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Dr. Deepak Gupta

Radiologist, Delhi

Dr. Deepak Gupta Radiologist, Delhi
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I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family....more
I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family.
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Dr. Deepak Gupta is a trusted Radiologist in Rohini, Delhi. He is currently practising at Jha Clinic in Rohini, Delhi. Book an appointment online with Dr. Deepak Gupta and consult privately on Lybrate.com.

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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

3713 people found this helpful

Diseased Uterus - Can it be Replaced?

Health and Medical ARC Fertility
IVF Specialist, Chennai
Diseased Uterus - Can it be Replaced?

In case you have a diseased uterus, which makes you infertile, you can undergo a procedure known as uterus transplant or uterine transplant to get pregnant. In the process of sexual reproduction, a diseased uterus does not allow embryonic implantation. This factor is referred to as uterine factor infertility or UFI. As a result, you will not be able to get pregnant. Learn more about having healthy pregnancy.

Who requires a uterus transplant?
This procedure involves women who have UFI and women who had their uterus removed by hysterectomy. Women who have a damaged uterus on account of an injury or infection, which does not function anymore, can also undergo a uterus transplant procedure. Women from the age of 21 to 45 are eligible for this procedure. Many women are born without having a uterus. This condition is called Mayer-Rokitansky-Küster-Hauser syndrome.

Procedure
Uterus transplantation begins with undertaking a uterus retrieval surgery on the uterus donor. The uterus, which is recovered has to be stored and transported to the location of the patient undergoing the transplant. An ischemic tolerance may last over 24 hours. Three major surgeries have to be carried out with the recipient. Firstly, a transplantation surgery is required in which the donor’s uterus gets transplanted. In case pregnancy develops, a caesarean section surgery has to be performed. The patient is given immune suppressive therapy. After childbirth, a hysterectomy is done in order to terminate the immune suppressive therapy.

Will the women be able to get pregnant after having sex?
Women receiving a uterus transplant will not be capable of becoming pregnant without undergoing fertility treatments. The transplanted uterus is not connected with the fallopian tubes, which is the location of the normal fertilisation process. The women will require to carry out IVF or in vitro fertilisation to become pregnant after a uterus transplant. IVF is a process in which the eggs are removed from the ovaries and get fertilised in a laboratory. Then, they are implanted in the uterus. After undergoing the uterus transplant procedure, a woman has to wait for a period of one year. The uterus requires time for healing and after recovery, the embryo may be implanted for pregnancy. After giving birth successfully, a woman will be able to keep the transplanted uterus. This is a reason why IVF is a popular procedure.

She has the option to get pregnant again. However, after giving birth twice, a hysterectomy must be carried out for the removal of the uterus. This is done so that the woman can stop using the immune suppressant drugs, which are associated with major risks. Uterus transplant is a relatively new technology. In October 2014, the first healthy baby was born to a woman who had undergone a uterus transplant. This surgery is kind of experimental in nature and is usually the last option for getting pregnant.

3818 people found this helpful

I have problem of sleep disc, and sometimes its agony what are the exercise for this?

M.D. (Ayurveda )
Ayurveda, Patiala
I have problem of sleep disc, and sometimes its agony what are the exercise for this?
Slip disc is a serious problem and can become debilitating too. Ayurveda has panchakarma to maintain such serious conditions. It can reduce the pain as well as its recurrence. Kindly consult some panchakarma consultant for best treatment. And consult yoga expert for exercises. Good luck.

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 43 years old and I have taken scan and in my report there is a small fibre on the both wall of the uterus, can you please tell me whether it is danger or not.

BHMS
Homeopath, Chennai
Homeopathy is much more effective in treatment of uterine fibroids. Out of all possible alternatives, Homeopathy is the best non surgical treatment for fibroids. The homeopathic medicines slowly but surely retard the growth of fibroids. Over a period of time, the fibroids disappear completely. This is a far more effective and the most convenient treatment of fibroids.
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Sir I have a problem of slipped disc in cervical spine. I am a dance choreographer so I should do my profession or I should stop it.

