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Dr. Vikram Chohan

MBBS, DMRD, DNB

Radiologist, Pune

30 Years Experience
Dr. Vikram Chohan MBBS, DMRD, DNB Radiologist, Pune
30 Years Experience
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Personal Statement

Our team includes experienced and caring professionals who share the belief that our care should be comprehensive and courteous - responding fully to your individual needs and preferences....more
Our team includes experienced and caring professionals who share the belief that our care should be comprehensive and courteous - responding fully to your individual needs and preferences.
More about Dr. Vikram Chohan
Dr. Vikram Chohan is a trusted Radiologist in Paud Road, Pune. He has over 30 years of experience as a Radiologist. He has done MBBS, DMRD, DNB . You can visit him at Image Sonography Clinic in Paud Road, Pune. You can book an instant appointment online with Dr. Vikram Chohan on Lybrate.com.

Lybrate.com has top trusted Radiologists from across India. You will find Radiologists with more than 43 years of experience on Lybrate.com. You can find Radiologists online in Pune 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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Specialty
Education
MBBS - B J MEDICAL COLLEGE PUNE, - 1987
DMRD - G. S. Medical College KEM Hospital, - 1989
DNB - G. S. Medical College KEM Hospital, - 1991
Languages spoken
English
Hindi

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Gopal Park, Pandit Dindayal, navin Abhinav sala, Paud Phata.Landmark:New Karnataka Highar Secondary School, PunePune Get Directions
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I have been suffering from disk problem since 7 months. I have consulted a doctor. I took x-Ray as per his advice. He said disk has been narrowed. He prescribed some painkillers and vitamin tablets. Could anyone please prescribe some medicine for me. I am really unable to sit without any support.

Diploma in Orthopaedics
Orthopedist, Morena
Dear, do the following things. 1. Hot fomentation for 1/2 hrs with lukewarm water. 2. Back extension excercises. 3. Pavan muktasan yoga 4. Bujangasan 5. Muscle relaxant tablets for 5-7 days. 6. Local application of analgesic ointment. 7 vitamin d in form of capsules/sachets under guidance of doctor. Check your vit. B12 level.
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I am having problem in l4 and I5. This problem is from around 3 years. But the condition is improved now. Can you please suggest some exercises?

PG Diploma in Emergency Medicine Services (PGDEMS), Bachelor of Ayurveda, Medicine and Surgery (BAMS), MD - Alternate Medicine
Ayurveda, Ghaziabad
Hi Apply pranacharya restopain oil or prasarini oil on your affected part then give hot fomentation. Take maha rasnadi kwath 2-2 tsf twice a day. And agni tundi vati and maha yograj guggul 1-1 tab twice a day..
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Breast Cancer - 6 Ways You Can Prevent it

MBBS, DGO, MD - Obstetrics & Gynaecology
Gynaecologist, Mumbai
Breast Cancer - 6 Ways You Can Prevent it

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-

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. Breastfeed, If Possible: Breastfeeding for almost one year or more brings down the danger of breast cancer. It additionally has extraordinary medical advantages for the baby as well, especially in terms of immunity.
  6. Keep away from Birth Control Pills: Contraceptive pills have both dangers and advantages. In many cases, the more young a lady is, the lower the danger is. While ladies are taking birth control pills, they have more chances of falling prey to breast cancer as per various medical studies. This danger leaves rapidly in the wake of stopping the pill. The danger of stroke and heart attack is increased while on the pill, especially if the woman smokes. Long term use can likewise have essential advantages, such as bringing down the danger of ovarian cancer, colon tumor and uterine cancer and undesirable pregnancy. In case you are exceptionally worried about breast cancer, staying away from birth control pills is also an alternative to lower the risk. If you wish to discuss about any specific problem, you can consult an oncologist and ask a free question.
3959 people found this helpful

I am suffering from slip disc l4 l5 problem from last 5 yrs. I have tried all the treatment. But. please provide some tips.

