Breast cancer is a type of cancer, which occurs due to the development of cancerous cells in breasts. Women are usually affected by breast cancer and breast cancer is one of the most common forms of cancer after skin cancer. Usually fatal if not diagnosed in its early stage, breast cancer is a very serious medical ailment. Read on more to find all about the different symptoms, causes, preventive measures and treatment of breast cancer.

Symptoms
Breast cancer has few distinct characteristics and if you have a few or all the following symptoms you could be more likely to suffer from breast cancer. 
a) The formation of a lump in your breast, which is different from the surrounding tissue and usually more thickened.
b) The discharge of bloody fluid  material from the nipples.
c)  Sudden change of the size, shape and appearance of the breast.
d) Certain distinct changes to the skin over the breast for example an indentation in the skin similar to that of a dimple.
e) Appearance of an extra nipple which is inverted.
f)  If the darkened area around the nipples known as the areola is flaking or peeling off.
 
Causes
Studies and researches remain inconclusive on what causes breast cancer. Breast cancer occurs due to abnormal division of the cells located in the breast, which over time accumulate and form lumps. They
might spread to other parts of the body. Breast cancer is caused mainly due to a complex interaction of personal genetics, environment and lifestyle choices. Breast cancer can also be caused due to genetics as about 5% to 10% of cases are due to gene mutations which pass onto generations.

Risk factors
There are certain factors, which increase the probability of contracting breast cancer. Increasing age, personal and family history of breast cancer, obesity, radiation exposure, pregnancy at an older age, postmenopausal hormone therapy are some of the factors that increase the chances of breast cancer.

Treatment
Several forms of surgical methods exist to treat breast cancer. Depending on the condition and spread of the disease a suitable surgery is performed. These include mastectomy, lumpectomy, axillary lymph node dissection and removal of both breasts. Other forms of treatment include chemotherapy or the use of high doses of drugs to destroy cancerous cells. Radiation therapy where X-rays are used to destroy the cancer cells is also effective.

All About Breast Cancer

Minimally invasive spinal surgery is a quicker and safer alternative to open surgery. The spinal discs, vertebrae and nerves are present deep inside the body. A small incision is made and the surgical instruments and a camera is inserted which push aside the muscles and reach the problem area.

Which medical conditions can be addressed with minimally invasive spine surgery?

1. Degenerative Disc Disease (osteoarthritis of the spine)
2. Herniated Disc (the disc protrudes from its right place)
3. Spinal Tumours
4. Vertebral compression fractures (collapse of the vertebra)
5. Lumbar spinal stenosis (narrowing of the space near the spinal cord)
6. Scoliosis (the spine curves sideways)
7. Spinal infections
8. Spinal instability

What are the goals of minimally invasive spine surgery?

1. Decompression: this procedure eases the pressure being exerted on the spinal cord or the nerve roots. This pressure can be the cause of pinched nerves.
2. Stabilization: sometimes, a segment of the spinal cord that has come loose can be the source of pain. A stabilizations surgery fuses the segment to the rest of the structure.



The three most common methods of minimally invasive spine surgery are-

1. Tubular: it is also called  muscle splitting  surgery. A tubular retractor passes through the muscles of the back and reaches the spine.
2. Mini-open: it is a lot like open surgery but with fewer risks and blood loss. The possibility of post-operation infection goes down significantly.
3. Endoscopic: it is also called a keyhole surgery. A small camera is introduced through a small incision and guided to the spine. The camera gives an internal view of the spine to the doctors.

The three types of Minimally Invasive Spinal Surgery are-

1. Microdiscectomy: involves the removal of the intervertebral disc that is putting pressure on the spinal cord.
2. Foraminotomy: spinal conditions can lead to narrowed foramen (the area where the spinal nerve exits the spine). The aim of the surgery is to expand the foramen.
3. Microlaminectomy: this is yet another type of decompression surgery. The aim is to relieve pain caused pinched nerves or a segment of the bone pressing down on the nerves.

What are the benefits of minimally invasive spine surgery?

  Speedy and pain-free recovery after surgery
  A patient is discharged the same day
  Very little loss of blood
  Reduced chances of infection
  Less scarring because the operation is done through small incisions
  Less muscle damage

Are there any risks attached to minimally invasive spine surgery?

No surgery is free of risks or side effects. Some common problems in the aftermath of minimally invasive spine surgery are-

  Allergies
  Reaction to anaesthesia
  Blood clots
  Infections
  In rare cases stroke and paralysis.

Minimally invasive spinal surgery incorporates the latest advances in the world of technology. It is the relatively hassle-free procedure and convenient for both doctors and patients.

Minimally Invasive Spinal Surgery - A Safer Alternative To Open Surgery!

Breast cancer is a form of cancer which develops from the breast tissue. Breast cancer is indicated by signs such as a lump in the breast, changes in breast shape, fluid flowing from the nipple, dimpling of skin, or the development of red scaly patches. Breast cancer is a fatal form of cancer in women and immediate diagnosis is required on observing the symptoms.

