Breast Cancer Treatment and Surgery in India
Breast Cancer Treatment in India:
- Breast cancer is the most common cancer among women.
- There are many types of breast cancer that differ in their capability of spreading (metastasize) to other body tissues.
- The causes of breast cancer are not yet fully known, although a number of risk factors have been identified.
- There are many different types of breast cancer.
- Breast cancer is diagnosed during a physical exam, by self-examination of the breasts, mammography, ultrasound testing, and biopsy.
- Treatment of breast cancer depends on the type of cancer and its stage (0-IV) and may involve surgery, radiation, or chemotherapy.
What are the different types of breast cancer?
There are many types of breast cancer. Some are more common than others, and there are also combinations of cancers. Some of the most common types of cancer are as follows:
- Ductal carcinoma in situ: The most common type of noninvasive breast cancer is ductal carcinoma in situ (DCIS). This type of cancer has not spread and therefore usually has a very high cure rate.
- Invasive ductal carcinoma: This cancer starts in a duct of the breast and grows into the surrounding tissue. It is the most common form of breast cancer. About 80% of invasive breast cancers are invasive ductal carcinoma.
- Invasive lobular carcinoma: This breast cancer starts in the glands of the breast that produce milk. Approximately 10% of invasive breast cancers are invasive lobular carcinoma.
- The remainder of breast cancers are much less common and include the following:
- Mucinous carcinoma are formed from mucus-producing cancer cells. Mixed tumors contain a variety of cell types. Medullary carcinoma is an infiltrating breast cancer that presents with well-defined boundaries between the cancerous and noncancerous tissue.
- Inflammatory breast cancer: This cancer makes the skin of the breast appear red and feel warm (giving it the appearance of an infection). These changes are due to the blockage of lymph vessels by cancer cells.
- Triple-negative breast cancers: This is a subtype of invasive cancer with cells that lack estrogen and progesterone receptors and have no excess of a specific protein (HER2) on their surface. It tends to appear more often in younger women and African-American women.
- Paget’s disease of the nipple: This cancer starts in the ducts of the breast and spreads to the nipple and the area surrounding the nipple. It usually presents with crusting and redness around the nipple.
- Adenoid cystic carcinoma: These cancers have both glandular and cystic features. They tend not to spread aggressively and have a good prognosis.
The following are other uncommon types of breast cancer:
- Papillary carcinoma
- Phyllodes tumor
- Angiosarcoma
- Tubular carcinoma
Symptoms :
Breast cancer symptoms vary widely from lumps to swelling to skin changes and many breast cancers have no obvious symptoms at all.
In some cases, a lump may be too small for you to feel or to cause any unusual changes you can notice on your own. Often, an abnormal area turns up on a screening mammogram (X-ray of the breast), which leads to further testing.
In other cases, however, the first sign of breast cancer is a new lump or mass in the breast that you or your doctor can feel. A lump that is painless, hard, and has uneven edges is more likely to be cancer. But sometimes cancers can be tender, soft, and rounded.
- swelling of all or part of the breast
- skin irritation or dimpling
- breast pain
- nipple pain or the nipple turning inward
- redness, scaliness, or thickening of the nipple or breast skin
- a nipple discharge other than breast milk
- a lump in the underarm area
These changes also can be signs of less serious conditions that are not cancerous, such as an infection or a cyst.
Diagnosis:
- Breast exam. Your doctor will check both of your breasts and lymph nodes in your armpit, feeling for any lumps or other abnormalities.
- Mammogram. A mammogram is an X-ray of the breast. Mammograms are commonly used to screen for breast cancer. If an abnormality is detected on a screening mammogram, your doctor may recommend a diagnostic mammogram to further evaluate that abnormality.
- Breast ultrasound. Ultrasound uses sound waves to produce images of structures deep within the body. Ultrasound may be used to determine whether a new breast lump is a solid mass or a fluid-filled cyst.
