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Dr. Nitu Luthra Khurana

MBBS, DNB Radiology

Radiologist, Delhi

14 Years Experience
Dr. Nitu Luthra Khurana MBBS, DNB Radiology Radiologist, Delhi
14 Years Experience
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Hello and thank you for visiting my Lybrate profile! I want to let you know that here at my office my staff and I will do our best to make you comfortable. I strongly believe in ethics; a......more
Hello and thank you for visiting my Lybrate profile! I want to let you know that here at my office my staff and I will do our best to make you comfortable. I strongly believe in ethics; as a health provider being ethical is not just a remembered value, but a strongly observed one.
More about Dr. Nitu Luthra Khurana
Dr. Nitu Luthra Khurana is a renowned Radiologist in Rohini, Delhi. She has over 14 years of experience as a Radiologist. She studied and completed MBBS, DNB Radiology . You can visit her at Shubh Heart & Ultrasound Clinic in Rohini, Delhi. Book an appointment online with Dr. Nitu Luthra Khurana and consult privately on Lybrate.com.

Lybrate.com has a nexus of the most experienced Radiologists in India. You will find Radiologists with more than 25 years of experience on Lybrate.com. You can find Radiologists online in Delhi and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Education
MBBS - dr s n medical college jodhpur - 2003
DNB Radiology - Rajiv Gandhi University of Health Sciences - 2012
Languages spoken
English
Hindi

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Good day to you. For a few months i've been having numbness and weakness in my left leg and scrotum. Got my mri results back and they say. Mild scoliosis at L4 L5 region with minor disc bulge with no nerve compression. No sign of cauda equina. Small annular tear at L4 region with muscular spasm. What's causing my numbness? How do I fix the disc bulge?

MBBS, MD - General Medicine, DM - Neurology
Neurologist, Hyderabad
Good day to you.
For a few months i've been having numbness and weakness in my left leg and scrotum. Got my mri resul...
Most likely, the cause of your symptoms are disc bulge. The best treatment at this stage is physiotherapy. Medications such as pregabalin and gabapentin are also 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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Hello Dr. My mother facing the problem regarding slip disk in the year of 2012 now she is fine but some time he faced pain what I will do so he will get normal.

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. In asymptomatic periods in slipped disc, one should go for intensive back exercises daily brisk walks for 2-3 km every day in morning try to keep your weight to normal levels - take adequate supplementation of calcium and vitamin d as per requirement avoid heavy physical activity, acute forward bending in early morning as disc is hydrated in morning and has high chances of prolapse, avoid travelling on uneven surfaces for a long time. The mainstay is exercises, and more she does them, better is is, also keeping yourself physically fit is very important. Do not hesitate to contact me if you need any further assistance.
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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 an advocate and have got sitting job for long hours and walking job too. I am suffer from slip disc. Any treatment?

Fellowship In Arthroplasty and Arthroscopy, MS Orthopaedics, MBBS
Orthopedist, Gurgaon
Regular exercises and maintaining good posture whie sitting is the key to avoid most of the back pain problems. Please do take frequent breaks every hr and strech your muscles and do not sit for long.
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Doctor my 13 year old daughter has developed slip disc in her L4 and L5 vertebrae. What should be her treatment?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Disc prolapse at age of 13 years is not common, though it still may occur. Treatment is analgesics, back care, rest and physiotherapy. However, the child needs to be examined before I can suggest precise treatment
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I have severe lower back pain for last 18 years which increases during periods. I'm 32 years old and unmarried. It's constant, it always pains. Is it slip disc or what Please help.

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
I have severe lower back pain for last 18 years which increases during periods. I'm 32 years old and unmarried. It's ...
For confirmation x-ray and mri must so tk heat fermentation twice a day avoid toward bending and long standing or sitting.
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How to Reduce Urea Levels in Blood Naturally

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Navi Mumbai
How to Reduce Urea Levels in Blood Naturally

All healthy individuals will always have some amount of urea in the blood. Yet, when the urea level in the blood becomes too high, that means there is a malfunction in some part of the body due to which the body is not being able to remove this excess urea successfully. This urea can be formed in the liver when there is a process in terms of the protein metabolism's chemical balance. This urea is then transported to various parts of the body until the kidney cleans it out as urine. But when this urea does not get cleaned out properly, the urea gets concentrated in the blood and signifies a problem with the kidneys and other internal organs as well as the blood flow to the kidneys. 

