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Knowlege
Bank
PLEASE
NOTE
*The procedures
listed in this section may /may not be covered under your
Mediclaim /Health Insurance Policy. Please check the coverages
for claim purpose.
*This material is provided for information only and does
not constitute a recommendation or endorsement with respect
to any kind of treatment.
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BREAST
CANCER
Definition
of Breast Cancer
Cancer is a disease characterized by the uncontrolled growth of
abnormal cells. Breast cancer is any type of malignant (cancerous)
growth in the breast tissue.
Causes and Risk Factors of Breast Cancer
No
one knows exactly why a normal breast cell becomes a cancerous
one, and there is probably no single cause. It is thought, however,
that breast cancer results from a combination of risk factors.
The
most common risk factors include:
>a family history of breast cancer
> early menstruation
> late menopause
> women who are over 40 years of age when they bear their
first child
> women who have not borne children
> obesity and high-fat diet
Speculated risk factors include:
>
use of hormones (postmenopausal estrogen therapy and birth control
pills)
> diet (high intake of fats and fibers)
> environmental toxins (exposure to electromagnetic fields
and pesticides)
> obesity
> existing medical conditions such as diabetes, hypertension,
chronic cystic disease of the breast
> women with malignancies in other body sites
>
alcohol consumption
Symptoms of Breast Cancer
Early breast cancer usually does not cause pain. In fact, when
it first develops, breast cancer may cause no symptoms at all.
But as the cancer grows, it can cause these changes:
>
a lump or thickening in the breast or armpit
> a change in the size or shape of the breast
> discharge from the nipple
> a change in the color or texture of the skin of the breast
or areola (such as dimpling, puckering, or scaliness).
Note: any changes in the breast should be reported to a doctor
without delay. Symptoms can be caused by cancer or by a number
of less serious conditions. Early diagnosis is especially important
for breast cancer because the disease responds best to treatment
before it has spread. The earlier breast cancer is found and treated,
the better a woman's chance for complete recovery.
The
diagnosis may be established by a careful physical examination,
mammography, ultrasonography and, if needed, a biopsy
> Mammography is an x-ray of the breast
that reveals any suspicious areas.
> Ultrasonography uses high frequency sound
waves that enter the breast and bounce back. The pattern of
their echoes produce a picture called a sonogram that detects
whether the breast lump is solid (possibly cancerous) or filled
with fluid (non-cancerous).
> If further tests are needed, the doctor will recommend
a biopsy. There are three ways to do breast
biopsies: fine needle aspiration, large core breast biopsy and
surgical biopsy. Fine needle aspiration (FNA) uses a fine needle,
inserted into the breast tissue, to withdraw cells from the
suspicious area. Large core breast biopsy uses a large core
needle in a spring-loaded device that removes "cores"
or plugs of tissue from the suspicious area. Surgical biopsy
is the surgical removal of part or all of the lump or suspicious
area.
Needle
Biopsy of the Breast
| If
breast cancer is diagnosed, the doctor will then determine
the stage (phase or progression) of the cancer
Treatment of Breast Cancer
There are two methods of treatment - local or systemic.
Local treatments are used to remove, destroy, or
control the cancer cells in a specific area. Surgery and
Radiation therapy are examples of local treatments.
Systemic treatments are used to destroy or control
cancer cells all over the body. Chemotherapy and hormone
therapy are examples of systemic treatments.
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Surgery is
the most common treatment for breast cancer. There are two types:
breast-sparing surgery and mastectomy.
Breast-sparing
surgery such as lumpectomy removes the cancerous
lump but not the breast. If needed, the doctor will also remove
the fat pad from the armpit through a small underarm incision
for analysis. This procedure is called axillary node dissection
and is usually performed at the same time as the lumpectomy.
Mastectomy
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LOCAL
TREATMENTS
Radiation
therapy (also
called x-ray therapy, radiotherapy, cobalt treatment, or irradiation)
uses high-energy rays to damage cancer cells and stop them from
growing. Radiation may come from an outside source or from radioactive
materials placed directly in the breast, sometimes both are used.
The patient receives external radiation treatments as an outpatient,
usually 5 days a week for 5 or 6 weeks. At the end of that time,
an extra "boost" of radiation is usually given to the
treatment site. The boost may be either external (using electron
beam therapy) or internal (using an implant). A short hospital
stay is required for implant radiation.
SYSTEMIC
TREATMENTS
Chemotherapy
uses drugs to stop the growth of cancer cells. Chemotherapy may
be given in different ways - by mouth or by injection into a muscle
or vein. It can act on cancer cells outside the breast area. Some
of these drugs are given in cycles so that treatment periods alternate
with rest periods. Depending on the specific drugs, most patients
take their chemotherapy as an outpatient at the hospital, at the
doctor's office, or at home. Sometimes it may be necessary to
stay in the hospital for a period of time so the effects of the
treatment can be watched.
Hormone
therapy
is used to prevent cancer cells from getting the hormones they
need to grow. This treatment may include the use of drugs (such
as tamoxifen [Nolvadex]) that interfere with hormone activity
or surgery that removes hormone-producing organs. Like chemotherapy,
hormone therapy can act on cells all over the body.
Prevention
of Breast Cancer
Remember:
1. Examine Your Breasts Every
Month Beginning At Age 20 (see your doctor for self breast
exam instructions). Check for: new lump (painful or not), unusual
thickening of tissue, discharge from the nipples, change in
the skin of nipples or breasts, or different breast size or
shape than before.
2. Have Your Doctor Examine Your Breasts Every Year Or Two Beginning
At Age 30
3. Have A Mammogram Every Year After Age 50
Questions
To Ask Your Doctor About Breast Cancer
What caused
the cancer?
What is the usual course of the disease?
Metastasis: If the cancer spreads, where will it go and how
will it be detected?
What are the symptoms of recurrence?
What can be done if the treatment doesn't work?
What determines whether the treatment is working or not?
How can the symptoms of cancer, such as pain, fatigue and weight
loss be alleviated?
What does remission mean?
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