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Breast Cancer Prevention:
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.
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:
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:
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
Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast.
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.
Enlarge Drawing of female breast anatomy showing the lymph nodes, nipple, areola, chest wall, ribs, muscle, fatty tissue, lobe, ducts, and lobules.
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.
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:
Older agea personal history of breast cancer or benign (noncancer) breast diseasea family history of breast cancerinherited gene changesdense breasts
The following are protective factors for breast cancer:
Less exposure of breast tissue to estrogen made by the bodytaking estrogen-only hormone therapy after hysterectomy,
Estrogen-only hormone therapy after hysterectomyselective estrogen receptor modulatorsaromatase inhibitors and inactivators
Risk-reducing mastectomy ovarian ablationgetting enough exercise
It is not clear whether the following affect the risk of breast cancer:
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 is the main risk factor for most cancers. The chance of getting cancer increases as you get older.
A personal history of breast cancer or benign (noncancer) breast disease
Women with any of the following have an increased risk of breast cancer:
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.
A family history of breast cancer
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:
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.
Men who have inherited certain changes in the brca2 gene have a higher risk of breast, prostate, and pancreatic cancers, and lymphoma.
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.
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.
Exposure of breast tissue to estrogen made in the body
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:
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.
Radiation therapy to treat cancer in one breast does not appear to increase the risk of cancer in the other breast.
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 increases the risk of breast cancer, especially in postmenopausal women who have not used hormone replacement therapy.
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:
Less exposure of breast tissue to estrogen made by the body
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.
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.
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:
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.
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.
Studies have not proven that being exposed to certain substances in the environment, such as chemicals, increases the risk of breast cancer.
Studies have shown that some factors do not affect the risk of breast cancer.
The following do not affect the risk of breast cancer:
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.
Cancer prevention clinical trials are used to study ways to prevent cancer.
When the skin of a breast looks uneven, it is known as a dimpled skin. Sometimes the skin might appear to be red or inflamed. In this condition, the breast tissue gets affected and this can be a serious sign of concern for cancer. Moreover, this sign is hard to detect on your own. Usually when the sign occurs, it only occurs in one of the breasts. If a woman has it in both the breasts, then likely that it has not been caused by cancer.
Causes of breast cancer dimpling are as follows
1. Advanced breast cancer
2. Breast abscess: A hollow space in the breast that is filled with pus and is at times surrounded by an inflamed tissue.
3. Duct obstruction: The ducts that carry the milk from the nipple are obstructed causing rapid abnormal growth and functioning of the cells present in the breasts causing cancer.
4. Fat necrosis: In this condition, the neutral fats are split into glycerol and fatty acids because the adipose tissue tends to degenerate.
5. Inflammation: Inflammation in the fatty tissue of the breast
6. Mastitis: The breast tissue tends to swell up and get infected. This happens because of the bacteria that enter the breasts through the nipple and this may cause infection in the milk glands.
7. Genetic: Carrying the faulty gene is one of the main reasons why many women end up literally inheriting breast cancer. This can usually be tested with a mammography, especially if one has a history of breast cancer in the family. Yet, one must remember that it is not advisable to take this test too many times as it puts you at risk of contracting breast cancer even if you do not have it, when there is repeated exposure.
First, the doctor might perform certain tests to diagnose and determine the problem. Tests like an ultrasound, MRI or even a mammogram might be used. Depending on what the diagnoses is, the doctor might even want to perform a biopsy. In case breast cancer is diagnosed, there are certain treatments that are available. These include:
- Surgery: The cancerous tissue is removed from the breast or at times when the tissue is too big, the entire breast might have to be removed.
- Chemotherapy: Chemotherapy is a medication that uses a method to send fluids that tend to kill the cancerous cells or prevent them from growing. It is a three to four hour long session at times.
- Radiation: High beam x-rays are used in order to target and destroy the cancer cells present in the breasts.
- Hormonal therapy: In this treatment, the hormones that fuel the growth of cancerous cells are blocked either through medications or surgically. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
The spine plays a very crucial role, both from a person’s movement and sensation point of view. It carries the nervous supply for a lot of internal organs and the lower body. By virtue of its structure, it also helps in movement through the disks. Due to various reasons, spinal injury is common, causing pain along the back, lower extremities, neck etc.