The cause may include burns, heart failure, renal artery embolism, vomiting and loose motions as well as more serious ailments like Diabetes. This can lead to long term kidney damage and symptoms like thirst, fluid retention, headaches, fatigue, dizzy spells, accelerated pulse, restlessness in limbs, pain in the abdomen and more. Here are the best ways to reduce the blood urea levels in a natural manner.

Herbal Medicines:

Ayurveda is an ancient science that can be used for the benefit of many patients suffering from chronic and painful ailments like diabetes, kidney failure, cardiovascular ailments and more. One of the mainstays of Ayurveda includes the use of herbs to create medicines and concoctions that will help in giving relief with their 100% natural elements. Medicines like Mutrakrichantak Churna, Punarnava Mandur, Varunadi Vati and many others can be used to avoid dialysis and bring down the urea levels in the blood by aiding better functioning of the kidneys.

  1. Punarnava: The name of this herb has been derived from two words - Puna and Nava. While Puna means again, Nava means new and together they help in renewed functioning of the organ that they treat. This herb helps in flushing out the excess fluid in the kidneys by reducing the swelling without any side effects. This herb is basically a kind of hogweed.
  2. Varun: This is the common caper which can be used to break down the stones present in the renal region and even as a cure for urinary tract infection. This herb helps in removing any element that may be obstructing the urinary tract and finally removes the excess fluid build up and inflammation.
  3. Gokshur: This is a diuretic that can be used as a herbal tonic to give strength to the weak kidney cells for regeneration.

Other aspects of Ayurvedic treatment for this condition include proper protein intake and better hydration along with massages and Yogic postures.

3266 people found this helpful

Cervical Lordosis Straightening Treatment

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
Cervical Lordosis Straightening Treatment

Most commonly known as a military neck a straight or forward curve of the neck is abnormal and may cause an unkind progression of symptoms leading ultimately to cervical disk degeneration.

Reversal of cervical lordosis explained

The anatomy of the neck features a lordotic curvature in its typical and healthy state. This means that the cervical region has a gentle curvature with the open end of that curve facing the rear of the body. The base and top of the curve will be further posterior than the mid point, which will be further anterior.

When the lordosis is straightened, the neck becomes more upright and linear. This is more common than the next progression of atypical curvature, which is the subject of this article.

Actual reversal of curvature means that part or all of the cervical spine develops a kyphotic profile, with the open end of the curve facing anteriorly. Usually, this reversal is extremely mild, but is still very abnormal. What we now see is the middle of the curve being positioned posterior to the top and bottom.

In essence, picture the letter c and now turn it backwards: This is the shape of a reversed cervical lordosis.

Reversal of cervical lordosis causes

The spinal curvature in the neck is constantly in flux to some degree.

Congenital conditions and developmental conditions can have lasting effects on the natural degree of curvature typically demonstrated from patient to patient. These circumstances may be explainable due to injury or degeneration, or may be idiopathic:

Scoliosis can affect the normal lordotic curvature in the neck.

Cervical spondylolisthesis is a major source of reversed lordotic curvature.

Severe disc pathologies can facilitate a gradual loss or reversal of cervical lordosis.

Vertebral irregularities, such as wedging, can definitely contribute to lordotic alteration.

Traumatic injury, including vertebral fracture, can create the ideal circumstances for a reversal of lordosis to take place.

Severe neck muscle spasms can actually reshape the spinal curves, although these are usually temporary expressions and not actual structural conditions.

Effects of reversal of cervical lordosis
The neck is designed to curve in order to balance the spine, absorb stress, distribute force and provide proper movement of the head. When this curvature is diminished or reversed, symptoms may result, although this is not an inherent part of any altered lordotic condition.

Patients may experience stiffness and tension in the neck. Pain may be present and may even be severe in rare cases. Neurological dysfunction is possible in extreme cases, since the neuroforamen might not align properly, thereby causing a cervical pinched nerve.

In the worst circumstances, central spinal stenosis in the neck might affect the viability of the spinal cord, possible enacting the most dire of symptoms throughout the body.

Patients will also be more prone to injury, since the normal shock absorption qualities of the typical curvature have been lost.

While all these effects are certainly possible, they are not usual. In fact, a great majority of patients have minor symptoms or even no symptoms at all from mild reversed lordotic curvatures.