Fellowship in Shoulder and Upper Limb, Fellowship in Joint Replacement, MS - Orthopaedics, MBBS
Orthopedist, Mumbai
If the problem is recent and correctly diagnosed you should take rest for a couple of weeks and then start gradually with neck physio. Once your neck muscles are strong then you can gradually restart your dance activity.
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I am 38 years old man having back pain lasting for 20 days from mild to severe in left hip side. In consultation to orthopedic surgeon and after MRI one doctor told me the disease sciatica and another its slip disc. MRI of LS SPINE report says the result of AP diameter L1-L2=15, L2-L3=08, L3-L4=15, L4-L5=10 , L5-S1=09 Impression: 1) Degenerative DISC DISEASE with generalised disc bulge at L3-L4. Please tell.

DHMS (Hons.)
Homeopath, Patna
I am 38 years old man having back pain lasting for 20 days from mild to severe in left hip side. In consultation to o...
Hi, it might b sciatica which is painful when you r in absolut rest & b relieved when you r mobile. Take, homoeo medicine: @ rhus tox 1000-6 pills, wkly. Avoid, junk food, alcohol, caffeine, nicotine, cold intake, jerks, riding tk, rest.
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I am 33 and my body has became very stiff due to no physical exercise. I have slip disk and neck ailments. Also mental tension getting worse. But need to come over this. What could be the starter guidelines for getting started with Yoga/Meditation.

B.Sc. - Dietitics / Nutrition, Nutrition Certification,Registered Dietitian
Dietitian/Nutritionist, Delhi
I am 33 and my body has became very stiff due to no physical exercise. I have slip disk and neck ailments. Also menta...
The best way to get started is with pranayam. Do daily breathing exercises for half an hour and then start with suryanamaskar. Do atleast 21 cycles of suryanamskar. You will start seeing the results within 15 days.
1 person found this helpful
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I have noticed that the space between c5 and c6 of my spine have increased and as a result my neck and shoulder are very painful. I have also little tmj. What will I do now? Please Please help me.

PG Diploma in Emergency Medicine Services (PGDEMS), Bachelor of Ayurveda, Medicine and Surgery (BAMS), MD - Alternate Medicine
Ayurveda, Ghaziabad
Hello Lybrate user according to Ayurveda Vata vikriti is the main factor for pain. Treatment- 1-apply prasarini oil or pranacharya restopain oil on your affected part and give hot water fomentation. 2-take yograj guggul and agni tundi vati after lunch and dinner with warm water. 3-Take maha rasnadi kwath 2-2 tsf twice a day. 4-Take pranacharya vatari capsule and syrup twice a day. Diet- Avoid fermented food. Junk food. Potato rice. Sleep well.
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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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Causes and Symptoms of Ewing's Sarcoma

European Society for Medical Oncology certification, DM - Oncology, MD - General Medicine, MBBS
Oncologist, Faridabad
Causes and Symptoms of Ewing's Sarcoma

Collectively grouped under the Ewing sarcoma family of tumors, Ewing's sarcoma is the second most common form of bone cancer, which is commonly seen in children and adolescents. Very rarely is it experienced in adults above the age of 30.

Typically forming in the bones of the chest, pelvis, head, back or trunk and in the long bones of the arms and legs, Ewing's sarcoma is believed to originate in certain kinds of primitive cells. When it begins to affect similar kind of cells found outside the bone, it is usually called an extraosseous Ewing's sarcoma.

Causes
1. Similar to all types of Ewing tumors, Ewing's sarcoma is generally caused by an alteration in a certain cell compelling a gene named EWS found on chromosome no. 22 to move over to a DNA section on any one of the surrounding chromosomes resulting in the activation of the EWS gene.
2. While it is not a hereditary condition, it usually occurs after childbirth, but no substantial evidence has been found as to why it happens so.

Symptoms
Symptoms of Ewing's sarcoma may include:
1. Swelling and pain especially in the arms, legs, back, chest or pelvis
2. Swelling accompanied by joint immobility
3. A bone breaks having no apparent cause
4. Swelling which may or may not be accompanied by a warm, tingling sensation
5. Fever resulting from unknown causes
6. Lumps or bumps which do not subside over time
7. Abnormal weight loss
8. High levels of fatigue
9. Tumors which have spread over to the lungs may cause shortness of breath
10.Tumors spread over to the spine may cause weakness or even paralysis.

Because the symptoms of Ewing's sarcoma can hardly be distinguished from symptoms caused by other infections or injuries, an early diagnosis is absolutely necessary for a successive treatment. If you wish to discuss about any specific problem, you can consult an oncologist and ask a free question.