Diagnosis of breast cancer
Other than the regular breast screening, the diagnosis of breast cancer involves the following steps and methods:

Seeing your general practitioner (GP): It is very important to visit your GP soon after noticing the symptoms of breast cancer. Your GP will examine you properly and in case your symptoms need more assessment, he/she will refer you to a breast cancer clinic.
Mammogram and breast ultrasound: You will be required to have a mammogram, as recommended by a specialist breast unit. This is an X-ray of the breasts. An ultrasound scan may also be required. Breast ultrasound should be undertaken only if you are less than 35 years of age. This is because, young women have denser breasts and a mammogram is not as effective as ultrasound in the diagnosis of breast cancer. In ultrasound, high frequency sound waves are used for obtaining an image of your breasts. It is observed to notice any abnormality or lumps. A breast ultrasound is also important for determining whether a lump is solid or contains liquid.
Biopsy: In this diagnosis process, a sample of the tissue cells is taken from the breasts and tested under a microscope to find out if it is cancerous. A scan and needle test for the lymph nodes present in your armpit is also done to check whether they have also been affected. A biopsy is undertaken in several ways, depending upon the condition and severity. A needle aspiration biopsy is used for testing a sample of your breast cells without the removal of the tissues. This is the most common form of biopsy and it is also used for draining a small fluid-filled lump or benign cyst. During the process, you will be given a local anesthetic. Usually, a needle biopsy is carried out guided by an X-ray, ultrasound and an MRI scan as well. This helps in distinguishing it from non-invasive changes such as ductal carcinoma in situ.
Another form of biopsy used for the diagnosis of breast cancer is called vacuum assisted biopsy or mammotome biopsy. In this process, a needle gets attached to a suction tube, which helps in obtaining the sample and for clearing the bleeding.

How Is Breast Cancer Diagnosed?

The human body has 206 bones and bone cancer can affect any of these bones. This condition starts when healthy bone marrow cells mutate and grow out of control to form a tumor. There are many different types of bone cancer. Treatment of bone cancer varies from case to case and depends on factors such as, type of cancer, stage at which it is diagnosed and the patient s overall health amongst other factors.

Surgery, chemotherapy, and radiation are the three most common types of treatments favored for bone cancer. Surgery is usually used for low-grade tumors. This involves the removal of tumor and the surrounding healthy cells and tissues to ensure that that cancer does not recur. For high-grade tumors, surgery may be accompanied by chemotherapy, radiation or a combination of the two. 

Chemotherapy involves the delivery of medication to destroy cancer cells orally or intravenously. Radiation involves the use of high energy X rays to kill cancer cells. This is often used to treat patients with a tumor that cannot be surgically removed.

Apart from these standard forms of treatment, bone cancer patients are often advised to take part in clinical trials for their treatment. This can be described as a research study to test the efficiency of new approaches to the treatment of bone cancer. A clinical trial can be used to treat the safety and efficacy of a new drug, the new dosage of standard drugs or a new combination of treatment types. As a member of a clinical trial, you may be one of the first few people to benefit from treatment even before it is available to the general public. 

Some of the new options available through clinical trials are:

Immunotherapy: This is also known as biologic therapy. It is designed to boost the patient s immune system to fight cancer cells. Mifamurtidesi one of the types of immunotherapy being tested. Immune checkpoint inhibitors such as monoclonal antibodies are also being tested for their ability to block specific molecules.
Targeted therapy: This type of therapy targets the genes and proteins that contribute towards the growth and survival of cancer cells. Targeted therapy limits the damage caused to healthy cells and tissues and only blocks the growth of cancer cells.
Myeloablative therapy: This involves an intense regimen of chemotherapy. High doses of chemotherapy aim at destroying all the cancer cells. Unfortunately, in the process, healthy cells may also be killed. This may be followed by introducing stem cells through a bone marrow transplant to the patient s body to renew blood cells.
Intraoperative radiation therapy: These trials evaluate the use of radiation given inside the patient s body during a surgery. In cases where tumor is in a distant location of the body, stereotactic body radiotherapy and radiofrequency ablation may be used.


Bone Cancer - Understanding The New Approaches For Treatment!

As life expectancy is increasing so is the incidence of vertebral body (VB) fractures now being the commonest fracture of the body. PVP is an established interventional technique in which bone cement is injected under local anaesthesia via a needle into a fractured VB with imaging guidance providing instant pain relief, increased bone strength, stability, decreasing analgesic medicines, increased mobility with improved quality of life and early return to work in days.

In this era of minimally access surgery replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression fracture spine.

Morbidity & consequences of spinal fracture:

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory & GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc element
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Results / Outcome

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral.
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Percutaneous Vertebroplasty (PVP) is an emerging interventional technique in which surgical polymethyl methacrylate bone cement is injected under local anaesthesia via a large bore needle into a vertebral body (VB) under imaging guidance providing increased bone strength, stability, pain relief, decreased analgesics, increased mobility with improved QOL and early return to work. Started in 1984 by Galibert PVP is done in host of indications.

