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Patient Review Highlights
I had a breast lump which i showed to my gynaec in Gurgaon but she ignored it. As it kept on increasing, I met Dr Khandelwal after a reading his blog. He suspected it to be cancerous and my worst fears came true when the biopsy report came out as positive. Fortunately, he picked it on time and I just required surgery& RT for the management on cancer. Thankful to Dr. Rohan Khandelwal
Doctor rohan is an excellent doctor & humand being. Very patient, humble and he helped me in every step of the way during my breast cancer treatment
Mastalgia can be a debilitating problem for a lady. Maintaining a'pain diary' goes a long way in the proper management of these patients.
I am 18 years old and I think I have gynecomastia i. E man boobs from last two years. I am doing gym from last two years and couldn't see any change in my chest. I will really appreciate it if you will help me Thank You.
In the last week, I have seen two patients who have presented with features of a breast abscess but they ultimately turned out to be breast cancers. Although, inflammatory breast cancers are a known entity and they can present as breast abscesses but this fact is not well known among patients and many general practitioners, which leads to late detection of these cancers.
With this case, I want to highlight some pointers to diagnose these lesions early. A 39-year-old, nonlactating mother presented to with complaints to swelling in the right breast for the last 3 weeks. She had already taken a course of antibiotics from a general practitioner but did not get relieved of her symptoms. On examination, she had a swelling involving the skin fold below the breast (inframammary crease) with swelling and hardness spreading till the lower part of the breast. In addition to this, she had lymph nodes (glands) in the underarm area (axilla) as well.
An USG revealed a lump in the breast associated with the fluid collection, which on biopsy turned out to be an invasive cancer. Fortunately for the patient, on further examination, the cancer was found to be restricted to the breast and the underarm area only.
When should we suspect that a breast abscess can actually be associated with a malignancy (cancer)?
A nonhealing breast abscess - which is persisting despite antibiotics and surgical management
Breast abscess in a patient who is not lactating.
Breast abscesses in elderly patients
Breast abscesses associated with hard lumps in the breast
Patients with these symptoms should get an ultrasound and biopsy done to confirm the diagnosis. In India, another entity which should be ruled out is Breast Tuberculosis.
Hi. How to reduce chest flesh? Bec my chest looking like breast. Please help in reducing soon. It Leads me more inferiority complex in public places.
How to get rid of man boobs commonly called gynecomastia. How to increase testosterone production in male. With help of exercises as well as medicine which have not bad impact at body.
Sir. M 28 yrs. My 2 breast are looks puberty girls breast. When I use tshirt. It shows. Frm outside. I fell uncomfortable when I used to outside. Kindly help how to recover from this plbm.
My problem is that my chest look like girls. So I can not show my body in front of anybody. What should I do please tell me.
What is the side effect of circumcision operation And gynecomastia surgery cost and how long it will take to require.
Hello doctor. She has a fibroid in breast. Examined it by a gynecologist. It is only common fibroid. Doctor said no problem. Can she cure it without surgery?
Myth #1: If you have a family history of breast cancer, you are likely to develop breast cancer, too.
While women who have a family history of breast cancer are in a higher risk group, most women who have breast cancer have no family history. Statistically only about 10% of individuals diagnosed with breast cancer have a family history of this disease.
If you have a first degree relative with breast cancer: If you have a mother, daughter, or sister who developed breast cancer below the age of 50, you should consider some form of regular diagnostic breast imaging starting 10 years before the age of your relative’s diagnosis.
If you have a second degree relative with breast cancer: If you have had a grandmother or aunt who was diagnosed with breast cancer, your risk increases slightly, but it is not in the same risk category as those who have a first degree relative with breast cancer.
If you have multiple generations diagnosed with breast cancer on the same side of the family, or if there are several individuals who are first degree relatives to one another, or several family members diagnosed under age 50, the probability increases that there is a breast cancer gene contributing to the cause of this familial history.
Myth #2: Breast cancer always appears as a lump
Approximately 10% of those diagnosed with breast cancer have no lumps, pain or other indications of a problem in their breasts.
And among lumps that are detected, 80 to 85% are benign. They’re often cysts or benign tumors called fibroadenomas. That said, any lump or breast symptom (especially from the list below) that does not go away should be checked by a breast surgeon:
A change in how the breast or nipple feels or looks
A lump or thickening in or near the breast or in the underarm area
Breast pain or nipple tenderness
A change in the size or shape of the breast
A nipple or skin that turns inward into the breast
Feeling warm to the touch
Scaly, red, or swollen skin of the breast, areola, or nipple, perhaps with ridges or pitting that resembles an orange peel
Myth #3: Deodorant and antiperspirants cause breast cancer.
One email rumor claimed that antiperspirant prevents you from sweating out toxins, which can then accumulate in the lymph nodes and cause breast cancer. But in 2002, researchers at the Fred Hutchinson Cancer Research Center in Seattle conducted a study to address this rumor—and found no link between deodorant or antiperspirant and breast cancer.
A second rumor speculated that certain chemicals in antiperspirants, such as aluminum and parabens, may cause breast cancer because there is a lower prevalence of the disease in developing countries where women don’t use these products. However, toxins are not usually released through sweat, and in Europe, where antiperspirants are not widely used, the rate of breast cancer is higher than it is in the United States. Finally, although a 2004 study found parabens in the tissue of breast cancer tumors, so far no studies have shown that these or any other chemicals in deodorants and antiperspirants cause breast cancer.
