Breast Cancer Program

The Breast Cancer Program at the Nanavati Max Institute of Cancer Centre is a dedicated program offering the most comprehensive treatment options for breast cancer, irrespective of the complexity of the type of cancer. Our team of highly qualified, compassionate, world-renowned oncologists and reconstructive surgeons holds specialised expertise in treating all types of breast cancer from early to advanced stages and is ascertaining new ways to bring the best care for managing breast cancer.

We offer a full spectrum of services such as state-of-the-art infrastructure, cutting-edge technology, on-site multidisciplinary experts, second opinion, and innovative treatment methodologies. We follow a team-based approach for diagnosis and advanced treatment options in breast cancer surgery, radiation, and chemotherapy and targeted therapy, thereby offering seamless, coordinated breast cancer care under one roof.

What Is Breast Cancer?

Breast cancer is one of the most common invasive cancers in women that develop when cells in the breast begin to grow out of control. This uncontrolled growth of the cells usually forms a tumour that can be felt as a lump. There are two most common kinds of breast cancers:

• Invasive Ductal Carcinoma: In this case, the cancer cells grow outside the ducts in different parts of the breast. These invasive cancer cells can easily spread or metastasise, to other parts of the body.

• Invasive Lobular Carcinoma: It is a type of breast cancer that begins in the milk-carrying ducts/ glands (lobules) of the breast and spreads beyond it to other areas of the body Other types of breast cancer

  • • Ductal Carcinoma in Situ (DCIS)
  • • Inflammatory Breast Cancer
  • • Male Breast Cancer
  • • Metastatic Breast Cancer
  • • Paget's Disease of the Nipple
  • • Phyllodes Tumour of the Breast
  • • Breast Cancer in pregnancy

What Are The Sign & Symptoms of Breast Cancer?

Different people have different signs and symptoms of breast cancer. Some of the very common ones include:

  • • A lump in the breast or under the armpit. Lump is the most common symptom of breast cancer and is most commonly painless
  • • change in the consistency or feel of the breast, this change in feel may be localised to one area or may be in the whole breast
  • • A change in the texture of the skin such as puckering or dimpling (like the skin of an orange)
  • • Redness or rash around the nipple or on the skin of the breast
  • • A change in shape, position or the look of the nipple (nipple might become pulled or changes its position)
  • • Discharge from the nipple without squeezing
  • • A change in size or shape of either one or both the breasts

These are the very common symptoms that indicate breast cancer. In some cases, a patient does not experience any signs or symptoms; therefore a regular screening for breast cancer (after 20 years of age) is a must.

How is Breast Cancer Diagnosed?

At Nanavati Max Institute of Cancer Care, we offer you the most advanced diagnosis and treatment techniques for breast cancer, irrespective of its complexity. Our doctors conduct several tests to diagnose cancer, these tests include:

  • • A thorough clinical examination
  • • Sonograms (Breast ultrasound)
  • • Mammography
  • • Magnetic resonance imaging (MRI)
  • • Core Biopsy (ultrasound-guided)/ FNAC
  • • Image guided biopsy for small tumours with the advanced techniques of vaccum assisted stereotactic biopsy or wire guided biopsies.

What Are The Possible Treatments For Breast Cancer?

Our multidisciplinary team of national and international oncologists offers a personalised treatment plan to patients diagnosed with breast cancer. Some of the advanced treatment options we offer include:

Surgical Process: Surgery is performed by the experts to remove the cancer tumour from the affected part. There are two types of surgeries performed for breast cancer:

o Mastectomy: To remove the whole breast along with the removal of axillary lymph nodes.

o Breast Conservation Surgery: To remove the tumour with surrounding healthy breast tissues with removal of axillary lymph nodes.

o Sentinel Node Biopsy: This procedure is done for decreasing the extent of surgery in the axilla which is oncologically safe and also decreases the chances of lymph oedema after breast cancer surgery. It is performed in selected cases, where clinically and radiologically axillary lymph nodes (located in armpits) are not involved. In this procedure, only limited lymph nodes at the lower level are selectively removed. It is performed by using Radioisotopes, gamma camera and probe.

o Oncoplastic surgeries: These array of procedures are done keeping in mind that breast conservation is now possible in suitable cases even if the tumours are big. The surgeons reconstruct the part of the breast using perforators flap harvested from the fat around the breast or from the patients back. These procedures are done keeping the oncological safety at the top prority and also help the patients have cosmetically acceptable breasts after cancer surgeries. They can be combined with symmetrisation procedure of the opposite breast.

o Microsurgical Breast Reconstruction It is an advanced surgical procedure after removal of the part or whole of a breast for cancer, it involves transferring of tissue (skin and fat) from the normal part of the patient’s body to the chest for reconstruction. This transplant process requires the use of a microscope to connect small blood vessels. The surgeon during the surgery takes skin, fat, and muscle from the patient’s own body to create a new breast mound and reconstruct the breast.

Radiation Therapy: Radiation therapy is a very important tool used in the fight against cancer and the treatment of as many as 50% of all cancer patients. Radiation therapy is given post-operatively and after completion of all chemotherapy for local control and control of distant metastases. Radiation therapy is also given in metastatic breast cancer at the site of bony mets and it helps in getting good pain control in painful bony mets. Radiation therapy is a safe & effective procedure where radioactive isotopes or high-energy photons, electrons or other particles are used to destroy the cancer cells. There are two types of radiation.