Fellowship in Shoulder and Knee Surgeries, DNB (Orthopedics), Diploma In Orthopaedics (D. Ortho), MBBS
Orthopedist, Nagpur
Do not lift weight Use hot fomantation twice daily Don't bend forward Show MRI for further information on the problem
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Back bone slip disk, sitika. I ask in Hindi rid ki haddi ke manke sarke hue hai. Unka koi ilaj hai kya. Koi bhi ilaj jese aurved ya koi or ilaaj hai to please batana. Unko bahut pain hota hai. Or koi kam bhi nahi kar sakte hai. Pura bed rest hai.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
Back bone slip disk, sitika. I ask in Hindi rid ki haddi ke manke sarke hue hai. Unka koi ilaj hai kya. Koi bhi ilaj ...
Apply hot fomentation twice daily. Avoid bending in front. Postural correction- sit tall, walk tall. Extension exercises x 15 times x twice daily. Bhujang asana. Core strengthening exercises. Back stretching. Do the cat/cow stretch.
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Am 24 years old and facing disc bulge from past 4 years (L4, l5, l6) I have taken treatment with exercises, massages and Physio therapy. Which is best way to cure in a quick time.

MBBS, MS - Orthopaedics, DNB (Orthopedics)
Orthopedist, Mumbai
Continue your physiotherapy and avoid bending forward and lifting heavy weights, do regular back and core strengthenin exercise, take a healthy diet of calcium and vitamin d usually slipped discs regress on their own in a period of 6 to 8 months.
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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 suffering from slipped disc in cervical spine from 6 months. So my question is that I am a dance choreographer should I continue with my dance or not can you suggest me and how this problem Will be cured.

Fellowship in Joint Replacement, MS - Orthopaedics
Orthopedist, Dhamtari
24 years old with slipped cervical disc. Depends upon the extent of slip and your symptoms if you are experiencing neck pain and upper limb pain then you should not do activities involving sudden, jerking movements of neck. Medicines and neck muscle strengthening exercises can very well take care of this problem further intervention is needed only of disc is causing nerve or cord compression.
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I am 36 year old having problem of of disc slip in lumbar spine Dr. Asked for the surgery is only surgery is the option please suggest me other treatment.

DNB (Radiodiagnosis), DMRD, MBBS
Radiologist, Bangalore
Hi, thanks for writing in to us. It is possible that the disc bulge might have increased in severity recently. Please get a repeat mri scan done and discuss the findings please. It is possible that you might get relief through physical therapy or mild pain relief medications. If there is no relief with medicines then there is the option of steroid injection and radio frequency nerve block procedure. Surgery is the last resort and done only in extreme cases. Please do not worry. Regards,
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Causes and Symptoms of Uterine Fibroids

Fellowship In Minimal Access Surgery, MS - Obstetrics and Gynaecology, MBBS
Gynaecologist, Hyderabad
Causes and Symptoms of Uterine Fibroids

Uterine fibroids are referred to as benign, abnormal growths which tend to develop in the uterine walls of a woman. The size of such growths can range from a few centimeters to even excess of a few inches. As such, they can cause the uterus to increase to the size of a five month pregnancy. Although, the symptoms of fibroids are not always apparent, they often cause heavy bleeding and pain in women. A recent research concluded that around 60 to 75 percent women contract such fibroids by the age of 50, at least once in their life.

Depending on the site of formation, uterine fibroids are distinguished into different types. Intramural fibroids in the lining of the uterus and subserosal fibroids which develop outside the uterus are the most commonly observed fibroids.

What causes Uterine Fibroids?
Although, the exact reason for the formation of fibroids are obscure, medical professionals have determined certain factors that may affect their formation. Some of them are:
1) Hormones: Progesterone and estrogen, produced by the ovaries regenerate the uterine lining during each menstrual cycle and trigger the growth of fibroids.
2) Family history: If you have had a family history of uterine fibroids, then you're likely to develop the condition yourself as well.
3) Pregnancy: The production of progesterone and estrogen increases during pregnancy which increases the likelihood of fibroids.

What are the signs of the condition?
Depending on the location and size of the tumors, symptoms of such fibroids include:
1) Heavy bleeding and blood clots during periods
2) Pain in the pelvis
3) Frequent menstrual cramps
4) Pressure and pain in the lower abdomen
5) Swelling in the abdomen
6) Pain while intercourse

What is the procedure of the treatment?
Ultrasound and pelvic MRI are common diagnostic procedures to check for uterine fibroids. After diagnosis, depending on your age, size of the fibroid and your comprehensive health, the doctor would prescribe you with appropriate medications. Only after medications prove futile, doctors opt for minimally invasive surgeries. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

2789 people found this helpful

I am 33 years old my weight 69 kgs .l will take medicine to my disc problem before take medicine my weight 60 how to weight loss give me suggestion?