Senile osteoporotic compression remains the commonest Indication. Other indications are Metastatic VB, Multiple myeloma VB, VB haemangioma, Vertebral osteonecrosis & for strengthening VB before major spinal surgery. The benefit has been extended to the traumatic stable uncomplicated VB compression (VCF) which is commoner in younger age group with active life profile and prime of their career where strict bed rest and acute or chronic pain are unacceptable and they are more demanding for proactive treatment approach so as to be back to work ASAP.

Discovering the fact that VB is the commonest of body, its incidence >the hip, it becomes imperative to take it more seriously. With increasing life-span there is more of aged osteoporotic population, more so due to sedentary indoor lifestyle and post menopausal osteoporosis. Diabetics, smokers & alcoholics are at higher risk of developing osteoporosis. I have seen such alcoholic patient developing six spine fractures in just three months time from a single fracture being on complete bed rest.

Quick fix of fracture spine makes patient walk back same day instead of bed rest of months together avoiding morbidity & mortality of prolonged bed rest, making bedridden patient walk, in a way bringing patient back to normal life.

In this era of MAS replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression.

Morbidity & consequenses of spinal 

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly.
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory &
GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc elements.
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics.
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Morbidity and complication of spinal surgery 

Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Preparation & Procedure:
X-ray spine in a/p & lat view. CT is more informative of bone & morphology. MRI is good for soft tissue injuries. Ask for pedicle size in all dimensions and construct a 3D image aiming needle placement and cement filling in scan room itself as rehearsal of PVP. This reduces operative time & gives better results. Conventionally PVP is done by hammering the vertebroplasty needle through the bone. Here we use light weight drill to bore through the vertebra. It is important to set the needle at exact entry site & side with right trajectory aiming the defects.

In lateral view needle should go through middle of the pedicle going up to anterior 1/3 of VB. In P/A view the needle can be in midline or paramedian depending upon & if uni/bipedicular approach is planned. Approach varies as per location of vertebra, anterolateral in cervical, costotransverse/parapedicular in thoracic & transpedicular in lumbar vertebra.

Do bone biopsy if there is any doubt about lession. Do dye test (vertebral venography). Make cement more radiopaque by adding barium /or tungsten. Inject cement with 1or2 ml luerlock syringes strictly under fluoroscope in lateral view & cross checking in P/A view. Stop injecting either there is adequate filling or at the first sight of ectopic cement leak. Keep sample cement to see for hardening. Remove needle with rotational movement before cement hardens.

Pain relief is by virtue of different mechanisms postulated :

Cementing of fragments.
Thermal neurolysis of VB nerve ending due to heat of polymerization.
Washing away of nociceptor chemicals.
Neurolytic action of liquid monomer.
By allowing early ambulation decreasing pains of immobility & bed rest.
Complications 

PVP is generally safe with low risk.
Ectopic cement leak is frequent but generally inconsequential.
Outcome 

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty.
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

The incidence of breast cancer is increasing worldwide, especially in the western world due to a variety of factors like diet, genetics and lifestyle, including body weight. Other predominant factors are ovarian function and oestrogen exposure, pregnancy, and lactation. It is the second most common carcinoma in women and it occurs mostly after the age of 30. It s most commonly seen in the age group of 40-60. Even though there is so much of awareness about this cancer, there is a high incidence of this cancer going undetected.

This cancer is treatable if detected early. For this, we need to know its common symptoms, which are

Lump in breast i.e. presence of a hard mass in the breast with no defined margins
Bleeding from nipple
Nipple retraction
Redness and pain
If left undetected, cancer in the breasts can spread to the bones, liver and even the brain.

Homeopathic treatment
We all know that Homeopathy, a popular holistic system of medicine cures by using the principle of  Like cures like . Homeopathy relies on a specialised remedy based on the physical, psychological and emotional symptoms of a patient. This is the reason that self-medication fails abysmally in homoeopathy. The homoeopathic medicines for breast cancer in this article thus should be used just as a reference and you should consult a good homoeopath for a complete cure. Several proven homoeopathic remedies are available to treat symptoms of breast cancer like:

Conium Mac: It is an excellent cure for breast cancer, especially when the breasts are hard and tender. The breast becomes rock-hard and there is a stinging pain in this type of breast cancer which starts in the milk ducts and spreads to outer regions. This type of breast cancer is tackled by Conium Mac.
Baryta Carb: This homoeopathic drug is used when the breast is enlarged and inflamed. The mammary gland is also hard and stony plus sensitive to touch. The milk glands in this type of cancer become enlarged and tender. Blood from the nipple is another indication for use of Baryta carb.
Hydrastis Can: The patient has to swell of the mammary glands and complains of pain and tenderness. Her nipples are engorged, have cracks and a watery discharge.
Iodine: This homoeopathic remedy works mostly on the enlargement of the breasts which may be malignant or malign. In this type of cancer, the mucous membrane of the mammary glands as well as the breast tissue gets inflamed. The breast tissue becomes enlarged and hard and presents with nodes.
Phytolacca: A hard, irregular tumour with retracted nipples is the main indication for this homoeopathic remedy. A sore that extends from the breasts to the arms is another predominant feature.

Breast Cancer - Is Homeopathy Helpful In Treating It?

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