Breast cancer has emerged as leading cancer among women. The incidence of breast cancer is on the rise, especially in metropolitan cities and the treatment options for breast cancer depend on many factors, including the type and stage of the disease.
Late detection of cancer can be fatal and most no. of the time lack of awareness is the principal cause of late detection.
To address the same Healthwire Media organized a Live Webinar On Personalising Breast Cancer Treatment- Multidisciplinary Care A Healthwire Web series with-Dr Sapna Nangia, Senior Consultant, Radiation Oncology, Apollo Proton Cancer Centre, Chennai, Dr Ramesh Sarin, Senior Consultant, Radiation Oncology, Indraprastha Apollo Hospitals, Dr Bhawna Sirohi, Medical Oncologist- Breast Cancer, Apollo Proton Cancer Centre, Chennai
The complexity of cancer diagnosis and treatment, together with the increasing need for individualized patient care, has led to the organization of services into multidisciplinary teams (MDTs).
What is MDT?
MDT is a group of people of different healthcare disciplines that meets together at a given time to discuss a given patient, and who are each able to contribute independently to the diagnostic and treatment decisions about the patient.
The benefit of an MDT is the provision of coordinated, consistent, expert-driven, and cost-effective care to the patient.
When should one begin screening for breast cancer?
Breast cancer is not one disease; rather it is several diseases that behave differently. Breast cancer is a common term for a cancerous tumor that starts in the cells that line the ducts and/or lobes of the breast.
Although self-examination is technically not breast cancer screening most cases are diagnosed by noticing newly developing masses of visual irregularities while self-examining.
The biggest risk of skipping breast cancer screening is that cancer has more time to grow and potentially progress into a more advanced stage.
Whenever a patient comes to us we would like to take her history, the purpose of history is not a diagnosis but risk assessment. A family history of breast cancer in a first-degree relative is the most widely recognized breast cancer risk factor.
We examine the patient and for a breast lump, we examine both in the sitting posture where we undress the patient from top-up to the hips, examine her breast with the hands lying down hands being on the side of the patient and hand raised above the head and we look for any changes in the nipple area, the skin of the breast, and the size of the breast and any seen mass in the underarm or in the breast.
How do you decide which patient should have a mammogram MRI or ultrasound?
After the history and the clinical examination, we get a good idea as to whether we are dealing with suspicious breast cancer, or we are dealing with a benign breast mass.
For anybody who is below the age of 30 years ultrasound of the breast is the first investigation and if the ultrasound and the clinical examination suggests, it’s a benign non-cancerous by blood anoma or a cyst or just glandular tissue and there are no strong risk factors we advise the patient depending on the size and the other factors.
If the women are above the age of 30 and we suspect cancer then we examine it through mammograms and ultrasound.
Below the age of 30 the mammogram does not help you much because the breasts are usually dense that means your glandular tissue, which is the part that makes the milk and carries the milk is very prominent and it looks white or mammograms and cancer also look white so we can miss cancer.
Your treatment based on some prognostic and predictive factors talks a little bit about it. So basically, after a breast cancer diagnosis, you and your doctors will put together a treatment plan specific to your situation, based on your pathology report.
Your treatment plan will be made up of one or more specific treatments that are intended to target the cancer cells in different ways and reduce the risk of future breast cancer recurrence.
What are the possible side effects of each treatment option?
There’s a tendency that when we discuss cancer treatment people got so scared about everything revolved around breast cancer or cancer treatment, that sometimes we forget that these treatments have enormous benefits.
There are few temporary side effects of breast cancer treatments that go away soon after treatment is completed, as well as longer-term side effects that last months or years.
In surgical procedures, the muscles of the arm may feel weak, and the skin in the breast area may feel tight. Some may experience side effects like nausea, vomiting, fatigue after chemotherapy treatment and for some time afterward. There are few temporary side effects from radiation therapy which may include- skin irritation — such as itchiness, redness, peeling or blistering, mild to moderate fatigue.
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