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Breast cancer is a form of cancer which develops from the breast tissue. Breast cancer is indicated by signs such as a lump in the breast, changes in breast shape, fluid flowing from the nipple, dimpling of skin, or the development of red scaly patches. Breast cancer is a fatal form of cancer in women and immediate diagnosis is required on observing the symptoms.
Diagnosis of breast cancer
Other than the regular breast screening, the diagnosis of breast cancer involves the following steps and methods:
- Seeing your general practitioner (GP): It is very important to visit your GP soon after noticing the symptoms of breast cancer. Your GP will examine you properly and in case your symptoms need more assessment, he/she will refer you to a breast cancer clinic.
- Mammogram and breast ultrasound: You will be required to have a mammogram, as recommended by a specialist breast unit. This is an X-ray of the breasts. An ultrasound scan may also be required. Breast ultrasound should be undertaken only if you are less than 35 years of age. This is because, young women have denser breasts and a mammogram is not as effective as ultrasound in the diagnosis of breast cancer. In ultrasound, high frequency sound waves are used for obtaining an image of your breasts. It is observed to notice any abnormality or lumps. A breast ultrasound is also important for determining whether a lump is solid or contains liquid.
- Biopsy: In this diagnosis process, a sample of the tissue cells is taken from the breasts and tested under a microscope to find out if it is cancerous. A scan and needle test for the lymph nodes present in your armpit is also done to check whether they have also been affected. A biopsy is undertaken in several ways, depending upon the condition and severity. A needle aspiration biopsy is used for testing a sample of your breast cells without the removal of the tissues. This is the most common form of biopsy and it is also used for draining a small fluid-filled lump or benign cyst. During the process, you will be given a local anesthetic. Usually, a needle biopsy is carried out guided by an X-ray, ultrasound and an MRI scan as well. This helps in distinguishing it from non-invasive changes such as ductal carcinoma in situ.
Another form of biopsy used for the diagnosis of breast cancer is called vacuum assisted biopsy or mammotome biopsy. In this process, a needle gets attached to a suction tube, which helps in obtaining the sample and for clearing the bleeding.
Sir I have a problem of slipped disc in cervical spine. I am a dance choreographer so I should do my profession or I should stop it.
I am suffering from l5-s6 disc prolapse from a year. Not undergone surgery. Little weight lift becomes problem in next morning. Is there a permanent solution for my problem. Thanks in advance.
Sir I have slip disk problem in l4 l5 Vert disk and pain in lower spine and pain goes to leg randomly both legs. This is from last 6 months What is easiest way to solve this problem.
Q1. What exactly is Laparoscopy?
Laparoscopy is an alternative to 'Open' surgery wherein the abdomen is opened by tiny 'key hole' incisions and surgery is done. 'Scopy' means the use of an endoscope or telescope to see inside the abdomen. This is attached to a camera and a light source and the inside of the abdomen is projected on to a monitor. The surgeon performs surgery looking at this screen. The surgeon makes a total of 2-4 small cuts on the abdomen ranging from half to 1 cm through which the telescope and other thin surgical instruments are passed into the abdomen. When the uterus is removed , known as hysterectomy, there is also a cut at the top of the vagina where the uterus is attached.
Q2. What kind of gynaecological surgeries can be performed by Laparoscopy?
Most surgeries done in gynaecology can now be performed by Laparoscopy and do not require the large incision as for open surgery. Laparoscopy can be done sometimes only for diagnosis and is called Diagnostic Laparoscopy, as in checking whether the tubes are open or not and to look for any causes of infertility or pain outside the uterus. In women who are unable to conceive, Diagnostic Laparoscopy is often combined with Hysteroscopy (endoscope inside the uterus, inserted from below, via the vagina). When laparoscopy is done to perform some surgical procedure inside the abdomen it is called Operative Laparoscopy. This may be for simple procedures like sterilization, minor adhesions, drilling ovaries; or for intermediate or major reasons like fibroids, endometriosis, removal of ovaries or tubes or both or removal of uterus, for staging of cancers or radical surgeries for cancer. However, about 5% of all surgeries including those for cancer or very large tumours may benefit from open surgery.
Q3. Why does an expert surgeon recommend Laparoscopy over Open Surgery?
Laparoscopic surgery has many advantages above open surgery: the incisions are much smaller (open surgery incisions are 8-10 cms long), therefore pain is much less; requirement for pain killers (which can have side-effects like sleepiness, impaired judgement) is lesser; hospital stay is shorter; complications fewer; requirement for blood transfusions infrequent; recovery in terms of physical, emotional and mental state is much better and quicker; return to work is faster with consequent lesser loss of working and earning days. Surgery with laparoscope is more precise because it is magnified view. Further vision is much better because it's like having your eye behind the structure because you can see with the telescope at places where the surgeon's eye cannot reach.
Q4. If the cuts on the abdomen are so small in Laparoscopic surgery, how do you remove the uterus or a large tumour from inside the abdomen?
