age of 12) 
  6. Late menopause (after the age of 55) 
  7. Never had children 
  8. Late childbearing 
  9. No breast feeding 
  10. Excessive consumption of alcohol 
  11. Use of hormonal replacement therapy (HRT) for a long period of time

However, most women who have breast cancer have none of the above risk factors. Likewise, not having any of these risk factors does not mean that you will not get breast cancer.

Early Detection and Screening

More treatment options are available when breast cancer is diagnosed at an early stage and hence the chances of recovery is also higher. So regular breast screening is important for early detection even if there are no symptoms. Following are the ways of screening:

  1. Breast Self-Examination (BSE): Perform BSE once a month about a week after your menses are over. If you no longer menstruate, choose a date each month which is easy to remember e.g. your date of birth or anniversary.
  2. Clinical Breast Examination: Get a breast specialist to examine your breast once a year if you are 40 years and above.
  3. Mammogram: Go for a screening mammogram once a year if you are 40 to 49 years old and once every two years if you are 50 years and above even if you do not have any symptom. It is not recommended for younger women (less than 40 years of age) as they have dense breasts, making it difficult for small changes to be detected on a mammogram. So ultrasonography of the breasts is advisable to them.

Types of Breast cancer

  1. Non-Invasive Breast cancer: These are confined to the ducts within the breasts. They are known as Ductal carcinoma in-situ (DCIS).
  2. Invasive Breast cancer: It occurs when cancer cells spread beyond the ducts or lobules. Cancer cells first spread to the surrounding breast tissue and subsequently to the lymph nodes in the armpit (Axillary lymph nodes). These cells can also travel to the other parts of the body such as bones, liver, lungs or brain and hence known as metastatic breast cancer.

Making A Diagnosis 

If you notice any unusual changes in your breasts, you should see a doctor immediately. He will examine you clinically and may ask you to undergo some tests so that a definitive diagnosis can be made. Further, the staging work up is done to find out the stage of the disease and management accordingly.

Treatment options 
Treatment of breast cancer may include various methods such as surgery with or without breast reconstruction, chemotherapy, radiation therapy, hormonal therapy and targeted therapy. Treatment options offered, depend upon the number of factors such as the stage of cancer and likelihood of cure, your general health and your preference. If you wish to discuss about any specific problem, you can consult an oncologist.

1931 people found this helpful

I have back pain before 3 years. I have checked MRI test in hospital that result show the mild disc dics bulge noted at L4 and L5 level intending the thecal sac without neurological compression. Doctor has given pain relief tablets but no get relaxation. Please give me solution.

DNB (Orthopedics), MS - Orthopaedics, MBBS
Orthopedist, Bhopal
I have back pain before 3 years. I have checked MRI test in hospital that result show the mild disc dics bulge noted ...
Your mri is normal as mild disc bulge is inconsequential. You better start some lower back muscle strengthening exercise (available on internet or visit a physio)
1 person found this helpful
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I am suffering from suffering from slip disk. What would be the best treatment for it?

DNB, Diploma in Medical Radio Diagnosis (DMRD)
Radiologist, Durg
Is it confirmed on MRI. If not you need to get an MRI done first. Then visit an orthopedic surgeon who would assess the severity of the condition. Minor bulges may be taken care off with medicine and lifestyle changes. However severe ones may require surgery depending on your health status.
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I am 63 year old. I am having sciatica, back pain and numbness in both legs. I do not have BP and my sugar level is with in limit. As per CT scan report the impression are as follows: Lumbar Spondylitis with Disc herniation at L4-5, L3-4 levels and disc bulge at L5-S1 level. Canal stenosis at L4-5 level. Cervical spondylosis - Decreased height of C5 and C6. Vertebral bodies with end plate irregularities at C4-C7 levels. Disc bulge at C3-4 level. Disc herniation with canal stenosis at C4-5, C5-6 and C6-7 levels. Can it be cured with Homeopathy.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful use no pillow under the head. Do hot fomantation. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck back knee & general exercises. It may have to be further investigated. Make sure you are not allergic to any of the medicines you are going to take. For emergency treatment contact your nearest hospital or family doctor. If it does not give relief in 4-5days, contact me again. Why not discuss with me in a video conference? (facility provided by lybrate. Com)
2 people found this helpful
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Lumbar Degenerative Disc Disease

MBBS, Diploma In Orthopaedics (D. Ortho), DNB - Orthopedics, mch
Orthopedist, Delhi
Play video

Different methods to treat Disc problems

3712 people found this helpful

Left paracentral L5-S1 disc protrusion causing compression of left traversing nerve roots associated with diffuse L1-L2 Disc bulge. Now what is best treatment for me.

