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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.
What is Bone cancer?
Bone cancer is malignant tumour of the bones which can spread to lungs or other parts of the body. It may have arisen primarily from the bone itself (primary bone cancer) or more commonly, may have spread to the bones (secondary bone cancer) from cancer of some other body organ like Breast cancer, Prostate cancer etc.
Primary bone cancer usually occurs in growing children and young adolescents, whereas, secondary bone cancer usually occurs in older age group. Usually, the patient experiences pain in the affected area, which over the time, gets worse and continuous. There may also be swelling in the involved region. It can cause weakening of bones resulting in fracture. Some patients may attribute these symptoms to any prior antecedent trauma. Unintentional weight loss may also be seen. Sometimes, these patients are wrongly being treated for infection, thus delaying the correct treatment which may have a bearing on the final outcome.
How common is bone cancer?
Secondary bone cancer is the most common type of bone cancer with bone being the third most common site of cancer spread (metastasis) from other organs. However, primary bone cancers are rare accounting for less than 1% of all cancers.
Causes of bone cancer?
There are no known environmental or other hereditary factors which cause bone cancer, however, certain patients are at a greater risk for bone cancer which include:
- Patients who have received prior radiation therapy
- Patients with a history of Paget’s Disease
- Patients with hereditary retinoblastoma - a type of eye cancer that most commonly affects very young children
- Patients with Li-Fraumeni syndrome - a rare genetic condition
How is it diagnosed?
A patient suspected with bone cancer needs to be investigated thoroughly with blood tests, Xrays, MRI to look for local extent of disease. Since bone cancer can spread to lungs and other bones, staging of the disease is done either with whole body PET CT or a bone scan with CT Chest. Alongwith that, a biopsy (usually with a needle) is required to establish the diagnosis. It’s important to do biopsy from the correct site since wrong biopsy site can be detrimental in limb salvage and can result in amputation (cutting the limb). Therefore, it’s recommended that the biopsy should always be done by the surgeon (Orthopaedic Oncologist) who will be doing the final surgery for bone cancer.
Treatment of bone cancer is a multidisciplinary approach requiring an Orthopaedic Oncologist (Bone & Soft tissue tumour specialist), Medical Oncologist (Chemotherapy Specialist), Radiation Oncologist (Radiotherapy specialist) and Pathologist (Specialist in tissue diagnosis).
Usually in primary bone cancers, chemotherapy is given to the patient followed by surgery to remove the diseased bone which is further followed by adjuvant chemotherapy. Limb salvage surgery is possible nowadays for bone cancers in which the part of the bone involved with tumour is removed surgically (rather than cutting the whole limb) and the defect is reconstructed with artificial joint, thereby saving the limb. In some cases, the cancerous bone so removed is given very high dose of radiation so as to kill all the cancer cells and the sterilised bone so formed is fixed back to the parent bone with the help of plates and screws, a technique commonly called as Extra Corporeal Radiation Therapy (ECRT). In children, since the artificial joint will not grow as the child grows leading to unequal limb lengths over a period of time, the defect can be reconstructed with expandable joint which can be lengthened as the child grows which allows to maintain limb length equality at the time of skeletal maturity.
Is cure possible in bone cancer?
With the current chemotherapy regimes and advanced surgical technology, cure is possible in upto 70-75% patients with primary bone cancer. In patients with secondary bone cancer, cure can still be achieved depending upon the primary cancer and the extent of disease. In advanced cases also, a lot can be done to control the disease and give a quality of life to the patient.
Is it possible to prevent bone cancer?
Since the exact cause of bone cancer is not known, as of now it’s not possible to prevent bone cancer.
Whom to consult?
First chance is the best chance when it comes to curing bone cancers. So, it’s advisable to seek treatment from a trained Orthopaedic Oncologist when confronted with a bone cancer to achieve maximum beneficial outcome.
What should I be doing to releave the pain for two herniated disc's one above and one below a fusion surgery of the cervical spine.
Sir my sister aged 32 years is going under total hip replacement. I much confused about prosthetic which one to go for Ceramic with poly or Ceramic on Ceramic Please advice which one is better.