Quite often if the tumour is not malignant and contains fluid, it is punctured to collapse it into a smaller size. If it is solid, it can be cut into smaller pieces inside the abdomen using a special instrument. The collapsed or cut structures can be removed gently through the 1 cm cut on the abdomen which may be increased a bit if required. After hysterectomy, the uterus can be removed easily from below, through the vagina.
Q5. Will there be much pain or discomfort after Laparoscopic Surgery?
There may be some pain and discomfort in lower abdomen for one day to few days after Laparoscopic surgery but this is much less as compared to open surgery because the incisions on the abdomen are much smaller and there is much less tissue handling inside the abdomen by fine instruments instead of rough, big, gloved hands which can cause tissue injury in open surgery. There may be some pain in the shoulder following laparoscopy. This is not serious and is due to the gas used in the surgery to make space for instruments.
Q6. When can I be discharged from hospital?
Following Diagnostic Laparoscopy or with simple Operative Laparoscopy you can expect to be discharged from hospital latest by the morning after surgery. In most other cases of intermediate or even major surgery, discharge is generally 1-2 days following the surgery unless there is some health issues prior to the surgery or any complication during the surgery. The complication rates for Laparoscopic surgery are not more than for open surgery and depend upon patient factors like anaemia, diabetes, obesity and skill of the surgeon.
Q7. When can I perform routine household activities or return to work after Laparoscopic Surgery?
Recovery after surgery depends upon many factors: presence of health problems before surgery; why the surgery is required; what surgery is being done; problems or complications of surgery, anaesthesia or blood transfusions. If all is well, one can perform routine household activities by 1 week, provided one doesn't feel tired. Although there may not be any harm, it may be unwise to be normally active within 48 hours of procedure. Following Diagnostic Laparoscopy or Operative Laparoscopy for simple procedures, one can return to work in 1 week. For other procedures, a 2-3 week off from work is reasonable. It depends on the type of work you are returning to. Avoid too rapid return to work if it is manually hard or requires standing for long durations of time. Sometimes a surgical procedure brings on a well needed rest and break from a lifetime of work. Mostly, when you return to work depends upon your own body and its signals of tiredness. You need to listen to those signals.
Noncancerous growths of the muscle tissue surrounding the uterus are known as uterine fibroids. This is a common disease which about 70 to 80% of women contract by the time they are 50 years of age. The uterine fibroids can sometimes be very big and cause heavy periods as well as severe abdominal pain while at other times, uterine fibroids give no signs or symptoms whatsoever and go away on their own. This is why it is crucial to know what type of uterine fibroids you have and how to diagnose them. Here are the types of uterine fibroids and how to diagnose them;
There are three main types of uterine fibroids. They are;
1. Intramural fibroids
The most common type of uterine fibroids are intramural fibroids. They typically appear in the endometrium and may grow larger which results in your womb getting stretched.
2. Subserosal fibroids
Subserosal fibroids are called so because they form on the serosa. The serosa is the outside of your uterus. Sometimes, Subserosal fibroids may grow so large that your uterus appears bigger on one side.
3. Pedunculated fibroids
Pedunculated fibroids tumors are basically Subserosal fibroids with a stem. A base which supports the tumor is called the stem.
There are a number of tests done to diagnose uterine fibroids. They are;
1. Pelvic exam
A pelvic exam is a thorough inspection of a woman pelvic area. The organs which are in the pelvic area include the cervix, ovaries, uterus and vagina. Normally, this and the next test in this article are enough to diagnose uterine fibroids.
2. Medical history
The history of your periods as well as the other symptoms you have will often be enough to diagnose the uterine fibroids. If your medical history is not enough, then you might need to undergo a pelvic exam.
3. Pelvic ultrasound
An ultrasound is when high-intensity sound waves are used to produce images of the pelvic area. This is only done when a pelvic exam and your medical history are not enough to diagnose uterine fibroids. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
I am 33 and my body has became very stiff due to no physical exercise. I have slip disk and neck ailments. Also mental tension getting worse. But need to come over this. What could be the starter guidelines for getting started with Yoga/Meditation.
Breast cancer begins when the cells that are present in the breast start to go out of control. These cells generally form a tumor which can be seen on mammogram or one can feel it as a lump. The tumor is threatening if the cells can grow into the tissues that surround it or spread to other areas of the body. Breast cancer happens mostly in ladies. Here are a few methods with which you can prevent breast cancer:
- Keep your weight in check: Maintaining a healthy weight is important for everyone although, it is easy to tune it out since it is said so often. Being overweight can expand the danger of a wide range of cancers, including breast cancer, particularly after menopause.
- Be physically active: Women who are physically active for almost or at least 30 minutes a day have a lower danger of breast cancer. Normal activity is additionally one of the ideal approaches to keep weight under control.