MBBS
General Physician, Mumbai
Best treatment is to do go for laparoscopic surgery and treatment depends on the symptoms and if there are bearable symptoms than we can do ESWT through a physiotherapist.
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Treating Breast Cancer With Ayurveda

Skin Diseases Cancer Heart Diseases Musculoskeletal Disorders Male Sexual Disorders AIDS, Hypertension Diabetes Mellitus Blood Disorders Respiratory Disorders, Gastrointestinal Disorders Endocrine Disorders ENT Disorders, Gynecological Disorders Opthalmic Disorders Psychiatric Disorders Urological Disorders
Ayurveda, Indore
Treating Breast Cancer With Ayurveda

Breast cancer, is a type of cancer, which is common to women, where cancer cells grow on the breasts or the female mammary gland. It starts out with the formation of a small lump in your breast and can spread out to your other organs very rapidly. It generally affects women above forty years of age. Breast cancer can be classified into two types. They can either start forming on the inner linings of your milk ducts ( known as Ductal carcinoma) or in the lobules which supply milk (known as Lobular carcinoma).

There are many causes responsible for breast cancer they are mentioned below

  • Obesity or post-menopausal obesity (Learn more about Heart Diseases Post Menopause)
  • Exposure to frequent radiation (X-ray)
  • Consumption of alcohol
  • Being taller than average
  • Start of periods at an early age
  • Late menopause
  • Hormone replacement therapy
  • Consumption of birth control pills

The most common symptoms of breast cancer are as follows

  1. Formation of a lump in your breast
  2. Swelling or shrinking of your breast
  3. Change of size, shape and color of your nipple
  4. Blood or milk discharge from the nipple
  5. Breast pain
  6. Itching sensation
  7. Appearance of rashes (Learn more about to maintain the skin health)

Breast cancer if not diagnosed and treated at an early stage may turn out to be fatal. Ayurveda offers promising cures for breast cancer.

A few of the Ayurvedic remedies are mentioned below

  1. Include foods, which are well supplied with vitamin D in your diet. Researches show that women with less amount of vitamin D in their bodies are more likely to develop breast cancer. Consider including foods like eggs, orange juice, dairy products and fish like salmon in your diet.
  2. Drink more of green tea as it has anti cancer properties.
  3. Exercises like walking, yoga, meditation and certain breast exercises can help you to relax the pain sensation, reduce stress and also get cured.
  4. Incorporate bitter gourd in your diet. Researches show that bitter gourd can kill those cancer cells, which cause breast cancer.
  5. Ayurvedic herbs like Ashwagandha, tulsi, curcumin have certain properties that can destroy cancer cells.

Since, breast cancer has less survival rates, it is absolutely essential for you to visit an Ayurvedic practitioner if you wish to get cured through Ayurvedic treatment.

5880 people found this helpful

I have a Acl tear in my left knee doctor advised for an operation should I go for it I am a athlete and 21 year old male.

BPT
Physiotherapist, Hyderabad
I have a Acl tear in my left knee doctor advised for an operation should I go for it I am a athlete and 21 year old m...
Hi, we physiotherapist and rehabilitation can restore the knee to a condition close to its pre-injury state and educate the patient on how to prevent instability. This may be supplemented with the use of a hinged knee brace.
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My wife is suffering from slip disc in spine after mri doctor diagnosis that she also suffering bone tb with unbearable pain in lower portion. Now as per doctor advice completely she is in bed rest. Now she cannot able to stand. Kindly advice.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful use no pillow under the head. Do hot fomantation. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck, back & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. If it does not give relief in 4-5days, contact me again. Do not ignore. It could be beginning of a serious problem. I would like to examine her personally as soon as possible.
5 people found this helpful
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Breast Cancer Prevention:

Homeopath,

Breast Cancer Prevention:

  1. Anything that increases your chance of developing cancer is called a cancer risk factor; anything that decreases your chance of developing cancer is called a cancer protective factor.