  • o External Beam Radiotherapy (EBRT)
  • o Brachytherapy or interstitial (HDR)

Radiation Oncologist is the specialised doctor for this treatment. Radiotherapy regimens or schedules and protocols are specific for different tumours and hence the time for treatment differs from case to case.

Hormone Therapy: Hormone therapy is a treatment that uses medicines to slow down or stop the growth of hormone-dependent cancer, it is because certain cancers have hormone receptors on them, and hence they can safely control cancer and give the quality of life with minimal side-effects. Hormone therapy is often offered after surgery to reduce the risk of cancer recurrence . It is can also be used before surgery in certain large cancers to downsize the tumour burden. Hormone therapy can also be used to treat cancer that has come back or has spread to other parts of the body.

Chemotherapy: Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy is usually given to a patient through injection, or infusion, and rarely by mouth depending on the type and stage of the cancer being treated. We offer tailored protocols of chemotherapy as per the specific patients need, tolerability and type of cancer. Along with chemotherapy we also give medications to keep the side effects of the chemotherapeutic agents to the minimum. We also try to maximise day-care chemotherapy to allow our patients to carry out their daily lifestyle activities with ease.

Targeted Therapy: Targeted therapy works by targeting the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. These genes and proteins are found in cancer cells or cells related to cancer growth, Hence it does not affect other tissues. Targeted therapy is used by itself or along with chemotherapy and immunotherapy. These agents have shown to give results as good as and sometimes better than chemotherapy with minimal side effects.

Immunotherapy: Cancer immunotherapy is the artificial stimulation of the immune system to treat cancer, improving the immune system's natural ability to fight cancer. It is considered as a fundamental application of the research of cancer immunology and is a growing subspeciality of oncology. The current use of immunotherapy is restricted to certain breast cancers that do not have any receptor positivity.

• Dynamic Compression Therapy: Dynamic compression therapy an advanced form of inflatable compression therapy is being provided at Nanavati Max Super Speciality Hospital which reduced the lymph oedema significantly in most cases.

What Are The Precautions One Must Take To Avoid Breast Cancer?

Some of the major precautions and lifestyle changes must adopt include:

• Watch Your Weight: Obesity or being overweight increases your risk of breast cancer.

• Breastfeed Your Baby: Women who breastfeed their baby are at very low risk of breast cancer than women who do not breastfeed at all.

• Reduce Your Hormone Intake: women who take hormone replacement therapy for prolonged periods are at risk of developing breast cancer. Discuss with your doctor before taking hormones to relieve menopausal symptoms.

• Avoid Use Of Birth Control Pills: Certain kinds of Birth control pills can alter your hormones and increase your chances of breast cancer if used for prolonged periods, particularly if you smoke or above 35 years of Age.

• Opt For Regular Screening: It is must opt for regular screening for breast cancer every year, o Regular Self breast examination (after 20 years of age) o Breast Cancer Screening: visit your doctor atleast once a year for a breast examination. Mammographic screening between the ages of 40 and 75 have been recommended by various international guidelines. Discuss with your doctor to find out what your risk of getting breast cancer is and how often should you get screened.

• Limit Your Alcohol Intake: Excessive intake of alcohol can increase your risk of breast cancer • Exercise: Women who work out every day for about 40 minutes, have a lower risk of developing breast cancer.

Are There Any Risk Factors Involved?

• Non modifiable risk factors

o Ageing: As you age the risk for breast cancer increases, most of the breast cancer cases appears after 50 years of age.

o Genetic Mutations: Women who inherit certain genes like BRCA1 and BRCA2 are at higher risk of breast and ovarian cancer.

o The Family History Of Breast Cancer: Having a first-degree relative either from mother’s or father’s side of the family, who have had breast cancer increases a woman’s risk of developing breast cancer.

o Reproductive History: Women who experience early menstruation that starts before 12 years of age or have menopause after 55 years of age are at risk of developing breast cancer.

o Having Dense Breasts: Women having heavy or dense breasts are at high risk of developing breast cancer. This is because dense breasts have more connective tissues than fatty tissues, which make it hard to detect cancer.

o Personal History Of Breast Cancer: Women diagnosed with breast cancer in the past are more likely to develop breast cancer for a second time. Modifiable risk factors

• Be Physically Active: Women who are Not active physically are at higher risk of getting breast cancer.

• Obesity Or Being Overweight: Women who have a high BMI index or get obese after menopause have a higher risk of getting breast cancer than those at a normal weight.

• Taking Hormones Therapy: Women taking certain oral contraceptives (birth control pills) or hormone therapy after menopause have increased risk of developing breast cancer.

• Reproductive History: Women with reproduction history after 30 years of age or women who are not breastfeeding or never had a full-term pregnancy may have increased risk of breast cancer.

• Smoking Cigarettes And Drinking Alcohol: Studies have shown that smoking or drinking alcohol puts women at higher risk of breast cancer.

• Any Radiation Therapy Treatment In The Past: Women who have undergone radiation therapy to the chest or breasts before 30 years of age are also at risk of developing breast cancer later in life.

Find Complete Relief from Nanavati Max Experts

If you think you are facing similar conditions, or have suffered from them in the past, please contact the Nanavati Max team to schedule an appointment at : +91 22 2626 7500

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