Breast reduction or breast reduction surgery is a form of cosmetic surgery where the size of disproportionately large breasts is reduced.

Extra large breasts may cause neck pain, back pain and several other physical symptoms. Many women undergo a breast reduction to make life easier. This surgery provides effective results.

The procedure of breast reduction surgery-

Breast reduction surgeries can be conducted in an outpatient facility. You may have to stay for one night at a hospital as well. While performing this surgery, a patient is given general anaesthesia, which will make the patient asleep during the process.

Breast reduction surgery requires about two to five hours to be completed successfully. During the process, the surgeon will create a cut around the nipple and then on the breast. The cut is made in the shape of a keyhole. Extra skin, tissue and fat will be removed from the breast through the keyhole-shaped incision. Drainage tubes are also utilized for removal of excess skin and fat. After the removal is complete, and enough skin has been removed, the breasts are stitched. They are then wrapped in a special gauze. Sometimes, a surgical bra is required to be worn by the patient during the surgery.

Recovery from breast reduction surgery-

After a breast reduction surgery is performed, the patient must take a minimal one week off from any kind of work or school. Some women require two weeks or more to recover. However, this varies from patient to patient, but not more than three weeks are required for recovery.

You will be having a follow-up appointments with your surgeon, where the bandages and stitches on the breasts are removed.

As a part of the recovery process, a woman must abstain from all kinds of physical activities for one month following the surgery. After the surgery, it is likely for a patient to feel tired and experience breast pain. However, this is normal and you can have oral pain killers prescribed by your surgeon to get relief and ease. Heavy lifting should be strictly restricted.

Breast reduction surgery is an efficient cosmetic surgery, which enables women to reduce their breast size and volume. The results of such a surgery are quite satisfactory.

Breast Reduction - Know The Procedure and Recovery!

Of all cancer types that affect the female population, breast cancer is the most common one. Statistics show that above 1 in 8 women in the USA are likely to develop breast cancer (invasive type, which is often severe). Changing lifestyles including prolonged use of birth control, smoking, alcohol abuse, lack of physical activity, dietary changes, etc., have led to an increased incidence. As these are here to stay, the only way is to prevent.

The likelihood of developing breast cancer is determined by risk factors. Some of these risk factors cannot be changed. For instance, age, ethnicity, and history of familial breast cancer. However, there are others, which can be acted upon or modified to reduce the chances of developing breast cancer. 

Some of the preventable risk factors are as follows:

Nicotine abuse: Quitting smoking has multiple benefits for a woman, and one major benefit is the reduced risk of developing breast cancer. Other benefits include reduced incidence of diabetes, heart disease, and other cancers.
Hormone replacement therapy: To the extent possible, avoid prolonged use of birth control pills or hormones for other treatment purposes. In addition to using non-hormonal methods, if not avoidable, constantly monitoring hormone levels is very important. Birth control pills should especially be avoided by women over 35 years of age who smoke. The risk associated with developing cancer reduces as soon as the hormone supplement is stopped.
Weight Management: One of the major risk factors is obesity, and in people with other non-alterable risk factors, it is best to work on weight management from an early age. Talk to your doctor about your ideal BMI and ensure this is maintained.
Physical Activity: Regular physical activity, at least 30 minutes per day, in addition to strength training will help in keeping the body agile and managing weight. It also reduces the risk of breast cancer.
Breastfeeding: Studies have shown that breastfeeding has protective effect against breast cancer; longer a baby is breast fed, greater is the protective benefit.
Screening: Even if not completely preventable, early detection of breast cancer is very important. This will help in less severe treatment and better prognosis. Recommended ages for mammography are as follows: 
In the age of 40 to 44, an annual mammogram is advised along with a discussion with the doctor on the risks.
An annual mammogram for all women in the age of 45   54 is important as most women enter menopause by this time. This needs to be continued annually, as self-breast exams alone cannot detect cancer, thus it is a good practice and anything abnormal will not go undetected.
These will help reduce the risk of developing breast cancer, help in early detection, and improve prognosis.

Breast Cancer - 6 Ways You Can Reduce The Risk!

A mammogram is an imaging test where an X-ray is taken to recreate the internal imagery of your breasts. This is a screening test that is widely used to find the earliest signs of cancer. There have been instances where the early signs of cancer have been found up to three years before the actual development of the same. There are a number of benefits and risks in this screening method. So let us find out more about getting a mammogram, and whether or not you should get one.

    Procedure: A special X-ray machine is used for conducting a mammogram. There is a clear plastic plate on which the specialist will place the breast while another plate will press on the breast from above. While both the plates serve to flatten the breast and hold it still, the X-ray will be taken. Some pressure will be felt and the same steps will be repeated so as to get the side view of the breasts. The same procedure will be repeated for the other breast. Meanwhile, once it is done, you will need to wait so that the technician can check for clarity, and whether or not the procedure needs to be done again. The results of this procedure cannot be relayed by the technician, and all the images will be different because all breasts are slightly different from each other.
    Preparation: You will need to remember that the process can be a slightly painful one, especially once the pressure gets applied. Many women complain of discomfort and pain. Yet, this discomfort gets over before you know it. The pressure and pain will depend on the size of your breasts and how much they will have to be pressed in order to get a picture. The skill of the technician will also come into play here. One must remember not to get this procedure done a week or so before or after the menstrual cycle, as the breasts tend to be tender around this time, and the pain will be much more.
    Radiologist: Within a few weeks after the procedure, the radiologist will usually deliver the result. This is the professional who does an accurate reading of the X-ray.
    Normal and Abnormal Readings: If your mammogram result has a normal reading, then you can resort to getting one done every once in a while. But an abnormal reading will require further X-ray and tests so as to be able to tell for sure.
    Why should I get one: If you are over 40 and have a family history of such ailments, then you will have to get a mammogram done regularly.

