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Dr. Saravanan

Radiologist, Chennai

Dr. Saravanan Radiologist, Chennai
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My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them....more
My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them.
More about Dr. Saravanan
Dr. Saravanan is a trusted Radiologist in Nanganallur, Chennai. Doctor is currently associated with Sri Venkateswara C M Hospital in Nanganallur, Chennai. Book an appointment online with Dr. Saravanan on Lybrate.com.

Lybrate.com has an excellent community of Radiologists in India. You will find Radiologists with more than 36 years of experience on Lybrate.com. You can find Radiologists online in Chennai and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Herniated Disc - What are the Risks Involved in it?

MCh - Neurosurgery, MBBS
Neurosurgeon, Chennai
Herniated Disc - What are the Risks Involved in it?

The symptoms caused due to herniated disc can be very severe and can also cause a bit of disability. The disc of the spine is like a cushion and separates the set of bones on the backside. The discs are shock absorbers of the spine and are mainly composed of 2 parts, a soft jelly centre called the nucleus and a tough outer covering called the annulus.

Effects of Herniated Disk
A herniated or cracked disc is a severe condition and it seems to happen most commonly in the lower back.  It happens when a fraction of the soft centre gets pushed through the destabilized area due to degeneration, trauma or by putting pressure on the spinal cord. 

Nerves are located precisely at the back of every disc and are responsible for controlling everything in our body. While a disc gets herniated, the external covering of the disc tears and creates a bulge. The soft jelly gets shifted from the centre of the disk to the region where the damage has occurred on the disc. Most commonly, the bulge occurs in areas where the nerve is located and it causes strain on the affected nerve. It has been observed that individuals do not feel any painful sensations even if their disc gets damaged.

When is Surgery Recommended for Herniated Disc?
Surgery for herniated disc is recommended only after options like steroid injections, pain relievers, exercise and non-steroid anti-inflammatory drugs do not work. If the pain persists even after these options, then it becomes important to go for surgery. There are certain risks involved in this surgery like infection, bleeding or nerve damage. 

There are chances that the disc may get ruptured again if it is not removed. If you are a patient suffering from degenerative disc disease, then there are chances that problem occurs in other discs. It is very important that a patient maintains healthy weight to prevent any further complications.

The main factor that increases the risk of herniated disc is excess body weight, which causes a lot of stress on the lower back. A few people become heir to a tendency of developing this condition. Even individuals with physically demanding jobs are prone to this condition. 

Activities like bending sideways, pushing, twisting, repetitive lifting can increase the risk of a herniated disk. At times, emergency surgery is also required to avoid paralysis in a patient. If you wish to discuss about any specific problem, you can consult an orthopedist.

3507 people found this helpful

Back Injury

BPTh/BPT
Physiotherapist, Delhi
Back Injury
Herniated disks or bone spurts in the vertebrae of the neck may become the reason behind severe neck pan. They sometimes take too much space and compress the nerves branching out from the spinal cord.
225 people found this helpful

I have back pain L4. L5 problem fast in 5 years. I want to reduce pain with out operation is possible. Please Inform

M.Ch, DNB (Orthopedics), MBBS
Orthopedist, Mohali
You should do a proper regime of medicaton and Exercises for 3 months. the kind of exercises depend on your x-ray and mri reports. Only of this fails completely then we think of other measures like injections to the spine, surgery etc. the basic principle of spine therapy is minimal intervention.
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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.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Kindly show me a photograph of the affected part--knees 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. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck, back, knee & 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.
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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.
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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 met accident and my back disk d8 and d12 injured and operted in banglore now i am paraplegia patient from 7 years any treatment to cure it please reply me i went for stem cell in chenni also

MS ORTHOPEDIST, MBBS
Orthopedist, Noida
Its sad to know about your conditions. Stem cell can provide little help on immediate spinal trauma... there r other parameters to evaluate the neurology which is not possible with chatting.. prognosis is not good in long standing cases...
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I am having slip disc. I want to know to cure it with exercises and what are the precautions to took for this?

