Breast Cancer

The early signs and symptoms of breast cancer can vary in nature and extent. This makes it all the more important for women, particularly those who are at high risk, to regularly self-examine and consult their personal physicians.

Some common early signs of breast cancer include –

• Presence of a lump or a hardened area in or around the breast
• Changes in the appearance of the breast tissue, such as changes in shape or size
• Pain, swelling, or soreness in and around the breast area
• The appearance of a rash or a patch of skin that looks different from the rest of the breast area, or around the areola
• Pitting, dimpling, or any change of the skin over the breast
• Inversion of the nipple; blood or any other discharge from the nipple
• Pain or presence of an enlarged node under the arms

The outcomes of breast cancer treatment improve significantly when the cancer is detected in its early stages. Please make sure to consult a doctor if you notice any physical or visual changes in the breast or underarm area.

• Age
• Pregnancy
• Late menopause
• Lack of breastfeeding
• Early-onset of periods
• Null parity or late childbirth
• Obesity and Sedentary Lifestyle
• Hormone replacement therapy
• Previous history of radiation
• Previous history of breast surgery

After understanding the causes and symptoms of breast cancer, a multi-pronged approach is mandatory for an accurate breast cancer diagnosis:

1. Screening Mammogram: Regular mammograms after the age of 40 years reduces the risk of dying from breast cancer by early detection of the disease. Low-dose X-ray of the breast is useful in evaluating palpable as well as non-palpable masses.
   
   
2. Breast Self-Examination: Helps you to be breast-aware, best done every month, 4-5 days after your periods or on a fixed day if you are post-menopausal.
   
   
3. Clinical Breast Examination: Yearly visit to a breast surgeon for a thorough breast examination after the age of 40 years.
   
   
4. Breast Ultrasound: required sometimes
   
   
5. Pathological Assessment
   
   
6. Fine Needle Aspiration Cytology (FNAC): A fine needle is inserted into the lump to aspirate a few cells and spread on a glass slide and studied on the microscope to arrive at a diagnosis. FNAC is mandatory for all breast lumps irrespective of the age of the patient.
   
   
7. Trucut Biopsy: If FNAC is negative in the background of a high index of suspicion. Cores of tissue give us a pathological diagnosis more reliably than an FNAC.

At Max Institute of Cancer Care, we are committed to recuperating our patients as soon as possible. Our dedicated team of leading oncologists provides the most advanced treatment for breast cancer using cutting edge technology, based on international standards. Cancer care requires medical professionals from different specialities to collectively execute an individualized patient care plan for the best results. The various treatment offered are as follows:

A) Breast Cancer Surgery

There are four main types of breast cancer surgery to remove cancer:

1. Breast-conserving surgery (also called lumpectomy), quadrantectomy, partial mastectomy or segmental mastectomy)
2. Mastectomy / Prophylactic Double Mastectomy
3. Sentinel lymph node biopsy
4. Modified Radical Mastectomy with reconstruction

B) Radiation Therapy

The radiation oncologist of breast cancer hospital in delhi will plan your treatment and your chest /Breast area will be marked with ink or markers. CT scan is then taken in the treatment position for planning Radiotherapy. This CT scan is then transferred to dedicated computers for radiotherapy planning. The radiation oncologist defines and identifies the target volume (breast/chest wall and lymph glands) to be treated and normal body organs like lungs heart etc to be saved. The treatment plan is then generated and optimized.

C) IMRT (Intensity Modulated Radiation Therapy)

This technology has contributed significantly to reducing complications of Radiation Therapy. In many situations, this allows a relatively higher dose of radiation to be delivered to the tumour, thus increasing the chance of cure.

D) IGRT (Image Guided Radiation Therapy)

The breast/chest wall moves with breathing and setup position can vary from day to day. Since the radiation dose is more and more confined to the tumour, the change in position of the tumour can be tracked with a CT image (called Cone beam CT), just before the treatment delivery and the Modified Radical Mastectomy (MRM) is recommended when:

• Cancer is found in more than one part of the breast.
• Breast is so small that a wide excision of a lump can severely deform the breast.
• A woman prefers MRM over breast conservation.

Following either surgery, you will have a drain placed in the axilla and another drain placed under the flaps after mastectomy. This will be removed in the outpatients after 7-14 days depending on the amount of fluid that is draining out. Stitches are removed after two weeks of surgery.

Radiation therapy may be recommended if lymph nodes in the armpit (axilla) are reported positive in the final histopathology report.

E) Chemotherapy

Many patients after surgery for breast cancer may require chemotherapy. A combination of drugs is usually used. The medical oncologist will plan therapy according to your individual case. Chemotherapy may be administered as:

• Neoadjuvant Chemotherapy – prior to definitive treatment (surgery)
• Adjuvant Chemotherapy- following surgery
• Palliative Chemotherapy- in a metastatic setting

F) Targeted Therapy

It is aimed at targeting only the cancer cells. In breast cancer, the Her-2-neu oncoprotein is overexpressed in the cancer cells. Drugs are now used to target these receptors and prevent the multiplication of these cells.

G) Hormonal Treatment

In patients whose tumour expresses the estrogen and progesterone receptors, hormonal therapy is recommended. This treatment is available in tablet form to be taken once daily.

Tumor Board

At Max Institute of Cancer Care (MICC), a team of our experts from surgical oncology, radiation oncology, medical oncology, pathology, imaging and related disciplines come together in the Tumor Board meetings to discuss various cases and form a customized/ joint decision and a treatment plan.

We believe that each patient and his/her disease is unique, hence our team of oncology experts prepare a 'personalized treatment plan' based on the discussions in Tumor Board conferences. We constantly review and improve our protocols and encourage the participation of our patients as well as caregivers to understand the disease and its treatment process.

At Max Institute of Cancer Care, we are committed to recuperating our patients as soon as possible. We firmly believe in delivering quality care, support and reassurance to our patients. Our dedicated team of leading Breast Cancer Oncologists provides the most advanced cancer treatments using cutting edge technology, based on International Standards. Breast cancer care requires medical professionals from different specialities to execute an individualized patient care plan for best results collectively.

The Max Breast Clinics provides a world of comprehensive breast care catering to the treatment of benign conditions like mastalgia, nipple discharge, infectious conditions, benign lumps on the one hand to breast cancer on the other. The clinics are under the Department of Surgical Oncology, Max Institute of Cancer Care, which has vast experience in carrying out all possible breast cancer surgical procedures.

Breast cancer is the most common cancer affecting women in India and around the world. Max Healthcare is one of the country's leading providers of world-class breast cancer treatment. The cost of breast cancer treatment in India will depend on a few factors, including:- 

• The staging and spread of the cancer
• Treatment protocols (surgery, chemotherapy, radiation, gene therapy, hormone replacement therapy etc.)
• Need for hospitalization

We offer the best in breast cancer treatment technologies, state-of-the-art facilities, treatment by empathetic teams of experts that include some of the most experienced oncologists in India, backed by peerless patient care.

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