The pathology leading to a neck curve reversal (cervical kyphosis shown below right) may be inspired by a multitude of conditions as follows:
Post whiplash
Post head injury
Stomach sleeping
Poor sitting/working postures
Congenital spinal curvatures
Osteoporosis
Degenerative cervical discs (a form of osteoarthritis that can either be the cause of or the result of a cervical kyphosis)
Compression fracture of vertebral body
Infection of the cervical spine

Anatomy: straight vs. Curved

I've always heard that it was good to stand up straight.

stand upright, stick your chest out and hold your shoulders back! otherwise you're going get widows hump.

Are these expressions as familiar to you as they are to me? one might think that having a curved neck goes against what we heard from parents and teachers as we were growing up, but the reality is that there is a little bit a truth in both. Maintaining good posture throughout our lives is crucial to both the health of our spine and vital organs. On the contrary, a special type of curve called a lordosis is a good thing, both in the neck and lower back.

When we look at a person from the back their spine should be truly straight, so that the left and right sides of one's body is symmetrical. However, when we view a person from the side, the front and back of their body is different and this is reflected in a coinciding curvature of the spine. Both the lower back and neck are hollowed out (concave) and the mid or thoracic spine is protrudes (convex). Thus there is an alternation of curves functioning to provide stability, shock absorption and aid in propulsion. A straight spine would be very stiff and not flexible. Imagine the plight of a pole vaulter with an inflexible pole.

Nature's design of our spine and rib cage facilitates breathing and offers protective and supportive framework for vital organs. Spinal disks are shock absorbers and because they are in the front of the spine, lordotic curvatures keep them from having to bear weight. Kyphosis or loss of such curvatures bears weight upon the disks, leading to their ultimate degeneration. This process of deterioration is a form of osteoarthritis and in the spine is known as degenerative spondylosis.

Diagnosis
Although most physiotherapists or conservative orthopedists can recognize a cervical curve reversal upon viewing the patient's posture, a definitive diagnosis may be obtained via a standing lateral (side view) x-ray of the neck. Cause can often be determined by corroborating a comprehensive history, a thorough examination, x-rays and questions about sleep, work and lifestyle.

In my professional career I found that the majority of young adults presenting with cervical kyphosis either had a whiplash or were stomach sleepers from an early age. For desk jockeys 40-60 years of age, many hours of sitting with their head flexed forward almost dictates the fate of developing kyphosis. In prior years I considered cervical kyphosis a job hazard for the careers of accountants, attorneys and often teachers because of years spent with their head in a book or paperwork. However, the digital age offers some relief in that respect. A well-planned, ergonomically-friendly office can do wonders for protecting the spine in the sedentary worker.

Treatment for cervical curve reversal (kyphosis)
During my chiropractic practice I had the opportunity to note a good percentage of correction toward a more normal lordosis (noted on x-ray) for 70% of patients under my care. This was almost always consistent with those patients that followed all recommendations and were model participants in their own care. Here is the recommended treat plan:

Spinal manipulation of stiff and fixated spinal segments by a qualified physio
Flexibility exercises for flexion and extension of cervical spine
Resistance exercises for flexors and extensors of the neck
Learn the Alexander technique for maintaining good posture (hint: the basic philosophy is to sit and stand like you were hanging by a string from the vertex of your skull. Liken it to a puppet on a string).
Elimination of stomach sleeping
Avoid standing on your head, although some yoga postures may be beneficial
Use of orthopedic neck pillow while sleeping.

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5 Ways to Deal With Uterine Cysts

Diploma in Advance Endoscopy, Royal College of Obstetricians and Gynaecologists (MRCOG), MS, MBBS
Gynaecologist, Delhi
5 Ways to Deal With Uterine Cysts

A uterine cyst, also called as ovarian cyst, is the formation of a fluid-filled sac within the ovary of a woman. Uterine cysts may sometimes cause several physical symptoms. They can cause great pain and unpleasant sensations. Most cysts go away by themselves, but still sufficient measures should be taken to deal with the inconvenience caused by a uterine cyst. In severe cases, the cyst can damage the ovaries. Scar tissue is also likely to build up in such cysts to form an adhesion, which causes discomfort.

Uterine cysts can cause great damage to the sexual organs of a woman, and hence, it should never be ignored. Here are 5 ways to deal with uterine cysts:

  1. Using Birth Control Pills: In case of recurrent uterine cysts, you can take oral contraceptives with the prescription of a doctor. This will prohibit ovulation, and the development of new cysts will be prevented. The risk of ovarian cancer is also reduced.

