Uncontrolled division of abnormal human cells is called Cancer. These cells destroy the organ in which they arise and later spread to neighboring structures and to dis tant organs causing more damage. Breast consists of fat cells, milk producing glands (lobules) and tiny tubes that carry milk from the lobules to the nipple (ducts).
When the cells lining these glands and duct start growing without control, it gives rise to malignant tumour of breast or breast cancer.
In-Situ cancer means when the cancer cells are confined within ducts or lobules wall. It is the initial stage of breast cancer. Once the cells breast the lining and spread outside into surrounding breast tissue it is called invasive cancer.
Not all breast tumors are cancerous, most lumps in young women are benign and occur because of the action of hormones on breast and most of these do not need any surgery
Tomosynthesis or 3D mammography is a new type of digital x-ray mammogram which creates 2D and 3D-like pictures of the breasts. This along with ultrasound improves the ability of mammography to detect early breast cancers. Core Needle Biopsy is done when there is suspicious mass on mammogram, under ultrasound or mammogram guidance a thick needle is used to sample a core of tissue from the mass. This is subjected to histopathology and IHC studies which are specialized and advanced techniques to predict the tumour behaviour. This biopsy report from the pathologist is very important because it decides the sensitivity of tumor to hormones and chemotherapy and hence helps in deciding treatment protocols for that particular cancer. MRI Breast can be done in case of further dilemma in the diagnosis and to assess the other parts of the breast as well as the opposite breast. PET CT scan-This test is done after injecting a radioactive tracer and scanning the body to see the extent and spread of cancer in the body (i.e stage of the cancer).
Cancer cells spread initially to the lymph nodes in the axilla, then neck and later through lymph system to blood stream and then to distal organs
Stage 0 Cancer is in-situ
Stage 1 Cancer is invasive but has not spread beyond the breast
Stage 2 Cancer is bigger in size and involves the lymph node in axilla
Stage 3 Cancer has larger and involves breast skin, or chest wall or lymph nodes in the neck.
Stage 4 or METASTATIC BREAST CANCER Cancer has spread into distant organs like lung, liver, brain, bones, ovaries, opposite breast or axilla
Here cancer cells in the breast and those which have escaped outside are destroyed with medicines. In Amrita Hospital, latest in ternationally approved drugs and protocols are followed. For side effects like hair loss, scalp cooling therapy is available. We also have a boutique in the breast clinic it self where you can select wigs of your choice.
In this therapy, high doses of radiation is used to kill cancer cells in breast and outside. In Amrita Hospital latest advances like 3D Conformal RT (3DCRT) and Intensity Modulated RT (IMRT) are available with breath coordinated RT for better tumor targeting and lesser side effect these techniques ensure very safe and effective radiation therapy.
This is useful in those cancers where the tumor is hormone dependent (oestrogen and or progesterone receptor positive), and it slows the growth of breast cancer.
Uses drugs monoclonal antibodies (trastuzumab) or Tyrosine kinase inhibitors (Lapatinib) that block the growth of breast cancer cells in specific ways (Eg. Blocking Her-2)
Surgery is the prime mode of treatment. The aim of surgery is to remove the cancer completely along with the lymph nodes in the axilla when they are affected. Surgery can be offered in different ways.
This involves removal of complete breast with the lymph nodes in axilla. This procedure is done for large and advanced breast tumors.
This is the standard of care for early breast cancer which is limited to breast and axilla. Here the lump with a margin of normal breast tissue is removed and is followed by radiation to the breast to ensure completion and oncological safety.
In early breast cancer where the lymph nodes are likely to be unaffected, with the help of blue dye and radiocolloid, the first draining node is removed and tested for cancer. If unaffected, the nodes of axilla are not removed thus avoiding the side effects of complete node removal.
These are specialized surgical procedures which use plastic surgery techniques to remove breast tumor with a better margin and give aesthetically and cosmetically better-looking breast. These techniques are useful in tumors behind nipple and areola, in lower half of breast and large tumors where simple removal of lump will not give an aesthetic result.
In large tumors where breast con servation is not feasible, breast can be reconstructed with skin from the back or abdomen (autologous flaps) or with artificial implants. This can be done at the time of surgery, or later after treatment is completed Secondary reconsruction).
After removal of the tumor, skin in the armpit and around the breast, is used to fill the defect in the breast for good shape.
Is also offered at our center to women with heavy, large breasts who would like to reduce the size of their breasts to increase their comfort. We also offer hidden scar breast lump removal for young girls with benign lumps.
Early breast cancer has 99% survival and cancer which is stage 2 or 3 has up to 86% 5-year survival. So early detected cancer can be cured.
Mammogram may be a little uncomfortable but with advanced techniques it is not at all painful.
In early breast cancer there is no difference in survival whether breast is removed or saved. That means by removing the complete breast there is no extra safety or guarantee of survival.
If the cancer is removed with a margin of normal breast tissue all around and radiation is given the chances of cancer coming back in breast are very low.
Removal of breast creates loss of body image and confidence. As after completion of treatment loss of breast is the only re minder of cancer. Other side effects all go away. Research has shown than patients with breast preserved after cancer treat ment are much happier.
With modern technology radiation is very focused on tumor bed and side effects are very minimal.
New research has shown that breast preservation has better long term and cancer free survival. This means that in selected cases of early breast cancer (Stage I and II), preservation of breast has better long term survival along with good breast cosmesis (Ref).
Breast conservation surgeries with simple techniques are smaller surgeries with a faster recovery period and lesser complications than mastectomy.
Cure from cancer is not dependent on breast removal or preservation in early breast cancer. It depends on tumour aggres siveness and additional chemotherapy, radiotherapy and hormone therapy. Cancer usually comes elsewhere in body and chances of survival are same whether breast is removed or preserved. Locally cancer can come in left over breast tissue also even after mastectomy.
Complete and comprehensive care for all breast related problems for all age groups