BHMS
Sexologist, Noida
I am 33 years old my weight 69 kgs .l will take medicine to my disc problem before take medicine my weight 60 how to ...
Mr. Lybrate-user I suggest you to take homoeoptahic medicine tuberculinum 200 and ars. Iod 30 tds for 1 month ok with take milk mixed with turmeric ok raise your immunity ok so solve your problem. Becouse of your immunity is very low ok.
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I am 27 year boy I have back pain l4 and l5 disk light move. I there any full relief treatment means contact me sir. Back pain person do sex fully or not. After two month marriage fixed so im tired.

BPTh/BPT
Physiotherapist, Delhi
I am 27 year boy I have back pain l4 and l5 disk light move. I there any full relief treatment means contact me sir. ...
Start with physiotherapy treatment. Learn spinal exercise. Don't sit on floor. Don't lift heavy things. Share your x ray report for further discussion.
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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.

B.Sc. - Dietitics / Nutrition, Nutrition Certification,Registered Dietitian
Dietitian/Nutritionist, Delhi
I am 33 and my body has became very stiff due to no physical exercise. I have slip disk and neck ailments. Also menta...
The best way to get started is with pranayam. Do daily breathing exercises for half an hour and then start with suryanamaskar. Do atleast 21 cycles of suryanamskar. You will start seeing the results within 15 days.
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My wife is suffering from slip disc in spine after mri doctor diagnosis that she also suffering bone tb with unbearable pain in lower portion. Now as per doctor advice completely she is in bed rest. Now she cannot able to stand. Kindly advice.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful use no pillow under the head. Do hot fomantation. Paracetamol 250mg od & sos x 5days. 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 4-5days, contact me again. Do not ignore. It could be beginning of a serious problem. I would like to examine her personally as soon as possible.
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I have a disc bulge at L4-L5 and L5-S1, its being more then 7 months now. My physiotherapy session is going on but i still have pain and weakness in my legs

M.Ch, DNB (Orthopedics), MBBS
Orthopedist, Mohali
You need and MRI and clinical assessment and may end up having a surgery if you have weakness which has not improved on censervative treatment for 7 months.
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Flattening of thoracic curvature ,to some extent .diminution of disc spaces with small osteophytes formation at the adjacent vertebral margins at T4>T8. No other obvious abnormality IMPRESSION - (Early/min) spondylitis changes -Mid-thoracic spine This is my x ray report please tell me is that a major problem or it can be heal with medicine and exercise and what r the reason for this. Please tell.

MPTh/MPT, BPTh/BPT
Physiotherapist, Gurgaon
Flattening of thoracic curvature ,to some extent .diminution of disc spaces with small osteophytes formation at the a...
This happens because foulty sitting posture. You should consult a good physiotherapist nearby and learn some stretching and strengthening exercises. Try to maintain neutral posture while sitting and standing. Avoid continues sitting for more than 30 minutes at a stretch.
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Lupus Disease

MD - Bio-Chemistry, MF Homeo (London), DHMS (Diploma in Homeopathic Medicine and Surgery), BHMS
Homeopath, Kolkata
Lupus Disease

This is a form of epithelial cancer and is a lose called eating cancer
Symptoms:- it first appears on the nose as a hard, dusky red sore and spreads in ulcerative form destroying the tissues till the bones are exposed. This affect women 10 time more than men. It usually appears in women between the age. Nausea, vomiting and abdominal pain may accompany. It is an ulcerative skin disease and requires a very long-term treatment. Sensitivity to sunlight is usually present. Lupus is caused by disruption of body waste disposal system from failure of special enzyme d nasil, which fails to remove wastes from the body.
Diagnostic tests
The disease is easily noticeable as it is outside the body on the the skin and biopsy is performed to confirm it.
If possible, the affected portion of the body is cut out.
I suggest homoeo doctor consult and homoeo treatment best.

