The multidisciplinary approach to breast cancer patients: Breast cancer patients are discussed in detail in a multidisciplinary tumor board consisting of medical oncologist, radiation oncologist, surgeon, pathologist, radiologist, nuclear physician and palliative team. Every patient’s treatment is individualized following the international and national protocols of breast cancer management.
Specialists related to breast oncology: All specialists required to treat breast cancer are available under a single roof. Our breast surgeon, medical oncologist, radiation oncologist, pathologist, breast radiologist, nuclear physicians, breast care nurse, palliative team, physiotherapist work together for the best possible outcomes.
Breast cancer statistics – the extent of the problem: Breast cancer is the most common cancer among urban women in India, and the incidence is set to increase steadily with increasing urbanization. As per the published data from the Indian Council for Medical Research, there were 14.5 lakh new cases in 2016. This number is projected to increase to 17.3lakhs in 2020.Overview
Breast cancer is the most common cancer among urban women in India, and the incidence is set to increase steadily with increasing urbanization. When found and treated early, breast cancer is most often curable. October has been internationally designated as the breast cancer awareness month, in recognition of the magnitude of the problem.
- Invasive ductal carcinoma: It is the most common type and constitutes 70 to 80% of all breast cancers. It arises from the milk ducts and spreads to the surrounding breast tissue.
- Invasive lobular carcinomas: It constitutes 10-15% of breast cancer and arises from the milk-producing lobules of the breast. These tumours are multiple and sometimes patients can have simultaneous lesions in the opposite breasts.
- Tubular carcinomas: It constitutes 1to 5 % of breast cancer
- Mucinous carcinomas: It comprises 1-2 % of breast cancers and has a good prognosis
- Medullary (seen in BRCA1 mutation)
- Invasive papillary carcinomas
- Inflammatory breast cancer: It is an aggressive variant with poor prognosis in which the entire breast is swollen and red because of the blockage of the lymphatics
- Metaplastic carcinoma
Determining the molecular subtype of the cancer is essential for formulating the treatment plan. After confirming the diagnosis of breast cancer by doing a biopsy, further analysis has to be done on the biopsy sample to check for the following receptors.
- Estrogen receptors (ER)
- Progesterone receptors (PR)
- HER2/neu receptors
- Ki-67: Proteins to assess how fast the tumour is growing
- PET-Scan (positron emission tomography) of the whole body
- Bone scan
- Ultrasound abdomen
- Mastectomy involves removing the entire breast along with an assessment of the armpit lymph nodes. This is indicated when the lumps are multiple or large.
- Breast-conserving surgery removes just the cancerous area and a small amount of surrounding normal tissue, along with the armpit lymph nodes for assessment. The remaining breast has to be radiated to prevent the local recurrence. This procedure is suitable for small single lumps in the breast.
- Radiation therapy – Radiation is given in locally advanced cancers, in patients with lymph nodal involvement and in patients undergoing breast-conserving surgery.
- Chemotherapy: Some women require medicines before surgery to shrink cancer and make it easier to remove while others require it after surgery to prevent the spread or recurrence of cancer.
- Hormone therapy: Some form of cancers grows in response to estrogen and progesterone, and medications are given to block the action of these hormones
- Monoclonal antibody: Some forms of breast cancer which are HER 2 enriched respond to drugs like trastuzumab/ pertuzumab.
It is best to consult your doctor if you find a lump or any other change in your breast, as early detection is the key to successful management. Fortunately, treatment outcomes for patients with breast cancer are improving with good survival rates, largely due to advances in treatment modalities and a better understanding of the disease.
- Examine your breasts once a month (best done 5-10 days from the first day of your period)
- If you no longer have periods, choose one fixed day each month.
- Visit a doctor if there are any changes
- Remember, most breast changes are NOT cancer, but DO checkup to be sure!