  2. Some risk factors for cancer can be avoided, but many cannot. For example, both smoking and inheriting certain genes are risk factors for some types of cancer, but only smoking can be avoided. Regular exercise and a healthy diet may be protective factors for some types of cancer. Avoiding risk factors and increasing protective factors may lower your risk but it does not mean that you will not get cancer. Different ways to prevent cancer are being studied, including:

  3. Changing lifestyle or eating habits. Avoiding things known to cause cancer. Taking medicine to treat a precancerous condition or to keep cancer from starting.


 

General information about breast cancer:

Key points:

  1. Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. Breast cancer is the second most common type of cancer in india

  2. Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast.

  3. The breast is made up of lobes and ducts. Each breast has 15 to 20 sections called lobes, which have many smaller sections called lobules. Lobules end in dozens of tiny bulbs that can make milk. The lobes, lobules, and bulbs are linked by thin tubes called ducts.

  4. Enlarge Drawing of female breast anatomy showing the lymph nodes, nipple, areola, chest wall, ribs, muscle, fatty tissue, lobe, ducts, and lobules.

  5. Anatomy of the female breast. The nipple and areola are shown on the outside of the breast. The lymph nodes, lobes, lobules, ducts, and other parts of the inside of the breast are also shown.

  6. Each breast also has blood vessels and lymph vessels. The lymph vessels carry an almost colorless fluid called lymph. Lymph vessels lead to organs called lymph nodes. Lymph nodes are small bean-shaped structures that are found throughout the body. They filter lymph and store white blood cells that help fight infection and disease. Clusters of lymph nodes are found near the breast in the axilla (under the arm), above the collarbone, and in the chest.

     

Avoiding risk factors and increasing protective factors may help prevent cancer. The following are risk factors for breast cancer:

  1. Older agea personal history of breast cancer or benign (noncancer) breast diseasea family history of breast cancerinherited gene changesdense breasts

  2. Exposure of breast tissue to estrogen made in the bodytaking hormone therapy for symptoms of menopause radiation therapy


 

The following are protective factors for breast cancer:

  1. Less exposure of breast tissue to estrogen made by the bodytaking estrogen-only hormone therapy after hysterectomy,

  2. Estrogen-only hormone therapy after hysterectomyselective estrogen receptor modulatorsaromatase inhibitors and inactivators

  3. Risk-reducing mastectomy ovarian ablationgetting enough exercise


 

It is not clear whether the following affect the risk of breast cancer:

  1. Oral contraceptives

  2. Factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk


 

Older age:

  1. Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.

  2. A personal history of breast cancer or benign (noncancer) breast disease

     

Women with any of the following have an increased risk of breast cancer:

  1. A personal history of invasive breast cancer, ductal carcinoma in situ (dcis), or lobular carcinoma in situ (lcis). A personal history of benign (noncancer) breast disease.

  2. A family history of breast cancer

  3. Women with a family history of breast cancer in a first-degree relative (mother, sister, or daughter) have an increased risk of breast cancer.


 

Inherited gene changes:

  1. Women who have inherited changes in the brca1 and brca2 genes or in certain other genes have a higher risk of breast cancer, ovarian cancer, and maybe colon cancer. The risk of breast cancer caused by inherited gene changes depends on the type of gene mutation, family history of cancer, and other factors.

  2. Men who have inherited certain changes in the brca2 gene have a higher risk of breast, prostate, and pancreatic cancers, and lymphoma.


 

Dense breasts:

  1. Having breast tissue that is dense on a mammogram is a factor in breast cancer risk. The level of risk depends on how dense the breast tissue is. Women with very dense breasts have a higher risk of breast cancer than women with low breast density.

  2. Increased breast density is often an inherited trait, but it may also occur in women who have not had children, have a first pregnancy late in life, take postmenopausal hormones, or drink alcohol.

