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Breast cancer is a condition in which the cells of one or both breasts grow out of control. These cells might spread beyond the breasts. In this case, the cancer is called metastatic. Breast cancer generally begins either in the glands that produce milk (called lobular carcinoma), or the ducts that carry milk to the nipple (called ductal carcinoma). The cancer can sometimes grow larger in the breast and often spread to nearby located lymph nodes or via the bloodstream to many other organs. The cancer may grow and affect tissues around the breast like the skin or chest wall. Various types of breast cancer generally spread and grow at varying rates. Some types of breast cancer take years to spread out of the breast, but others may spread quickly.
The common types of breast cancer are listed below:
- Invasive lobular carcinoma:In this type of breast cancer, cancer cells first begin in the lobules and then gradually spread to nearby breast tissues. These cancer cells might also spread to other body parts.
- Invasive ductal carcinoma:The cancer first starts in the ducts and then spreads outside the ducts to other parts of the breast tissues. Invasive cancer cells may also spread to other body.
- Ductal carcinoma in situ:This is a breast disease, which could ultimately lead to invasive breast cancer. The cancer cells are found only in the lining of the ducts and don’t spread to other tissues of the breast.
There are also many other types of breast cancer that are less common. These are lobular carcinoma in situ (LCIS), triple negative breast cancer, inflammatory breast cancer, phyllodes tumours of the breast, paget's disease of the nipple.
Causes and Symptoms
Doctor will ask to get various tests done for proper diagnosis of breast cancer. Some common tests for breast cancer are listed below:
Breast exam: A doctor will check both breasts and lymph nodes in the armpit to look for any lumps or other abnormalities.
Breast ultrasound: Ultrasound can be used to find if a breast lump is a fluid-filled cyst or a solid mass. In ultrasound, sound waves are used to create images of structures deep inside the body.
Mammogram: This is an X-ray of the breasts. Mammograms are generally used to detect breast cancer. If an abnormality is seen on a screening mammogram, the doctor could recommend a diagnostic mammogram for further evaluation of that abnormality.
Biopsy: A biopsy is considered the only definitive way of diagnosing breast cancer. During this diagnostic procedure, a doctor uses a specialized needle guided by X-rays or a specific imaging test to take out a core of tissue from the suspicious region. A small metal marker can be left at the site within the breast to identify future imaging tests.
Breast magnetic resonance imaging (MRI): This procedure uses a magnet and radio waves for creating images of the interior of the breast. Unlike other imaging tests, an MRI doesn't make use of radiation to produce images.
If breast cancer is diagnosed, several other tests are performed to determine whether cancer cells have spread within the breast or to other body parts. This process is known as staging. Whether the cancer is restricted to only in the breast, is located in lymph nodes under the arm, or has spread outside breasts mainly determines the stage of breast cancer. The stage and type of breast cancer helps doctors to decide what kind of treatment is needed.
Breast self-exam is a practice of regularly examining the breasts on your own, as it can be an important way to detect a breast cancer early. While no single test is able to detect all breast cancers early, performing a breast self-exam coupled with other screening methods may increase the chances of early detection. Breast self-exam is no doubt a convenient as well as no-cost way that can be used on a monthly basis as part of a breast cancer screening strategy.
Risk & Complications
Like any surgery, breast cancer surgery is also associated with certain risks and complications. These are listed below:
Seroma: Excess fluid accumulate at the surgery site after mastectomy and lumpectomy. Signs of seroma include drainage from the incision, increasing swelling and increasing pain.
Wound bleeding: There might be a small amount of blood on the wound dressing after the surgery. The nurse will check your dressing after the surgery. Talk to your doctor or nurse immediately if there is more bleeding.
Hematoma: This occurs when surgery site is filled up with blood and there may be a sudden onset of pain and swelling. This complication requires urgent medical attention.
Infection: There may be signs of infection such as chills, nausea, redness, a fever, vomiting and pain at the incision location. The also might be discomfort that does not go away with medications. Infection is a very common risk in any surgery. Antibiotics is generally prescribed to treat the infection. You may require to stay in the hospital longer in case you need antibiotics via a drip.
Nerve pain: You may experience numbness, a shooting pain or tingling in the armpit, shoulder, upper arm or chest wall. This happens because of damage to nerves during the surgery. The nerves generally gets repaired themselves, but it may take several weeks or months.
Shoulder stiffness: The shoulder may become stiff or painful after breast cancer surgery or lymph node removal. Your nurse or physiotherapist will tell you what exercises to do following your operation that helps improve movement in your shoulder.
Doctors understand that breast cancer generally occurs when some breast cells starts to grow abnormally. These abnormal cells multiply more rapidly than healthy cells and continue to build up, leading to the formation of a lump or mass. Researchers have identified lifestyle, environmental and hormonal factors that may raise your risk of breast cancer. But it is still unclear why some people with no risk factors get cancer, while other people with some risk factors never develop it. It is likely that breast cancer results due to a complex interaction of a person’s genetic makeup and their environment.
Limit alcohol consumption
Maintain a healthy weight
Indulge in physical activity
Avoid hormone therapy after menopause
Genetic counseling and testing
Reduce intake of saturated fat
Preparation of Treatment
Your doctor has a specific treatment plan to meet the patient’s needs about their diagnosis and breast surgery. The doctor may perform certain tests if needed. Your doctor will also review the current medications you are taking. Your pre-assessment clinic appointment is fixed to prepare you for your breast cancer surgery. During this appointment, you meet members of the treatment team. You may also need to sign the consent form for the operation. Your doctor may talk to you about the Enhanced Recovery Programme at the hospital.