- Removing a sample of breast cells for testing (biopsy). A biopsy is the only definitive way to make a diagnosis of breast cancer. During a biopsy, your doctor uses a specialized needle device guided by X-ray or another imaging test to extract a core of tissue from the suspicious area. Often, a small metal marker is left at the site within your breast so the area can be easily identified on future imaging tests.Biopsy samples are sent to a laboratory for analysis where experts determine whether the cells are cancerous. A biopsy sample is also analyzed to determine the type of cells involved in the breast cancer, the aggressiveness (grade) of the cancer, and whether the cancer cells have hormone receptors or other receptors that may influence your treatment options.
- Breast magnetic resonance imaging (MRI). An MRI machine uses a magnet and radio waves to create pictures of the interior of your breast. Before a breast MRI, you receive an injection of dye. Unlike other types of imaging tests, an MRI doesn’t use radiation to create the images.
Other tests and procedures may be used depending on your situation.
Staging breast cancer
Once your doctor has diagnosed your breast cancer, he or she works to establish the extent (stage) of your cancer. Your cancer’s stage helps determine your prognosis and the best treatment options.
Complete information about your cancer’s stage may not be available until after you undergo breast cancer surgery.
Tests and procedures used to stage breast cancer may include:
- Blood tests, such as a complete blood count
- Mammogram of the other breast to look for signs of cancer
- Breast MRI
- Bone scan
- Computerized tomography (CT) scan
- Positron emission tomography (PET) scan
Operations used to treat breast cancer include:
Removing the breast cancer (lumpectomy). During a lumpectomy, which may be referred to as breast-conserving surgery or wide local excision, the surgeon removes the tumor and a small margin of surrounding healthy tissue.
A lumpectomy may be recommended for removing smaller tumors. Some people with larger tumors may undergo chemotherapy before surgery to shrink a tumor and make it possible to remove completely with a lumpectomy procedure.
Removing the entire breast (mastectomy). A mastectomy is an operation to remove all of your breast tissue. Most mastectomy procedures remove all of the breast tissue — the lobules, ducts, fatty tissue and some skin, including the nipple and areola (total or simple mastectomy).
Newer surgical techniques may be an option in selected cases in order to improve the appearance of the breast. Skin-sparing mastectomy and nipple-sparing mastectomy are increasingly common operations for breast cancer.
Removing a limited number of lymph nodes (sentinel node biopsy). To determine whether cancer has spread to your lymph nodes, your surgeon will discuss with you the role of removing the lymph nodes that are the first to receive the lymph drainage from your tumor.
If no cancer is found in those lymph nodes, the chance of finding cancer in any of the remaining lymph nodes is small and no other nodes need to be removed.
Removing several lymph nodes (axillary lymph node dissection). If cancer is found in the sentinel lymph nodes, your surgeon will discuss with you the role of removing additional lymph nodes in your armpit.
Removing both breasts. Some women with cancer in one breast may choose to have their other (healthy) breast removed (contralateral prophylactic mastectomy) if they have a very increased risk of cancer in the other breast because of a genetic predisposition or strong family history.
Most women with breast cancer in one breast will never develop cancer in the other breast. Discuss your breast cancer risk with your doctor, along with the benefits and risks of this procedure.
Complications of breast cancer surgery depend on the procedures you choose. Breast cancer surgery carries a risk of pain, bleeding, infection and arm swelling (lymphedema).
Top breast cancer hospitals in India:
1. Tata Memorial Hospital, Mumbai, Maharashtra
2. Apollo Specialty Cancer Hospital, Chennai, Tamil Nadu
3. All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi
4. Adyar Cancer Institute, Chennai, Tamil Nadu
5. American Oncology Institute, Hyderabad, Telangana
6. Regional Cancer Centre, Thiruvananthapuram, Kerala
7. Fortis Hospital, Mulund, Mumbai, Maharashtra
8. KIMS Cancer Center, Thiruvananthapuram, Kerala
9. Indraprastha Apollo Hospital, New Delhi, Delhi
10. P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra
11. Gujarat Cancer and Research Institute, Ahmedabad, Gujarat
12. Medanta – The Medicity, Gurugram, Haryana
13. Lilavati Hospital & Research Centre, Mumbai, Maharashtra
14. Artemis Hospital, Gurugram, Haryana
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