  2. Laparoscopy: In case the cyst is small, a laparoscopy surgery can be conducted by a doctor. This will enable the surgical removal of the cyst. The process of laparoscopy involves making of a small incision around the navel region. A small instrument or device is inserted into the abdomen, which removes the cyst.

  3. Laparotomy: Laparotomy is a surgical procedure of removing a large uterine cyst. This procedure is applied when a cyst becomes too large to be removed using laparoscopy. The procedure involves the removal of the cyst via an incision made in the abdomen. An immediate biopsy is conducted and in case the cyst is found out to be cancerous, a hysterectomy surgery is conducted, which removes the ovaries and uterus completely.

  4. Herbal Tea: Moving from medical procedures to natural ways for dealing with uterine cysts, herbal tea is believed to be one of the best natural treatments for uterine cysts. Herbal tea helps in the breakdown of large cysts and the side effects of the cysts such as discomfort or pain are eased. Have a cup of herbal tea every day to get rid of uterine cysts.

  5. Diet: Uterine cysts may develop due to an unhealthy diet. Modern food items contain synthetic and natural estrogens, which cause disruption in ovarian health. Consuming adulterated meat, where the animals are given hormones, and antibiotics may result in uterine cysts. Soy contains a great amount of estrogen, which leads to uterine cysts. All the food items which may lead to ovarian cysts should be avoided.

Uterine cysts are common in women and are caused due to several complications. You should not let uterine cysts develop as development increases severity.

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Guideline Steps for Breast Examine by Patient

Homeopath,

Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips.


Here's what you should look for:

Breasts that are their usual size, shape, and color

Breasts that are evenly shaped without visible distortion or swelling

If you see any of the following changes, bring them to your doctor's attention:

Dimpling, puckering, or bulging of the skin

A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)

Redness, soreness, rash, or swelling


Step 2: now, raise your arms and look for the same changes.

 

Step 3: while you're at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood).


Step 4: next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a circular motion, about the size of a quarter.

 

Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage.

 

Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you've reached the deep tissue, you should be able to feel down to your ribcage.
 

Step 5: finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in step 4.

1 person found this helpful

I am having slip disc. I want to know to cure it with exercises and what are the precautions to took for this?

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

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai

Lung cancer occurs at slightly younger age in women than in men. Adenocarcinoma is the commonest type of lung cancer in women. It warrants testing for some molecular markers which form the basis of targeted therapies. Thus lung cancer in women behaves biologically and clinically different from that in men

Women should take care of their health, stay away from tobacco and think positive

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I am having ls S1 disk bulge problems if I am having physiotherapist it will cure or not?

DNB (Radiodiagnosis), DMRD, MBBS
Radiologist, Bangalore
Hi, thanks for your query a l 5 - s 1 disc bulge might respond to physical therapy. It cannot be cured completely like before but with precautions and medicine you will feel much better and have a normal life. Please take care not to involve yourself in any activity which might stress your lower back. This will delay recovery and might also cause complications and the pain and discomfort to increase. Avoid doing sudden movement involving lower back and lifting weight more than 5 kg. This will help you recover quickly. For mild pain you should use ointments with muscle relaxant and pain relief. In severe pain plase adk your doctor for oral ner pain reluef medicine and non steroidal anti inflammatory pills. Use of heat pack is also recommended. Regards.
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Mri report- mild diffuse disc bulge at l4-l5 level causing the cal sac indentation and bilateral mild neural formalin narrowing (l> r). Please advice.

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. These are mri findings which you have suggested, but actually it is better if you mention your clinical condition so that if significant we can correlate them with your mri findings. So please mention your back pain duration, any associated leg pain, numbness, parestheisas, weakness etc in legs. Do not hesitate to contact me if you need any further assistance. Thanks & regards Dr. Akshay kumar saxena Consultant orthopaedics fortis hospital, new delhi.
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Dear sir, I am 33 year old. I have back ache since 2010 mri also have been done it shown herniated slip disk and doctor has advised me surgery. But I am not willing to get surgery please advise me what should I do.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Not all pt. Of backache need surgery. Most of them can be managed with out operation. Kindly show me a photograph of the affected part. 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 Do hot fomantation. Paracetamol 250mg od & sos x 5days. Ubicar 1 tab odx10 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 1 wk, contact me again. Do not ignore. It could be beginning of a serious problem.
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Uterine Prolapse: Risks, Symptoms and Diagnosis

fellow in Obstetric Medicine , MS - Obstetrics and Gynaecology, FMAS, DMAS, MBBS
Gynaecologist, Hyderabad
Uterine Prolapse: Risks, Symptoms and Diagnosis

The uterus or womb, is a muscular structure and is held in place by ligaments and pelvic muscles. If these muscles or tendons become weak, they cause prolapse and are no longer able to hold the uterus in its place.