MS - Orthopaedics
Orthopedist, Surat
Till you have pain, exercises would have little help. Initially you have to take bed rest. Avoid forward bending & cross-legged sitting on ground. Sit with a straight back. You can wear l. S. Belt temporarily. When pain subsides you can start exercises as guided by your doctor to prevent future disc problems.
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Natural Ways to Treat Swollen Legs, Ankles and Feet

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Natural Ways to Treat Swollen Legs, Ankles and Feet

You know that feeling after a long day when your feet are so sore or swollen that you can’t bear the thought of standing on them for any longer? once you take off your shoes and sit down, or even soak them in a warm bath, it’s still an unpleasant experience. Luckily, I’ve collected 10 natural remedies for such an occasion and I want to share them with you.
 
Important: regular swelling vs potential health risks
When experiencing swelling in the feet and legs, apply pressure to the area with a finger. If the dimple created by the finger remains for more than a couple of seconds, it may indicate oedema, which can be the result of heart, liver, or kidney problems. When this occurs, see a doctor at the first possible opportunity.
If you experience swelling in one leg but not the other, you should also see a doctor as this may be an indication of deep venous thrombosis (a blood clot blocking the blood vessels).
If the swelling is accompanied by shortness of breath, fever, bluish skin, and chest pains, get immediate medical attention.
 
10 natural remedies:

1. Soak your feet in epsom salts
Pour 250g of epsom salt into a hot bath, and take a nice long soak. You can also add essential oils to the mix for enhanced relaxation. Your feet will thank you, your body will thank you, and you’ll emerge from that bath a happier person.
2. Massage the area
Massaging the painful area increases blood flow and moves the fluids that accumulate and cause the swelling. If you want to indulge, get someone to massage your feet for you, preferably with hot essential oils.
3. Stop smoking
If you smoke tobacco (cigarettes, cigars, etc.), you should know that one of the many negative effects of nicotine is constriction of blood vessels, which can lead to sore feet.
4. Stay hydrated
When the caffeine and sodium we consume accumulate in the body, they can cause swelling and pain in the limbs. The best way to dilute them and flush them out is by drinking water. If you want to maximize the efficiency of hydration, squeeze a lemon or lime into the glass of water for a boost of vitamins and antioxidants.
5. Eat healthy, avoid excess salt
While we need salt for our body to function well, when we overdo it, it can have adverse effects. Reduce the amount of salt you consume every day, and consider cutting down on caffeine as well.
6. Elevate the legs
If you’re suffering from chronically sore legs/feet, try keep your legs elevated for 30 minutes, three times a day. You will notice a difference within a couple of days. Also, when you’re in bed, use a couple of pillows to prop up your feet. Elevating the legs helps to drain the excess fluids that causes the swelling and pain.
7. Avoid sitting for prolonged periods
Whether you’re flying, taking the bus, or just sitting in an office all day, keeping your legs stationary can lead to pain and swelling. If you know you’re going to sit for a long period of time, make sure to stand up, stretch, and walk around every 20 minutes or so.
8. Use compression socks when traveling
If you’re going to fly overseas, another excellent solution is to use compression socks. These socks apply pressure to your feet, preventing fluid from building up – the main cause of swelling and pain in the feet.
 9. Exercise
Exercise will help boost your cardiovascular system, which in turn will reduce the possibility of swelling in the limbs. Exercise increases blood-flow in the body and reduces weight. 
10. Take magnesium supplements
Magnesium is essential for our body’s function. That said, many people suffer from a magnesium deficiency. By adding magnesium to your system, you will improve your overall health, reduce hangover symptoms and suffer less pain in your extremities

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As per my MRI report for lumber spine, disc protrusion seen at L5-S1 indenting anterior thecal sac and narrowing left neural recess. Disc hydration is Los at L5-S1. I have severe lower back pain for last one month. What is the ideal plan for treatment?

BPTh/BPT
Physiotherapist, Delhi
As per my MRI report for lumber spine, disc protrusion seen at L5-S1 indenting anterior thecal sac and narrowing left...
Take bed rest for 15 days. Consult physio they will guide you better. Avoid forward bending. Use hot pack for 15 mint at lower back.
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Dear sir. My mother is suffering from pain in waist and legs unable to stand for sometime and unable to walk due to L5 L6 displaced and make pressure on nerve. I don't want to operate for this . Is any other solution.