1 person found this helpful

MRI IMPRESSION 29 August 2016 -Posterior diffuse disc herniation at L4 -5 level with bilateral ligamentum flavum hypertrophy causing narrowing of bilateral neural recesses with compression of bilateral traversing nerve roots at same level. -Posterior diffuse disc bulge at L5-S1 level indenting ventral thecal space at same level -Changes of lumbar spondylosis I was having pain at my right hip joint on 15/8/16. It went unbearable extending to RT leg. On 3rd September night as usual on bed all the 24 hours trying to sleep on 4th at 5 am all my pain went. Till then no pain but having burning sensation on right foot, tingling, falling rt foot asleep when I sit on chair. Please advise:- 1. Surgical intervention required? Or 2.Pregabalin,Tolperisone, methylcobalamin,Calcium and D3 with rest will cure me fully? Or 3. Somekind of spinal exercises also required? ERODHA.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
MRI IMPRESSION 29 August 2016
-Posterior diffuse disc herniation at L4 -5 level with bilateral ligamentum flavum hype...
This treatment is being suggested on bases of the information provided. I would like to examine & investigate you in detail. Any way it may be tried, --. Dolokind Plus (Mankind) [Aceclofenac 100 mg +Paracetamol 350 mg 1 tab. OD & SOS. X 5 days. --. Caldikind plus (Mankind) 1 tab OD x 10 days. (You may need help of your local doctor to get these medicines.)--. Fomentation with warm water. Avoid direct flow of AC or Cooler. --. Sleep on a hard bed with soft bedding. --. Use no pillow under the head. --. Avoid painful acts & activities. -- .Do mild exercises for Back Do not ignore, let it not become beginning of a major problem. Do ask for a detailed treatment plan. If no relief in 2-3 days, contact me again (through this platform only) Kindly make sure, there is no allergy to any of these medicines. (Contact your family doctor, if needed). For emergency treatment visit nearest hospital. I hope I have answered your question to your satisfaction. Kindly rate the answer.Wish you a quick recovery & good health.
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Breast Cancer Prevention:

Homeopath,

Breast Cancer Prevention:

  1. 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.

  2. 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:

  3. 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:

Key points:

  1. 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

  2. Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast.

  3. 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.

  4. Enlarge Drawing of female breast anatomy showing the lymph nodes, nipple, areola, chest wall, ribs, muscle, fatty tissue, lobe, ducts, and lobules.

  5. 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.

  6. 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:

  1. Older agea personal history of breast cancer or benign (noncancer) breast diseasea family history of breast cancerinherited gene changesdense breasts

  2. Exposure of breast tissue to estrogen made in the bodytaking hormone therapy for symptoms of menopause radiation therapy


 

The following are protective factors for breast cancer:

  1. Less exposure of breast tissue to estrogen made by the bodytaking estrogen-only hormone therapy after hysterectomy,

  2. Estrogen-only hormone therapy after hysterectomyselective estrogen receptor modulatorsaromatase inhibitors and inactivators

  3. Risk-reducing mastectomy ovarian ablationgetting enough exercise


 

It is not clear whether the following affect the risk of breast cancer:

  1. Oral contraceptives

  2. 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:

  1. Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.

  2. A personal history of breast cancer or benign (noncancer) breast disease

     

Women with any of the following have an increased risk of breast cancer:

  1. 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.

  2. A family history of breast cancer

  3. 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:

  1. 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.

  2. Men who have inherited certain changes in the brca2 gene have a higher risk of breast, prostate, and pancreatic cancers, and lymphoma.


 

Dense breasts:

  1. 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.

  2. 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.

  3. Exposure of breast tissue to estrogen made in the body

  4. 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:

  1. 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.

  2. Radiation therapy to treat cancer in one breast does not appear to increase the risk of cancer in the other breast.

  3. 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:

Obesity increases the risk of breast cancer, especially in postmenopausal women who have not used hormone replacement therapy.


 

Drinking alcohol:

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:

  1. Less exposure of breast tissue to estrogen made by the body

  2. 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.


 

Risk-reducing mastectomy:

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.


 

Ovarian ablation:

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:

  1. Oral contraceptives

  2. 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.

  3. 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.


 

Environment

  1. Studies have not proven that being exposed to certain substances in the environment, such as chemicals, increases the risk of breast cancer.

  2. Studies have shown that some factors do not affect the risk of breast cancer.


 

The following do not affect the risk of breast cancer:

  1. 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.

  2. Cancer prevention clinical trials are used to study ways to prevent cancer.

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