Uterine prolapse happens when the uterus falls or slips from its ordinary position and into the vagina or birth waterway. It could be complete prolapse or even incomplete at times. A fragmented prolapse happens when the uterus is just hanging into the vagina. A complete prolapse depicts a circumstance in which the uterus falls so far down that some tissue rests outside of the vagina. Likewise, as a lady ages and with a loss of the hormone estrogen, her uterus can drop into the vaginal canal. This condition is known as a prolapsed uterus.

Risks: The risks of this condition are many and have been enumerated as follows:

  1. Complicated delivery during pregnancy
  2. Weak pelvic muscle
  3. Loss of tissue after menopause and loss of common estrogen
  4. Expanded weight in the stomach area, for example, endless cough, constipation, pelvic tumors or accumulation of liquid in the guts
  5. Being overweight
  6. Obesity causing extra strain on the muscles
  7. Real surgery in the pelvic zone
  8. Smoking

Symptoms: Some of the most common symptoms of prolapse involve:

  1. Feeling of sitting on a ball
  2. Abnormal vaginal bleeding
  3. Increase in discharge
  4. Problems while performing sexual intercourse
  5. Seeing the uterus coming out of the vagina
  6. A pulling or full feeling in the pelvis
  7. Constipation
  8. Bladder infections

Nonsurgical medications include:

  1. Losing weight and getting in shape to take stress off of pelvic structures
  2. Maintaining a distance from truly difficult work
  3. Doing Kegel workouts, which are pelvic floor practices that strengthen the vaginal muscles. This can be done at any time, even while sitting down at a desk.
  4. Taking estrogen treatment especially during menopause
  5. Wearing a pessary, which is a gadget embedded into the vagina that fits under the cervix and pushes up to settle the uterus and cervix
  6. Indulging in normal physical activity

Some specialists use the following methods to diagnose the problem:

  1. The specialist will examine you in standing position keeping in mind you are resting and request that you to cough or strain to build the weight in your abdomen.
  2. Particular conditions, for example, ureteral block because of complete prolapse, may require an intravenous pyelogram (IVP) or renal sonography. Color is infused into your vein, and an X-ray is used to view the flow of color through your urinary bladder.
  3. An ultrasound might be utilised to rule out any other existing pelvic issues. In this test, a wand is used on your stomach area or embedded into your vagina to create images of the internal organ with sound waves.
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Breast Cancer - Know More to Say 'No' More!

MBBS, DGO, MD - Obstetrics & Gynaecology, MRCOG
Gynaecologist, Delhi
Breast Cancer - Know More to Say 'No' More!

Cancer is the abnormal, uncontrolled growth of cells in a particular body part. With continued growth, pieces of this tissue travel through the blood to different body parts and continue to grow in the new area. This is known as metastases. Breast cancer is one of the most common forms of cancer and affects about 1 in 8 women in the USA. Read on to know more details of breast cancer – breast anatomy, causes, symptoms, risk factors, detection, prevention, and of course treatment.

Anatomy: The main function of the breast is lactation through its milk-producing tissue that are connected to the nipple by narrow ducts. In addition, there is surrounding connective tissue, fibrous material, fat, nerves, blood vessels and lymphatic channels which complete the structure. This is essential to know as most breast cancers develop as small calcifications (hardened particles) in the ducts or as small lumps in the breast tissue which then continues to grow into cancer. The spread can happen through lymphatic or blood flow to other organs.

Warning signs/symptoms: The following are some symptoms that need to be watched out for if you have a predisposition to breast cancer.

  1. A lump in either of the breasts or armpits
  2. Change in size, shape, or contour of either breast
  3. Redness of your breast or nipple
  4. Discharge of clear or bloody fluid
  5. Thickening of breast tissue or skin that lasts through a period
  6. Altered look or feel of the skin on the breast or the nipple (dimpled, inflamed, scaly, or puckered)
  7. One area on the breast that looks very different from the other areas
  8. Hardened area under the breast skin

Either one or a combination of these should be an indication to get a detailed checkup done. Early diagnosis results in controlling the disease with minimal treatment and reduced complications.

Causes and risk factors: The exact cause for breast cancer is yet to be pinned down. However, risk factors are clearly identified, and women with risk factors need to watch out for warning signs.

