Greenish Nipple Discharge

 

 

 

Nipple discharge is a common problem with which ladies present to our Breast Clinic. Nipple discharge can be of many types ranging from clear fluid to frank blood.

Greenish nipple discharge is commonly seen in ladies between the ages of 40-55 years. It is common in ladies who smoke and those are suffering from diabetes.

Breast Cancer should be ruled out in all these patients by doing a triple assessment, i.e. clinical examination, imaging & biopsy. Once cancer has been ruled out, patient should be re-assured and if there is any inflammation, antibiotics can be given. In case of persistent discharge and a lump, the implicated ducts can be surgically removed.

 

 

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Don’t ignore a lump in the breast, it could be breast cancer!

 

Breast cancer is the most common cancer among Indian women now. The most common presentation of this condition is in the form of a painless lump in the breast. Early diagnosis of this dreaded condition can lead to complete cure. So, don’t ignore a lump in the breast as it could be cancer.

 

Breast Cancer Myth Busted – Biopsy doesn’t lead to spread of tumor

A common problem that I face during my practice is that some patients refuse to get biopsies done when they are detected with a breast lump. The reason behind this misconception is that they feel that the cancer will start to spread after the biopsy.

Patients need to be explained that this is a myth and there is no scientific data to support this misconception. Also patients need to understand that it is not possible for doctors to come to a diagnosis of breast cancer, unless a biopsy is performed.

 

Scalp cooling device to reduce hair loss during chemotherapy

Hair loss during chemotherapy can be a huge psychological and physical blow to a lady. Today, we tried the Paxman scalp cooling device on two of our chemotherapy patients. This device leads to vasoconstriction of the scalp vessels and reduces hair loss during chemo.

Studies done using the device report a 70% reduction in hair loss with Paclitaxel based chemotherapy ( used for breast cancer, ovarian cancer) and a 30% reduction in hair loss with adriamycin (used for breast cancer) based chemotherapy.

 

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A salute to the real heroes 

Surviving cancer is not the end of a gruesome story but the beginning of a beautiful one. A big salute to all the cancer Conquerors out there. #cancersurvivorsday #cancerconquerors #breastcancer 

Changes in 8th AJCC Classification of Breast Cancer

Recently, the eighth edition of the TNM classification of AJCC (American Joint Commission of Cancer) was released. This had a few notable changes from the 7th edition, which have been highlighted below:

  • Immunohistochemically detected tumor markers (ER, PR, HER 2 neu) that are known to have great practical treatment importance are now incorporated into the staging system to refine prognosis of breast cancer
  • The eighth edition of the staging system also uses genomic assays (Oncotype Dx, Mammaprint, PAM 50) when available to downstage some estrogen receptor-positive, lymph node-negative tumors.
  • Lobular carcinoma in situ is removed from the staging system because it is not a malignancy but a risk factor. It is no longer considered Tis.
  • The expert panel clarified that the postneoadjuvant therapy pathological T category (ypT) is based on the largest focus of residual tumor, if present. Treatment-related fibrosis adjacent to residual invasive carcinoma is not included in the ypT maximum dimension.

 

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Axillary Lymph Node Biopsy

Axillary Lymph node (underarm gland) enlargement is a common problem among Indian women.

Patient usually present with complaints of pain in the armpit and/or lumps in the underarm area.

Majority of the times these lumps are reactive in nature, that means they enlarge due to non specific causes like mild hair follicle infection, which can occur after shaving or waxing of hair.

On the other hand, these glands can also become enlarged due to:

  1. Infections like tuberculosis, which can be associated with weight loss & fever
  2. Cancers – commonest cancer which gives rise to underarm nodes is breast cancer. Axillary lymph nodes are the first point of spread from breast cancer.

 

An ultrasound can confirm the diagnosis of axillary lymph node enlargement and if these glands do not resolve after a course of antibiotics, they require a FNAC (fine needle aspiration cytology or in simple terms a ‘needle test’).

If FNAC is inconclusive, then an axillary lymph node biopsy is required to confirm the diagnosis. Axillary lymph node biopsy is a minor procedure, which can be performed as a day care surgery.

 

If you or anyone whom you know has underarm pain or lumps, it is best to get yourself examined by a surgeon.

 

 

Information provided by:

Dr. Rohan Khandelwal

Breast Cancer Surgeon

W Pratiksha Hospital

Gurgaon