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi , This is Dr Akshay from Fortis Hospital. Kindly upload her x ray and MRI images so that i can see and opine accordingly. Thanks & Regards Dr Akshay Kumar Saxena
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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 am a student. Usually I used to sit more than 8 hours a day in chair. Now a days I am feeling very much pain on regions of backbone and neck. Is this a chance of disk failure?

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I am a student. Usually I used to sit more than 8 hours a day in chair. Now a days I am feeling very much pain on reg...
Neck advice hot fomentation x twice daily. Neck exercises. Neck stretching. Postural correction. Shoulder shrugs. Core strengthening exercises. Take frequent breaks at work use cervical pillow. Use back support. Back advice. Apply hot fomentation twice daily. Avoid bending in front. Postural correction- sit tall, walk tall. Extension exercises x 15 times x twice daily. Bhujang asana. Core strengthening exercises. Back stretching. Do the cat/cow stretch.
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I am having ls S1 disk bulge problems if I am having physiotherapist it will cure or not?

DNB (Radiodiagnosis), DMRD, MBBS
Radiologist, Bangalore
Hi, thanks for your query a l 5 - s 1 disc bulge might respond to physical therapy. It cannot be cured completely like before but with precautions and medicine you will feel much better and have a normal life. Please take care not to involve yourself in any activity which might stress your lower back. This will delay recovery and might also cause complications and the pain and discomfort to increase. Avoid doing sudden movement involving lower back and lifting weight more than 5 kg. This will help you recover quickly. For mild pain you should use ointments with muscle relaxant and pain relief. In severe pain plase adk your doctor for oral ner pain reluef medicine and non steroidal anti inflammatory pills. Use of heat pack is also recommended. Regards.
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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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Please tell me what can I do in slip disk problem please explain preventive & treatment methods without using drugs because I need not anymore drugs because I already taken lots of drugs.

Fellowship of the Royal College of Surgeons (FRCS), Membership of the Royal College of Surgeons (MRCS)
Orthopedist, Trichy
you have to avoid lifting heavy weight and doing strenuous activities. Core muscle strengthening exercises helps. weight reduction is necessary.
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I am an advocate and have got sitting job for long hours and walking job too. I am suffer from slip disc. Any treatment?

Fellowship In Arthroplasty and Arthroscopy, MS Orthopaedics, MBBS
Orthopedist, Gurgaon
Regular exercises and maintaining good posture whie sitting is the key to avoid most of the back pain problems. Please do take frequent breaks every hr and strech your muscles and do not sit for long.
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Lumbar Degenerative Disc Disease

MBBS, Diploma In Orthopaedics (D. Ortho), DNB - Orthopedics, mch
Orthopedist, Delhi
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Different methods to treat Disc problems

3712 people found this helpful

Sir I am FROM CHENNAI having back pain when mri scanned impression as follows Early lumbar spondylosis. Mild disc bulge with focal posterocentral and bilateral postrtolateraldisc at l3_ 4 disc level causing thecal sac ibdentation and bilatrral mild beural foranimal narrowings (L>R) MILD ligamentum flavum hypertrophy at L3_4 & L4_5 disc level causing mild posterior thecal sac indention Disc desiccation in L4_5 & L5_ S1 DISC LEVEL AS LOSS OF HYPERINTENSE SIGNAL ON T2W1 PLEASE HELP I REPLY ME POSITIVELY

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hello Sir, This is Dr Akshay from Fortis Hospital, New Delhi. It appears from your report that you have degenerative spine with multiple levels more at L3/4 level. I need to understand from you - How is your back pain? - Leg Pain? - How much distance can you walk? - Is there any numbness in legs, wekaness in legs etc? Please get back to me with answers and then we can start your treatment accordingly. Thanks & Regards Dr Akshay Email : akshaysaxena2004@yahoo.co.in
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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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