  1. Family history: Of all the risk factors, the family history is the most important. Breast cancer runs in families, and if there is a first-degree relative with the breast cancer, the chances of developing it are almost double. Two genes BRCA1 and BRCA2 are the carriers of the disease, and this testing can be done in women to identify if they are at risk.
  2. Family history of other cancers: Even if there is no breast cancer, if there are other cancers that run in the family, watch out.
  3. Age: Women over 50 are at higher risk of developing breast cancer.
  4. Race: Caucasian and Jewish women are at higher risk of breast cancer than African-American women.
  5. Hormones: Greater exposure to the female hormone estrogen increases the chances of developing breast cancer. Women who use birth control pills for contraception and hormone replacement after menopause are at a higher risk of developing breast cancer.
  6. Gynecologic milestones: Women who have abnormal menstrual milestones need to watch out. These include those who attain menarche before 12 years of age, get pregnant after 30, attain menopause after 55, and have menstrual cycles shorter than 26 days or longer than 29 days.
  7. Obesity and alcohol abuse are also likely to increase a woman’s chances of developing breast cancer.

Stages: Starting from stage 0, higher stages indicate advanced disease.

  1. Stage 0: The growth which has begun in the milk-producing tissue or the ducts has remained there (in situ) and not spread to any other area, including the rest of the breast.
  2. Stage I: The tissue slowly becomes invasive and has begun to affect the surrounding healthy tissue. It could have spread to the fatty breast tissue and some breast tissue may be found in the nearby lymph nodes.
  3. Stage II: The cancer at this stage grows considerably or spreads to other parts. There are chances that cancer may grow and also spread.
  4. Stage III: It may have spread to the bones or other organs but small amounts are present in up to 9 to 10 of the lymph nodes in the armpits and collar bones which makes it is difficult to fight.
  5. Stage IV: The cancer is widespread to far-flung areas like the liver, lungs, bones, and even the brain.

Screening: This is one of the most effective ways to identify the disease in its early stages. This will help in controlling cancer from spreading with minimal treatment.

  1. Self-examination: A thorough self-examination to look for changes in terms of shape, size, colour, contour, and firmness should be learned by all women. Watch for any discharge, sores, rashes, or swelling in the breasts, surrounding skin, and nipple. Examine them while standing and when lying down.
  2. In most women, annual screening mammograms are advised after the age of 40. However, in women who have a strong family history or genetic makeup, it is advisable to have screening mammograms starting at age 20 every 3 years and then annually from the age of 40.
  3. Women in high-risk categories should have screening mammograms every year and typically start at an earlier age.
  4. Ultrasound screening can also be given in addition to mammograms.
  5. Breast MRI is another way to screen for breast cancer if the risk is greater.

Breast Cancer Prevention: Now that there is so much awareness about causes and risk factors, there are definitely ways to prevent or delay the onset of the disease.

  1. Exercise and a healthy diet with reduced amount of alcohol are definitely effective in minimising the chances of developing cancer.
  2. Tamoxifen is used in women who are at high risk for breast cancer.
  3. Evista (raloxifene) which is used to treat osteoporosis after menopause. It is also widely used in preventing breast cancer.
  4. In high-risk women, breasts are surgically removed to prevent the development of cancer (preventive mastectomy).

Treatment: As with all cancers, treatment would depend on the stage at which it is identified and include a combination of chemotherapy, radiation, and surgery. As noted earlier, if you are at risk, look out for warning signs as early diagnosis is the key to maximum recovery.

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I am 63 year old male, having- (1) a sciatica on right side (2) herniation between in lumber, as a result suffering from leg and lower back pain. I want your valued answer of treatment.

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. For me to answer your question, I need some information from your side: - a detailed neurological examination including assessment of motor, sensory ex and analysis of deep tendon reflexes of lower limbs - dynamic x rays of ls spine - mri ls spine to correlate clinical findings with radiology. Do not hesitate to contact me if you need any further assistance. You can also discuss your case and treatment plans with me in a greater detail in a private consultation.
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Dear sir. My mother is suffering from pain in waist and legs unable to stand for sometime and unable to walk due to L5 L6 displaced and make pressure on nerve. I don't want to operate for this . Is any other solution.

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi , This is Dr Akshay from Fortis Hospital. Kindly upload her x ray and MRI images so that i can see and opine accordingly. Thanks & Regards Dr Akshay Kumar Saxena
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