  3. Exposure of breast tissue to estrogen made in the body

  4. Estrogen is a hormone made by the body. It helps the body develop and maintain female sex characteristics. Being exposed to estrogen over a long time may increase the risk of breast cancer. Estrogen levels are highest during the years a woman is menstruating.


 

A woman's exposure to estrogen is increased in the following ways:

Early menstruation: beginning to have menstrual periods at age 11 or younger increases the number of years the breast tissue is exposed to estrogen. Starting menopause at a later age: the more years a woman menstruates, the longer her breast tissue is exposed to estrogen. Older age at first birth or never having given birth: because estrogen levels are lower during pregnancy, breast tissue is exposed to more estrogen in women who become pregnant for the first time after age 35 or who never become pregnant.

 

Taking hormone therapy for symptoms of menopause:

Hormones, such as estrogen and progesterone, can be made into a pill form in a laboratory. Estrogen, progestin, or both may be given to replace the estrogen no longer made by the ovaries in postmenopausal women or women who have had their ovaries removed. This is called hormone replacement therapy (hrt) or hormone therapy (ht). Combination hrt/ht is estrogen combined with progestin. This type of hrt/ht increases the risk of breast cancer. Studies show that when women stop taking estrogen combined with progestin, the risk of breast cancer decreases.


 

Radiation therapy to the breast or chest:

  1. Radiation therapy to the chest for the treatment of cancer increases the risk of breast cancer, starting 10 years after treatment. The risk of breast cancer depends on the dose of radiation and the age at which it is given. The risk is highest if radiation treatment was used during puberty, when breasts are forming.

  2. Radiation therapy to treat cancer in one breast does not appear to increase the risk of cancer in the other breast.

  3. For women who have inherited changes in the brca1 and brca2 genes, exposure to radiation, such as that from chest x-rays, may further increase the risk of breast cancer, especially in women who were x-rayed before 20 years of age.


 

Obesity:

Obesity increases the risk of breast cancer, especially in postmenopausal women who have not used hormone replacement therapy.


 

Drinking alcohol:

Drinking alcohol increases the risk of breast cancer. The level of risk rises as the amount of alcohol consumed rises.


 

The following are protective factors for breast cancer:

  1. Less exposure of breast tissue to estrogen made by the body

  2. Decreasing the length of time a woman's breast tissue is exposed to estrogen may help prevent breast cancer. Exposure to estrogen is reduced in the following ways:


 

Early pregnancy: estrogen levels are lower during pregnancy. Women who have a full-term pregnancy before age 20 have a lower risk of breast cancer than women who have not had children or who give birth to their first child after age 35. Breast-feeding: estrogen levels may remain lower while a woman is breast-feeding. Women who breastfed have a lower risk of breast cancer than women who have had children but did not breastfeed.

Taking estrogen-only hormone therapy after hysterectomy, selective estrogen receptor modulators, or aromatase inhibitors and inactivators


 

Estrogen-only hormone therapy after hysterectomy

Hormone therapy with estrogen only may be given to women who have had a hysterectomy. In these women, estrogen-only therapy after menopause may decrease the risk of breast cancer. There is an increased risk of stroke and heart and blood vessel disease in postmenopausal women who take estrogen after a hysterectomy.


 

Selective estrogen receptor modulators:

Tamoxifen and raloxifene belong to the family of drugs called selective estrogen receptor modulators (serms). Serms act like estrogen on some tissues in the body, but block the effect of estrogen on other tissues.


 

Treatment with tamoxifen lowers the risk of estrogen receptor-positive (er-positive) breast cancer and ductal carcinoma in situ in premenopausal and postmenopausal women at high risk. Treatment with raloxifene also lowers the risk of breast cancer in postmenopausal women. With either drug, the reduced risk lasts for several years or longer after treatment is stopped. Lower rates of broken bones have been noted in patients taking raloxifene.


 

Taking tamoxifen increases the risk of hot flashes, endometrial cancer, stroke, cataracts, and blood clots (especially in the lungs and legs). The risk of having these problems increases with age. Women younger than 50 years who have a high risk of breast cancer may benefit the most from taking tamoxifen. The risk of having these problems decreases after tamoxifen is stopped.