Should You Get a Mammogram?

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.

Breast Cancer - In A Nutshell


Feeling a lump on your breasts can be a terrifying moment. 'Cancer' is the first thing that comes to mind but in reality, most lumps in the breast are not caused by cancer. Apart from cancer, breast lumps can be caused by non-cancerous growths, injuries and infections. The only way to correctly diagnose the cause of a lump in the beasts is through a biopsy. Hence, this is the first step towards treating a breast lump. From here on, treatment will depend on the cause identified.

Mastitis or Breast Infection

Mastitis is a painful infection of the breast tissue often faced by women who are breastfeeding. It can be treated with heat treatment and antibiotics. Massaging the breast while taking a warm shower or applying a warm compress. This will open up the milk ducts and should be followed by nursing the baby or using a breast pump to relieve the swelling and pain.

Abscess

Antibiotics are the first line of treatment against an abscess but this is effective only if given in the initial stage of the infection. In later stages, an abscess will need to be surgically drained.

Fibroadenomas

This is a non-cancerous tumour often found in young women. It is often difficult to distinguish between a Fibroadenoma and a cancerous tumour and hence these are usually surgically removed.

Fibrocystic Changes

In some cases, the breast itself is composed of knotted, rope like tissue. This is known as having fibrocystic breasts. If a new lump presents itself on fibrocystic breasts, a mammogram and an ultrasound are performed to evaluate the lump. In most cases fibrocystic changes do not require any medication or surgery.

Breasts Cysts

Cysts can be defined as fluid filled lumps. In some cases, these cysts become apparent at the time of ovulation and disappear after the period. In other cases, it may need to be drained with a thin needle. Cysts often recur and need to be re-drained.

Fat Necrosis and Lipoma

Fat necrosis is a lump caused by an injury to the fatty tissue in the breast. Lipoma is a fatty growth within the fatty tissue. In both these cases, no treatment is required but if it causes any problems, it can be removed.

Breast Cancer

If the biopsy reveals the presence of a cancerous tumour, you must immediately consult an oncologist. Treatment options for breast cancer include chemotherapy, radiation, surgery and hormone treatment.

Treating Lumps and Pain in Breasts of Women

Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. It occurs in both women and men, although breast cancer in men is rare.

Risk factors:

Lack of physical activity
Alcohol consumption
Advancing age
No childbirth or no breastfeeding
Family history of breast cancer
Early menarche (< 12 years of age) or late menopause ( > 55 years of age)
History of ovarian cancer or endometrial cancer
History of benign breast conditions (e.g. atypical hyperplasia) or lobular carcinoma in situ
Receiving hormonal replacement therapy (HRT)
History of receiving radiation therapy to the chest before age of 30
More importantly, you can lower your risk of having breast cancer by the following measures:

 Have regular physical activities, do at least 150 minutes of moderate-intensity aerobic physical activities per week (e.g. climbing stairs or brisk walking)
Avoid alcohol drinking;
Maintain a healthy body weight and waist circumference - aim for a body mass index (BMI) between 18.5 and 22.9, and a waist circumference of not more than 80cm for women; and
Have childbirth at an earlier age and breastfeed each child for longer duration factors include:
What are the common symptoms of breast cancer?

The symptoms of breast cancer may not be easily noticed at an early stage. Any of the following changes in the breast can be a symptom of breast cancer:

  Breast lump;

  A change in the size or shape of the breast;

  A change in skin texture of the breast or nipple (e.g. red, scaly, thickened or  orange-skin  appearance);

  Rash around the nipple;

  In-drawing of the nipple;

  Discharge from one or both nipples;

  New and persistent discomfort or pain in the breast or armpit; and

  A new lump or thickening in the armpit

What is breast cancer screening? Should I screen for breast cancer if I do not have any symptom?

Screening means examining people without symptoms in order to detect disease or fi nd people at increased risk of disease. It is often the fi rst step in making a defi nitive diagnosis. For breast cancer screening, its purpose is to fi nd women who have breast cancer, before they have any symptom, in order to offer them earlier treatment.

Mammography is widely used as a screening tool. It is an X-ray examination of the breasts. During mammography, the breast is pressed between 2 plates to flatten and spread the breast tissue, in order to obtain a clear image. Some women may find it uncomfortable or painful but the discomfort is usually short lasting. Mammography screening is safe in general and only a very small dose of radiation is used in the procedure. One in 5 female breast cancer patients may be missed by mammography.

Prevention and Screening for Breast Cancer: Information for women and their families

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