Breast-Cancer-Questions & Answers

Awareness regarding healthy Breast and educating masses regarding the signs and symptoms of Breast cancer is the most important factor for early detection of breast cancer. Yes early detection leads to better prognosis and increase in survival rate. Early detection means early stage cancer with low disease burden and hence better prognosis and survival.

Oncologist, Gynecologist, surgeons should regularly conduct seminars and camp regarding Breast cancer screening. Registered Medical Practitioners should be trained to suspect Breast cancer at the earliest because still in India the masses resides in villages. Breast health should be included as chapter in colleges so that masses get educated regarding this cancer from the very early years of life.

Fibroadenoma, Fiibroadenosis are some of the benign disorders that are not breast cancer. They are more common in younger women. They may be associated with tenderness and some time have cyclical variation with Menstruation cycle.

Breast cancer patients those undergoing chemotherapy should take healthy fresh cooked food. Raw foods should be preferably avoided. High protein diet should be taken like soybean, paneer, pulses and non vegetarian can add Fish, eggs chicken. Plenty of water should be taken. Those patients who have completed their treatment should take plenty of vegetables, fruits, salads, nuts and should avoid fast foods, saturated fats, alcohol and any food on regular basis that leads to obesity.

The estimated age standardized incidence of Breast cancer in India is 25.8 per 100 000. This means out of 1 lakh women 26 women will develop breast cancer in India each year. Among Indian cities the highest incidence is in Delhi is 41 followed by Chennai 37.9 and Bangalore 34.4 per 100 000.

No as of now i am not conducting any Breast Cancer trials. But we are using the latest drug for treatment of breast cancer. we are the first in Bihar to import new Breast cancer drug completely free of cost on Compassionate access from USA for the treatment of a lady with BRCA1 mutation positive Breast Cancer.

Yes cancer patients were one of the most affected group due to COVID-19 but we have continued our services without any break. we have tried to shift our breast cancer patient from IV chemotherapy to oral chemotherapy as much as possible during COVID pandemic so that hospital visit is minimised.

Advance age of first child birth( > 30 year), nulliparity, diet rich in saturated fat, lack of physical activity, post menopausal obesity, less fruits and vegetable in regular diet, Tobacco and alcohol intake, radiation to chest wall, familial in 8-10 % of cases mostly due to BRCA1/ 2 mutation.

Early stage breast cancer will present with painless lump in the breast. Any painless lump above 40 years of age is Breast cancer in most of the cases until and unless proved otherwise. on the contrary painful lumps are non cancerous in most of the cases. Painful lumps are mastitis, breast abscess. Very advance stage breast cancer can have ulcerative painful lumps. in stage 2 or 3 there will be lymph nodes in axilla and supraclavicular region of ipsilateral breast. in stage 3 there will be reaction of the nipple towards the lump, involvement of the skin of breast that is tethered to breast lump, in late stage the skin can be ulcerated due to delay in treatment, fixed to the chest wall, dimpling of the skin of breast commonly called as Peau d’orange. Stage IV Breast cancer patient presents with spread of cancer to Liver, Lungs, Bone, Brain and other distant sites.

All women should be screened for breast cancer after the age of 40 years with Bilateral Mammogram every one to two years. Any women with risk of familial Breast cancer with BRCA1/2 mutation should be screened from an earlier age.

level of awareness among Gynecologist is good and as par to any Western countries. But the level of awareness among general population need to be increased as “ Awareness is the key to early detection of Cancer and early detection is the key to cure of cancer”.

People in rural areas are not at a higher risk Breast cancer but on the contrary women in urban areas are are at higher risk of breast cancer. This is due to higher age of marriage and hence first child birth at a relatively higher age in urban areas due study, jobs and personal ambitions having more priority over family life. Apart from this sedentary life, more of saturated fatty foods with lack of physical activity in urban women carries a higher risk of breast cancer. Rural women on the contrary whatsoever lower percentage risk they carry the sad part is that they present with higher stage Breast cancer due to lack of Medical facilities which in turn have negative impact on their survival and poor prognosis.

Yes a women can be cured of breast cancer expect in stage 4. The earlier the stage more is the percentage of cure. The chances of recurrence increases as the stage increase. In stage 4 we can prolong the life span of the patients and now with modern medicines life span can be increased even more than 5 years. Surgery is the mainstay of treatment in stage 1 to 3. Surgery can be in the form of Modified Radical Mastectomy (MRM) in which the entire Breast is removed with axillary dissection or Breast Conservation Surgery (BCS) in which only the Breast lump along with margin of normal healthy Breast is removed. Chemotherapy is given either in adjuvant setting i.e post MRM or as Neo adjuvant chemotherapy i.e before Surgery in stage 3 or other early stage where Breast Cancer surgery is contemplated. Radiotherapy is given either post Breast Conservation Surgery or in axillary or Supraclavicular Node positive Disease or primary Tumor size of >5 cm. Post chemotherapy anti Her2 neu therapy is given for one year and Hormonal Treatment is given for 5-10 years in ER/PR positive Breast Cancer patients. The mainstay of treatment of stage IV breast cancer is Hormonal agents and CDK4/6 inhibitor for ER/PR positive cancer, anti Her2 agents for Her2 Neu positive disease, chemotherapy and the recent addition is Immunotherapy drugs as anti PD 1 or anti PDL1 agent and PIK3 inhibitor.

Women who have completed their Breast Cancer treatment should maintain healthy life style , regular physical exercise, avoid obesity, plenty of fruits, vegetables and avoid saturated fatty foods.

Awareness is the key to Early detection of Breast Cancer and Early detection is the key to Cure of Breast cancer. Since Breast cancer is curable upto stage 3 in most of the cases so any women who merits treatment for Breast cancer shouldn't be debared from it. Going for alternative medicine will only make curable Breast Cancer to incurable cancer as the window period is lost and these patients finally land up in stage 4 disease. 5-10 % of Breast cancer are familial so whenever suspicion these patients should be tested for BRCA1 and BRCA2 mutation testing and if positive then their sisters and siblings should be tested for the above mutation testing.