1968 people found this helpful

I have diagnosed with infiltrating ductal carcinoma, NOS, in right breast (in biopsy report, triple negative (ER-negative, PR-NEGATIVE, HER 2-NEGATIVE). The tumor measures 4 cm* 3 cm mammographically. After giving 3 no. Of chemo My doctor suggest me for modified radical mastectomy. Please tell me if I go for complete breast removal & subsequent chemotherapy Radiotherapy is must or optional?

MD - Radiation Oncology, MBBS, DNB (Radiotherapy)
Oncologist, Howrah
Surgery is the definitive treatment for carcinoma breast. After surgery, remaining cycles of chemotherapy needs to be completed. Whether radiotherapy will be given or not depends on postoperative histopathology report.
1 person found this helpful
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Neck Pain - Health Tip

Master of Physical Therapy MPT CARDIO, BPTh/BPT
Physiotherapist, Rajkot
Neck Pain - Health Tip
Herniated disks or bone spurts in the vertebrae of the neck may become the reason behind severe neck pain. They sometimes take too much space and compress the nerves branching out from the spinal cord.
10 people found this helpful

Herniated disk l3-14 mm L4-11 mm L5-10 mm S1-8 mm My age 23 /M Dr. suggest for surgery but I didn't want that any chances for normal.

MBBS, MD (Anaesthesiology)
Pain Management Specialist, Varanasi
It seems that you are having multiple disc herniation. I cannot comment unless I see you MRI but definitely you having at least two slipped disc at L4/5 & L5/S1. These days non surgical treatment are available like TFSI, Disc Fix and Percutaneous Endoscopic Lumbar Discectomy (PLED) done under Local anaesthesia, no blood loss, no stich required, patient walks within next few days. We will provide you detailed information if you wish or you may see on website. I may need your blood inv. Like TLC/DLC/ESR/CRP/HLA B-27 before giving further opinion.
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My MRI INDICATE 1. Lumbosacral transitional Vertebra with complete socialization of L5 2. Disc desiccation with diffuse disc bulge and broad based posterior central disc protrusion at L4-L5 level causing ventral thecal sac indentation and significant compromise of bilateral neural forminal (right>left). Mild ligamentum flavum thickening is also seen at this level with maintained spinal canal dimensions. 3. Cervical spondylitis changes with disc osteophyte complexes at C4-C5 and C5-C6 levels. Broad based left paracentral disc protrusion at C4-C5 level causing ventral thecal sac indentation and moderate compromise of left sided neural forminal. 4. Mild disc bulge at d5-d6 (screening of rest of spine revealed) I am confused. Dr. Said physio will fix it. I read too many damages. Please guide and suggest sustainable solutions. I am willing to take prolonged treatment. What does this report mean?

Radiologist, Delhi
Hello Mr. lybrate-user. The report says that there is significant compression of nerves at L4-5, C4-5 and C5-6 vertebral levels. You need to wear lumbar hot belt on regular basis, have to take medicines, you have to undergo physiotherapy and take precautions like no forward bending, no lifting weight, using ortho matress to keep spine straight. I would advise you to meet an orthopedician and discuss your symptoms in detail. Clinical examination and some further tests are required before prescribing medicines.
3 people found this helpful
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My husband is diabetic & his height is 5ft n 11 inch & weight 94 kg. From two months he is having edema in both foot. His blood reports of kidney I s. Cretenine 1.09. He is suffering from disc slip problem also so cant walk. I am worried about foot edema.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
My husband is diabetic & his height is 5ft n 11 inch & weight 94 kg. From two months he is having edema in both foot....
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. KINDLY CONSULT A PHYSICIAN FOR OEDEMA & RELTED PROBLEMS.
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My age is 22 I have slip disk my disk dislocated into 6 mm back so I have heavy pain when I bend or doing any work and long time sitting any home remedies to cure fast.

BPTh/BPT
Physiotherapist, Delhi
Some days do full bad rest after this don't sitting longer time its do bed effect on back pain, sitting but short time like 1-2 hour then you do rest like walking either 10-15 min. On bad you can use heating paid at two time in a day and some exercise also do you can take physiotherapy also some days like 10-15 day a after all this you feel batter you can do all your work but Physio. Live care fully live not sitting long time between a week do full rest all this do you u can do yoga also it's batter OK.
1 person found this helpful
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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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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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