Medicines and exercise are the first line of treatment for most spinal injuries. The issue, however, is that these only provide relief from the pain and the medicines, but do not actually ‘rectify’ the underlying problem. Whether it is a herniated disk or a pinched nerve, the medicines and exercise can relieve the symptoms, but the disk continues to be herniated and the nerve continues to be pinched. Definite treatment is in the form of surgery, and with recent advancements in the field of spinal surgery, there are minimally invasive surgical options, which provide complete cure with minimal recovery time. Some of the benefits of this are listed below-
Smaller incision compared to traditional surgical procedures, where only the injured area is accessed
The surrounding tissues are untouched, unless they are injured and require repair
Lesser bleeding compared to earlier techniques
Lesser painful procedure
Reduced hospitalization period
Quicker recovery and return to normal activities
The question, however, is whether this is indicated in everybody. A detailed discussion with your surgeon keeping the below points in mind will help identify the answer for this. The main driver should be the answer to the question – will the surgery be able to effectively relieve you of the pain and symptoms? Additionally, the following factors help in getting better results out of a minimally invasive spinal surgery.
Presence of symptoms relating to nerve compression, including pain from the spine down the leg.
Recent onset of symptoms, with pain starting days to months before seeing the doctor. This indicates the condition is relatively new and so damage is minimal, indicating favorable outcome. Chronic pain conditions take slightly longer time compared to recent injuries.
People with active lifestyle who engage in regular physical exercise are likely to have better benefits from the minimally invasive procedure.
Smoking reduces blood flow to the spine, leading to disk degeneration and weakening of bones. Healing is highly slowed down and recovery is overall delayed.
Excessive weight puts strain on the back, and so healing can be delayed or badly affected with more complications. It is not a contraindication, but be prepared for a longer recovery period.
Hi doctor. I have a severe backache as per Dr. Advice I have done mri. My mri report is as under kindly advise in matter degenerative lumber spondylitis are seen in the form of marginal osteophytes and multilevel disc dessication. 1. D12-l1 & l1-l2 discs show mild bulge, indenting anterior thecal sac without significant never root compression 2. L2-l3 disc reveals right paracentral disc extrusion, indenting anterior thecal sac and causing right lateral recess narrowing, impinging on right traversing l3 nerve root. 3. L3-l4 disc shows mild diffuse disc protrusion, indenting anterior thecal sac and causing bilateral mild neural foraminal narrowing, minimally abutting bilateraltraversing l4 nerve roots. 4. L4-l5 disc reveals mild diffuse disc protrusion, indenting anterior thecal sac and causing bilateral mild neural foraminal narrowing, minimally abutting right existing l4 nerve root-bilateral traversing l5 nerve roots. Nerve roots. Cord is seen ending at d11 vertebral level. Distal cord and conus appear normal. Both hip and si joints are normal. No pre / paravertebral, epidural soft tissue or haematoma is seen. Bilateral psoas and posterior paraspinous muscles are normal. Please advise for home exercise / medicine.?
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.
- 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:
- Formation of a lump in your breast
- Swelling or shrinking of your breast
- Change of size, shape and color of your nipple
- Blood or milk discharge from the nipple
- Breast pain
- Itching sensation
- Appearance of rashes
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:
- 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.
- Drink more of green tea as it has anti cancer properties.
- Exercises like walking, yoga, meditation and certain breast exercises can help you to relax the pain sensation, reduce stress and also get cured.
- Incorporate bitter gourd in your diet. Researches show that bitter gourd can kill those cancer cells, which cause breast cancer.
- 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.
Hi i'm from Kalimpong District west bengal .I have got slip disc. I'm taking medicine from yesterday only .Can I do any exercise or brisk walk apart of medicine. Please kindly suggest me.
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.
The uterus is a muscular structure held in place inside your pelvis with the help of muscles, ligaments, and tissues. These muscles weaken in women due to pregnancy, childbirth or delivery complications and can lead to severe complications. One such complication is a uterine prolapse. Uterine prolapse occurs when the uterus sags or slips from its normal position into the vaginal canal.
The causes of uterine prolapse are varied and include:
- Delivering a large baby
- Difficulty in labor and delivery
- Reduction in estrogen levels post menopause
- Traumatic childbirth
- Loss or weakening of the pelvic muscle
- Conditions which lead to increased pressure in the abdominal area such as a chronic cough, straining, pelvic tumors or accumulation of fluid in the abdomen
Uterine prolapse can be complete or incomplete depending on how far the uterus sags into the vagina. Women who have minor uterine prolapse may not have any visible symptoms. However, if the condition worsens, it manifests itself in visible signs.
Symptoms of moderate or severe prolapse are:
1. A feeling of fullness or pressure in your pelvis when you sit
2. Seeing the uterus or cervix coming out of the vagina
3. Vaginal bleeding or increased discharge
4. Painful sexual intercourse
5. Recurrent bladder infections
6. Continuing back pain with difficulty in walking, urinating and moving your bowels
Without proper attention, the condition can cause impairments in the bowel, and can also affect bladder and sexual function. If you wish to discuss about any specific problem, you can consult a gynaecologist.