Sir I am 62 l have got disc prolapse of my spine spine. Backpain- radiated toy right leg causing severe pain please give remedy.
My husband hs cirrhosis of liver stomach very distended+an ugly umbilical hernia+very dry skin+rash on legs +occasionally loose motions+disinterested in everything+lathargy+very weak+no energy+ frequent urination at nite with the result doesnt sleep well at nite. Medications urimax, lasilactone, lasix, heptapro. Are all these symptoms related to the cirrhosis. Latest sonography report shows right lobe of liver is contracted n left lobe is enlarged with coarse bright echogencity with nodular surface. Intraheatic biliary radicles normal. Cbd normal. Portal vein is patent. Gallbladder is distended with no calculi or polyps spleen is borderline enlarged. Free fluid is noted approximately 200cc impression cirrhosis of liver borderline splenomeagly. Cortical calcific speck in both kidney s free fluid 200cc can you tell how serious is this condition his sodium is low 126.
Are you experiencing excessive uterine bleeding? Excessive uterine bleeding may occur between a woman’s periods or before the periods, after having sex, or due to the development of spotting or bleeding after attaining menopause. Any menstrual cycle, which lasts longer than 21–35 days is called excessive, and this is an abnormal form of uterine bleeding.
Causes of Excessive Uterine Bleeding:
The various causes of excessive uterine bleeding are as follows:
One of the main causes is hormonal imbalance, as the balance between estrogen and progesterone gets disrupted. This balance is required for the regulation and development of the lining of endometrium or uterus lining. Because of the hormonal imbalance, the endometrium develops excessively causing heavy bleeding.
Uterine fibroids, which are non cancerous tumours, may lead to prolonged and excessive uterine bleeding.
Polyps are small benign developments on the uterus lining which cause heavy bleeding. They occur because of high levels of hormones.
Adenomyosis is a condition which develops when the endometrium glands get embedded in the uterine muscle, leading to excessive uterine bleeding.
Using intrauterine devices or IUDs may cause side effects as well.
Several uterine cancers, ovarian cancers and cervical conditions may be responsible as well. Inherited bleeding disorders such as von Willebrand’s disease is another likely cause.
Several medicines and drugs, including NSAIDs and anticoagulants are a common cause.
There are different ways of treating excessive uterine bleeding, depending upon the cause of bleeding and the patient’s age.
Medications: Several medicines are used for the treatment of abnormal uterine bleeding. Hormonal medicines and birth control pills are used to improve the regularity of periods. Non steroidal anti-inflammatory drugs are also used to manage excessive uterine bleeding. Several antibiotics are also used.
Surgery: In many cases, a woman has to undergo a surgery for the removal of polyps and fibroids, which cause excessive bleeding. Certain fibroids are removed via hysteroscopy and other techniques for treatment are used as well. Endometrial ablation can be carried out to manage the bleeding. This treatment aims at permanent reduction of the excess bleeding. Hysterectomy has to be carried out when other treatments are unsuccessful. This is a serious surgery and after it, a woman will no longer have periods, and she will not be able to conceive a child.
In case of excessive uterine bleeding, you must consult a doctor as soon as possible. This will enable early treatment and prevent the development of further complications.
I am a 30 years old male and since last 3 months I was having pain in right leg whenever I used to walk. My doctor advised me Lumbosacral MRI and my findings are as under: 1. Lumbar lordosis is mildly straightened. 2. Disc desiccation noted at L5-S1 noted. 3. Posterior disco osteophytes complex seen at L5-S1 level causing canal stenosis measuring 7mm and bilateral lateral recess stenosis, causing compression upon traversing S1 nerve roots and mild foramina narrowing with abutting bilateral L5 nerve roots. 4. Mild diffuse disc bulge at L4-5 level causing indentation of thecal sac with early lateral recess stenosis, however no significant neural compression seen.
L4-l5 and l5-s1 between disk problems years-44-women. Please give advise operation after disk moving
My mother is suffering from disc extrusion in L5, is surgery necessary? Or something other will be helpful.