Myth #4: Wearing a bra increases your cancer risk.
There is no good scientific or clinical basis to support the claim that plain or underwire bras cause breast cancer.
This rumor appears to have started after a book called Dressed to Kill suggested that bras obstruct toxin-laden lymph fluid from flowing out of the breast. However, this was speculation based on a survey and no scientific evidence. Since then, major medical institutions, such as the National Cancer Institute and the ACS, have refuted the claim.
Myth #5: Young women don’t get breast cancer.
While it’s true the disease is more common in postmenopausal women, breast cancer can affect people of any age.
In fact, women under 50 account for 25% of all breast cancer cases, and they tend to have higher mortality rates. This may be partly explained by the fact that younger women tend to have denser breasts, which makes it harder to spot lumps during mammograms. Because of this, it’s a good idea to perform monthly self- breast exams starting at age 20, have a clinical exam by a doctor every 3 years, and speak with your doctor about whether you should start mammographic screening at age 40.
1. Most common cause of pain between 15-35 years of age is fibro-cystic disease, which occurs due to hormonal fluctuations.
2. In fibrocystic disease, there is cyclical pain, which is more in intensity just before the menstrual periods
3. Cyclical pain is commonly seen in patients who are overweight and hypothyrooid.
4. Ultrasound should always be done to rule out any lumps/ cancer.
5. During these episodes of pain, try wearing a sports bra. It offers good support and reduces the pain. You can also apply anti-inflammatory gels over the site of pain.
6. Large cysts (>1.5 cm) should be aspirated - they help in reducing pain
7. Cancer usually presents as a painless lump in the breast
8. Sometimes breast pain can be due to musculo-skeletal causes.
9. If there is one particular point, where pain in occurring (specially close to the middle), then it could be due to costo-chondritis (inflammation of the joint between cartilage and bone)
10. Costo-chondritis can be managed by pain-killers and local injection of steroids
Please make sure you get yourself treated from an expert breast surgeon, who knows the various causes of breast pain and their management.
Risk factors for Male Breast Cancer:
1. Age: The risk increases with increasing age and male breast cancer usually presents in the 6th or the 7th decade of life
2. Family history of breast cancer/ Inherited gene mutations: The chances of male breast cancer are higher in people with BRCA 2 mutation and a positive family history of breast cancer
3. Klinefelter’s syndrome: Men with Klinefelter syndrome have small testicles (smaller than usual). Often, they are unable to produce functioning sperm cells, making them infertile. Compared with other men, they have lower levels of androgens (male hormones) and more estrogens (female hormones). For this reason, they often develop gynecomastia (benign enlargement of the male breast), which is also a differential diagnosis of male breast cancer.Patients with this syndrome have a higher incidence of Male Breast Cancer.
4. Radiation exposure
5. Exposure to estrogen: Excessive exposure to estrogen increases the chances of male breast cancer.
6. Liver disease
8. Testicular problems: Undescended testis, mumps and Klinefelter’s syndrome increases the chances of male breast cancer.
A common differential diagnosis of Male Breast Cancer is Gynecomastia (benign enlargement of the male breast). Gynecomastia usually results from an imbalance between androgen and estrogen production. This is commonly seen in adolescents or in elderly patients because testosterone levels increase during puberty and decrease with age. Besides these causes, many drugs—including steroids, antidepressants, diuretics, and antihypertensive medications—have also been implicated in the development of gynecomastia, although as many as 50% of cases have no known identifiable cause.
Certain risk factors are common to both gynecomastia and carcinoma: breast irradiation, mumps orchitis, and bilateral cryptorchidism (undescended testis), Klinefelter’s syndrome.
Lack of awareness is the major cause which prevents early diagnosis of this condition in males. Following are the danger signs, which can point towards a male breast cancer:
If you notice any persistent changes to your breasts, you should contact your doctor. Here are some signs to watch for:
a lump in the breast
an inverted nipple
nipple discharge (clear or bloody)
enlarged lymph nodes under the arm
Diagnosis of male breast cancer is achieved on the same lines as female breast cancer. Patient is usually subjected to an imaging test followed by histo-pathological confirmation of the diagnosis.
Some patients also require extensive work-up to rule out metastasis to other parts of the body.
Management & Prognosis:
Management of male breast cancer is similar to female breast cancer.
By virtue of the proximity between most male breast cancers and the skin and chest wall, extension to or invasion of these structures is more commonly observed than in women but the prognosis of male breast cancer remains the same as female breast cancer.
My wife delivered a baby 2 months ago. She is getting a lump in her left breast, can you please provide a solution on treating this?
Hello sir, I have a white bump on my nipple but it does not pain or itch. What might it be? Please tell me.
Adopt a healthy lifestyle to reduce your risk of getting this disease:
1. Regular exercise - at least 30 mins of exercise 4 times a week
2. Avoid smoking
3. Avoid alcohol consumption
4. Over-weight and obese individuals have a higher incidence of breast cancer. Maintain your weight in the normal range (bmi - 18-25)
8. If there is a family history of breast cancer, do consult your oncologist to discuss your risk of breast cancer. Also discuss the need to getting genetic testing.
Breast cancer can also be detected early. Remember these three simple tips:
1. Be breast aware - do regular self examinations
2. Clinical breast examination by an experienced breast surgeon after the age of 35 years (annually)
3. Regular mammograms after 40 years of age