On the day of surgery, the patient is not allowed to eat or drink anything after midnight. Smoking is also prohibited. Make your life easier and safer following the surgery by reducing household activities before the surgery. Arrange for assistance for household works when you first get home. You must also arrange for transportation to and from the hospital. You will be assigned a specialist breast nurse who will check what help and support you need and find what you will need when you are discharged. They are generally your main point of contact and care throughout your treatment.
Best Doctors for Breast Cancer Treatment
Best Hospitals for Breast Cancer Treatment
If diagnostic tests detect breast cancer, your doctor will create a treatment plan. Treatment of breast cancer usually starts within a few weeks after diagnosis. Breast cancer treatment depends on the size and location of the tumor, the stage of the disease and the result of lab tests. The doctor generally considers your age and overall health.
Breast-conserving surgery: In this procedure, the surgeon removes only the part of the breasts that is infected with the cancer, along with some adjacent tissues. The amount of tissues taken out depends on things such as the size as well as location of tumor. Such surgical procedure is called lumpectomy, partial mastectomy, quadrantectomy and segmental mastectomy.
Lymph node removal surgery: The doctor may take lymph nodes from under the arm to determine whether cancer has spread in them.
Mastectomy: In this, a surgeon removes the whole breast, along with the breast tissues and, sometimes, adjacent tissues. There are many types of mastectomy.
Radiation therapy for breast cancer makes use of high-energy X-rays, protons and other particles to destroy cancer cells. Rapidly dividing cells, like cancer cells, are more effective with radiation therapy than normal cells. The X-rays are painless and not visible. Patients are not radioactive after this treatment, and hence it is safe to be around other people. Exteal beam radiation for the whole breast is generally used after a lumpectomy. Radiation therapy can be used to treat breast cancer at all stages. It is an effective way to lessen your risk of breast cancer recurring following surgery. This treatment is commonly used to relieve the symptoms of cancer that has often spread to other body parts (as in metastatic breast cancer).
This involves taking drugs as pills or geing them injected into a vein. This may be the main treatment in case of advanced breast cancer. Chemotherapy can also be taken before surgery (called neoadjuvant chemotherapy) or after post-surgery (called adjuvant chemotherapy). Chemotherapy is also used when cancer has already spread to other body parts. This treatment may be recommended to control the cancer and reduce the symptoms the cancer is causing. The side effects of chemotherapy depend on the drugs used. Common side effects include vomiting, hair loss, nausea, fatigue and an hightened risk of developing an infection. Some rare side effects include premature menopause, infertility, heart and kidney damage, nerve damage, and in some cases, blood cell cancer.
Some cancers can grow under the influence of certain hormones. These medications prevent the hormones from aaching to breast cancer cells and hence block their growth. This therapy can also be recommended before or after surgery or any other treatments to lessen the chance of cancer recurrence. In case the cancer has already spread, this treatment may shrink and control it.
Immunotherapy uses the natural defenses of the body to fight cancer by boosting the immune system’s ability to kill cancer cells. The drug, which is a type of immunotherapy, is used for treating high-risk, early-stage breast cancer.
This treatment targets the cancer’s specific genes and proteins that triggers cancer growth and survival. This procedure is very focused and often work differently than chemotherapy. It blocks the growth as well as spread of cancer cells and also limits damage of healthy cells. All tumors do not have the same targets. To determine the most effective treatment, the doctor runs tests in order to identify the genes, proteins, and several other factors in the tumor. Treatment of breast cancer in India is gaining popularity worldwide due to several factors such as low cost, start-of-art hospitals, world-class doctors, and high success rates.
Cost of the treatment
Breast Cancer Treatment Cost in India can vary depending on several factors such as the stage of cancer, location of the hospital, type of treatment required and the duration of treatment. Breast cancer treatment cost in India may range from $1300 to $23,500. This includes the cost of surgery, tests, chemotherapy, radiation therapy, medication, and hospitalization. The cost of breast cancer treatment in India is summarized in the table below: Treatment Name Treatment Cost Lumpectomy ($2200 - $3000) Mastectomy ($3000 - $4500) Radiation Therapy ($2,000 - $7500) Chemotherapy ($2300 - $4000) Per cycle Targeted Therapy Around ($1200) Immunotherapy ($2,759) per session
Your wound usually heals within 6 to 8 weeks. However, it might take several months for your affected breast to feel normal again. In certain cases, the affected area may appear different. You will be able to resume your normal activities within a few weeks of the surgery. However, it varies from person to person and depends on the type of surgery performed. You may be able to take things gently at first. There can be discomfort and stiffness as you start moving your arm more and become more active. Your condition generally improves naturally over time. Once you get home after being discharged from hospital, you can try to involve in a little more physical activity every day.
Award-winning CEO of Marlin Medical Assistance Pvt. Ltd
Dr. Mohammad Afzal Siddiqui is an award-winning CEO of Marlin Medical Assistance Pvt. Ltd., a professionally managed medical tourism holding company and the active Director of Alshifa Healthcare Services Pvt. Ltd., a full-service medical tourism aggregation agency servicing JCI and NABH/ NABL accredited Hospitals across the country’s 5 locations.
In addition to Marlin, Alshifa also includes Media Group, which houses Arabic Medical Tourism e-Magazine healthandtour.com. The E-magazine “مجلة الصحة والسياحة” provides a wide scope of medical tourism information to healthcare travellers to find a safe, effective and cost-saving solution for their medical and healthcare needs. In addition to running E-Magazine, Dr. Mohammad Afzal also serves as Delhi-state coordinator in Foundation of Healthcare and Wellness Promotion focused on bringing India’s Healthcare closer to the world and smoothen world’s access to Indian Healthcare.