I am 34 years old male. I am suffering from back pain for the last 3 years. I have done MRI. In MRI it is found that 1. MILD DIFFUSE DISC BULGE IS NOTED AT L3-4 LEVEL CAUSING ANTERIORTHECAL SAC indentation MINIMAL NARROWING OF BILATERAL NEURAL forminal AS WELL AS LATERAL RECESSES. 2. MILD DIFFUSE DISC BULGE IS NOTED AT L4-5LEVEL CAUSING ANTERIOR THECAL SAC INDENTATION AND NARROWING OF BILATERAL NEURAL forminal AS WELL AS LATERAL RECESSES. MILD facial ARTHROPATHY IS NOTED BILATERALLY. please MAKE ME UNDERSTAND WHAT IS THE PROBLEM AND WHAT IS THE SOLUTION.
1. Eat calcium-rich foods
In addition to dairy products, choose fish with bones such as salmon, sardines or whitebait. For additional benefits, serve them with a side of dark leafy green vegetables or broccoli. Almonds, dried figs, fortified tofu and soy milk are also calcium-rich choices, says registered dietitian laura jeffers, med, rd, ld.
2. Take calcium supplements
The u. S. Recommended daily allowance for calcium is 1, 000 mg a day during your 20s, 30s and 40s. But your need rises as you age. Check with your doctor before starting supplements to find out what amount is right for you. For example, after menopause, most women need 1000 to 1, 500 mg a day unless they take hormone therapy. Your body only absorbs 500 mg of calcium at a time, Ms. Jeffers notes, so spread your consumption out over the course of the day.
3. Add d to your day
To help absorb calcium, most adults need 1, 000 to 2, 000 iu of vitamin d daily, combined calcium-vitamin d pills usually do not meet this requirement. And most of us who live north of atlanta do not get enough vitamin d the old-fashioned way — from the sun. Taking a vitamin d supplement will ensure you meet your daily needs.
4. Start weight-bearing exercises
To boost your bone strength, try exercise that “loads” or compresses your bones, says exercise physiologist heather nettle, ma. “running, jogging, high-impact aerobics, repetitive stair climbing, dancing, tennis and basketball are best for building bones. But if you have osteopenia, osteoporosis or arthritis, try walking or using an elliptical or other machine,” she says. Be sure to clear any exercise plans with your doctor first.
5. Don’t smoke, and don’t drink excessively
Bad news for bad habits: loss of bone mineral density is associated with tobacco use and excessive alcohol consumption, Dr. Sikon says. If you smoke, look into a program to help you quit. If you drink, stick to no more than one libation a day, she advises.
6. Get your bone mineral density tested
Doctors can get a quick and painless “snapshot” of bone health using a simple x-ray test called dxa. This test measures bone mineral density and helps determine risks of osteoporosis and fracture. Dr. Sikon recommends testing for women within two years of menopause. Earlier tests are recommended for men and women with certain diseases and for those taking medications that increase risk, such as long-term steroid therapy.
Perimenopausal women may consider hormone therapy to increase waning estrogen levels, which are linked to bone loss. And women and men diagnosed with osteopenia or osteoporosis can take various medications to prevent dangerous hip and spine fractures.
I want to know about disk pain. i am suffering from this pain from very long . please suggest me good treatment
My dad has a disc problem and in morning time he suffers from stiffness in lower back area. What should he do?
I am bodybuilder I had a disc replacement due to bulge in my disc. Is it possible to continue bodybuilding. Lifting weights etc. Plzz help me.
Myth: Brain damage is always permanent.
Fact: The brain can repair or compensate for certain losses, and even generate new cells.
People once believed that we were born with a finite number of brain cells, and that was it for life; if you damaged any of them you could never get them back. Similarly, many scientists believed that the brain was unalterable; once it was" broken" it could not be fixed.
Now, of course, we know that the brain remains plastic throughout life, and can rewire itself in response to learning. It can also generate new brain cells under the right circumstances.
I am 20 years old. But my weight is 85 and my height is 5.11 so is it correct weight or should reduce my weight? tell me how to reduce. And I have a backache means one disk in my back has pressed inside than the normal of other disks. So please give a perfect solution.
Sir I am suffering from. L4-5 problem since 2 years there is any treatment with out operation please help me.
I have disc bulge and getting pain in my left leg. I have MRI report my nerve is compressed of left leg.
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. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.