 

Taking raloxifene increases the risk of blood clots in the lungs and legs, but does not appear to increase the risk of endometrial cancer. In postmenopausal women with osteoporosis (decreased bone density), raloxifene lowers the risk of breast cancer for women who have a high or low risk of breast cancer. It is not known if raloxifene would have the same effect in women who do not have osteoporosis. Talk with your doctor about the risks and benefits of taking this drug.


 

Aromatase inhibitors and inactivators:

Aromatase inhibitors (anastrozole, letrozole) and inactivators (exemestane) lower the risk of a new breast cancer in women who have a history of breast cancer. Aromatase inhibitors also decrease the risk of breast cancer in women with the following conditions:

Postmenopausal women with a personal history of breast cancer. Women with no personal history of breast cancer who are 60 years and older, have a history of ductal carcinoma in situ with mastectomy, or have a high risk of breast cancer based on the gail model tool (a tool used to estimate the risk of breast cancer).

In women with an increased risk of breast cancer, taking aromatase inhibitors decreases the amount of estrogen made by the body. Before menopause, estrogen is made by the ovaries and other tissues in a woman's body, including the brain, fat tissue, and skin. After menopause, the ovaries stop making estrogen, but the other tissues do not. Aromatase inhibitors block the action of an enzyme called aromatase, which is used to make all of the body's estrogen. Aromatase inactivators stop the enzyme from working.


 

Possible harms from taking aromatase inhibitors include muscle and joint pain, osteoporosis, hot flashes, and feeling very tired.


 

Risk-reducing mastectomy:

Some women who have a high risk of breast cancer may choose to have a risk-reducing mastectomy (the removal of both breasts when there are no signs of cancer). The risk of breast cancer is much lower in these women and most feel less anxious about their risk of breast cancer. However, it is very important to have a cancer risk assessment and counseling about the different ways to prevent breast cancer before making this decision.


 

Ovarian ablation:

The ovaries make most of the estrogen that is made by the body. Treatments that stop or lower the amount of estrogen made by the ovaries include surgery to remove the ovaries, radiation therapy, or taking certain drugs. This is called ovarian ablation.


 

Premenopausal women who have a high risk of breast cancer due to certain changes in the brca1 and brca2 genes may choose to have a risk-reducing oophorectomy (the removal of both ovaries when there are no signs of cancer). This decreases the amount of estrogen made by the body and lowers the risk of breast cancer. Risk-reducing oophorectomy also lowers the risk of breast cancer in normal premenopausal women and in women with an increased risk of breast cancer due to radiation to the chest. However, it is very important to have a cancer risk assessment and counseling before making this decision. The sudden drop in estrogen levels may cause the symptoms of menopause to begin. These include hot flashes, trouble sleeping, anxiety, and depression. Long-term effects include decreased sex drive, vaginal dryness, and decreased bone density.


 

Getting enough exercise:

Women who exercise four or more hours a week have a lower risk of breast cancer. The effect of exercise on breast cancer risk may be greatest in premenopausal women who have normal or low body weight.


 

It is not clear whether the following affect the risk of breast cancer:

  1. Oral contraceptives

  2. Certain oral contraceptives contain estrogen. Some studies have shown that taking oral contraceptives (" the pill") may slightly increase the risk of breast cancer in current users. This risk decreases over time. Other studies have not shown an increased risk of breast cancer in women who take oral contraceptives.

  3. Progestin -only contraceptives that are injected or implanted do not appear to increase the risk of breast cancer. More studies are needed to know whether progestin-only oral contraceptives increase the risk of breast cancer.


 

Environment

  1. Studies have not proven that being exposed to certain substances in the environment, such as chemicals, increases the risk of breast cancer.

  2. Studies have shown that some factors do not affect the risk of breast cancer.


 

The following do not affect the risk of breast cancer:

  1. Having an abortion. Making diet changes such as eating less fat or more fruits and vegetables. Taking vitamins, including fenretinide (a type of vitamin a). Cigarette smoking, both active and passive (inhaling secondhand smoke). Using underarm deodorant or antiperspirant. Taking statins (cholesterol -lowering drugs). Taking bisphosphonates (drugs used to treat osteoporosis and hypercalcemia) by mouth or by intravenous infusion.

  2. Cancer prevention clinical trials are used to study ways to prevent cancer.

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