- Eat Your Fruits and Vegetables and Avoid Too Much Alcohol: A balanced and healthy diet can bring down the danger of breast cancer. Attempt to eat a considerable measure of fruits and vegetables and keep liquor at moderate levels or lower. While moderate drinking can be useful for the heart in most grown-ups, even low levels of intake can build the danger of breast cancer. If you do not drink, don't feel you have to begin. In case you drink modestly, there is less risk.
- Try not to Smoke: Smokers and non-smokers alike know how undesirable smoking is. It brings down a person’s quality of life and expands the danger of heart and lung diseases, stroke, and no less than 15 types of cancer, including breast cancer. It additionally causes bad breath, awful teeth, and wrinkles.
- Breastfeed, If Possible: Breast cancer is related to the hormone oestrogen. Many researchers believe the more our bodies are exposed to this hormone the greater the risk of the disease. Breast-feeding temporarily reduces a woman's oestrogen levels. It is also thought that breast-feeding causes the breast to go through certain physical changes that protect them against cancer-causing chemicals.
- Eat less fat: There is much debate about the link between breast cancer and diet. But there is evidence that certain western lifestyle factors - particularly our high fat diet - appear to increase the risk of the disease. If you wish to discuss about any specific problem, you can consult a gynaecologist.
Symptoms, causes and treatment for Breast Cancer Patients
Hello friends. My name is Dr. Gayatri Juneja. I’m a practicing gynecologist in Model Town for the last 20 years. I’m a visiting consultant in Apollo Cradle Hospital Moti Nagar, and Fortis Hospital Shalimar Bagh, and Sunder Lal Hospital Ashok Nagar. It’s a great pleasure for me to talk to you about certain problems which I think is becoming very important for all of us to know. I am going to talk about Breast Cancer.
Unfortunately, even in India, cancer breast is becoming very common. And it is not that it is a cancer which we cannot pick up at time. The only thing we need is to be aware of it. Only if we know what is happening with our body, is only then we can do what is normal, only then we can see what is not normal, right? It is one of the breast cancer is one of the easiest cancers to pick up. How? My body is my own. I should know what’s happening to me. So minimum a lady can do is do a self examination. Teach your daughters how to do a self examination for the breast. If you find any lump, any time, if you feel there is some pain, which was not there, if you see the nipple is not in the normal position, it is retracted inside, if you see there is skin changes on your breast, if you see any size difference. See minor size difference will be there. That is a natural thing. But if you see there is drastic change, and if you are not comfortable with something, do not neglect it. It’s not at all a normal thing. Go, see a gynaecologist.
It is a confidential thing between you and your doctor. Let her examine you. Let her guide you. You give her a proper history, if you have taken any contraceptive pills, even I-pill is very dangerous. I’ll come to it later how. The thing is…your doctor has examined you, then she will guide you what has to be done. There are various ways of diagnosing cancer of breast. First step is, you do a self examination. First step is over. You find the lump, you go to a doctor. Your doctor will ask for a sonography, that is ultrasound of the breast. And another part of it is an x-ray of the breast. Sometimes in younger age group the breast is very dense, and you cannot diagnose anything on mammogram.
You still are suspecting something, then your doctor might ask for an MRI. MRI is very effective in diagnosing, but we do not suggest it as first line treatment, first line of diagnosis. Once it is confirmed that yes, there is a lump, then what we do is, we ask for a biopsy. Now biopsy can be in 2 forms. It can be taken through the needle, which we call FNAC – Fine Needle Aspiration Cytology, and other is open biopsy, where we remove the whole lump, and send it for testing. If the test comes negative, good, fine, everything is fine. If it comes positive, then further treatment depends upon the type. Then they will do a special CT scan for you, where the will diagnose if any lymph nodes are involved.
Depending on preliminary staging, your doctor will ask for a surgery. Now the surgery will…it is better that the whole breast gets removed. Or what has to be done will be diagnosed, because it is not a single person specialty, it is going to be a multi-specialty treatment then. Now let’s come down to who are the people who are at higher risk. Why should I consider that I am at higher risk? What…who are those people? First, specially after menopause, obesity. If your lifestyle is not at all healthy, your food habits you eat lot of non-veg and processed food, like pizzas and burgers and frozen food, yes you are at risk. Then comes genetics.
If you have a family history of cancer in your nani, dadi, your bua, maasi, cousin, ya sister ya brother, or even cancer of ovaries, you are at high risk. But that doesn’t mean who all have had the history of cancer will also develop this. You are at higher risk, but it is better only to be careful. Then comes very tall ladies it has been seen they are also prone for diabetes. Obesity, and people who have had hormonal replacement therapy with…and once you’re diagnosed don’t get scared. It is a curable cancer, and life expectancy with variable modalities these days is quite good.The quality of life is also good.
So my suggestion would be, to conclude, that please be aware of what is happening with you, and take good care of yourself. If you are healthy, only then you can look after your family. Thank you so much.