Breast Cancer Care During COVID19 outbreak

At present, almost half the world is in lock-down due to the corona virus outbreak and it is difficult to predict for how long this situation might remain the same. In India, it is almost certain that the lock-down due to COVID 19 will be extended till at least end of April. Even though we are in a state of lock-down but our body is still functioning and that means diseases like cancer might still be growing inside our system. So how does one deal with a problem like breast cancer/ breast lump during this period.

Tips for existing breast cancer patients

  1. Remain in touch with your treating breast cancer surgeon/ breast cancer oncologist. They will outline the treatment protocol during this period
  2. If you have an early stage breast cancer which is curable, you should not defer your treatment during this period, as it can lead to progression of the cancer.
  3. If you are suffering from cancer which has spread to the body (metastatic breast cancer), then discuss with your doctor if the chemotherapy frequency can be reduced or if you can be shifted to hormonal therapy/ oral treatment for the time being.
  4. Corona virus infection is usually severe in patients who are suffering from pre-existing conditions like cancer, diabetes, hypertension. So, please take all precautions to prevent infections
  • Eat a healthy/ balanced diet. Avoid outside food.
  • Make sure you take your daily dose of  vitamin C. This can either be in the form of a supplement or just a glass of lemonade
  • If you are undergoing chemotherapy (which can lead to reduced immunity and white blood count), please monitor the blood counts and if they are low, consult your breast cancer doctor immediately
  • Wear a mask whenever you are venturing out of your home, especially, when you are going to the hospital
  • Maintain strict hand hygiene. Wash your hands multiple times a day and use a hand sanitizer liberally

 

 

 

 

Recently detected a breast lump – what should you do during this period?

During the lock-down, lot of ladies are taking out time to carry out breast self examination and they are picking up new breast lumps. If you are one of them, I would advise that you consult a breast lump surgeon immediately. This consultation can either be an online consultation or a physical visit to the hospital. In an online consultation, if the doctor feels the need to carry out a physical examination, he/she would call you to the hospital.

A breast lump should not be ignored because if it is cancerous, it can increase in size during this period. A mammography or an ultrasound should be done after physical examination and if the lump is suspicious, a biopsy/ needle test should be done to confirm the diagnosis. If the breast lump turns out to be non cancerous (benign), then the treatment can be deferred till the time COVI19 situation improves. Your doctor can provide you medicines during this period to deal with the problem/ breast pain associated with the lump.

If the lump turns out to be breast cancer, as I have highlighted above, please consult your doctor and make a treatment plan which is suitable to you.

These are testing times for everyone, including patients. One has to be cautious about not getting infected by the virus as well as make sure that their breast cancer/ breast lump treatment doesn’t suffer. If you follow the tips which I have highlighted above, you can tide over this phase without compromising your health.

 

 

This information has been provided by

Dr. Rohan Khandelwal

Breast Cancer Surgeon

CK Birla Hospital, Gurgaon

To book an online consultation with Dr. Rohan Khandelwal, click here

 

All underarm lumps are not cancerous

Ladies commonly present to our Breast Cancer unit with complaints of lumps in the underarm region (axilla) and their first concern is always breast cancer, but not all axillary lumps are a sign of breast cancer. In this article, I will highlight the common causes of under-arm lumps/ swellings, which ladies can develop:

  • Axillary lymph node enlargement – this is the most common cause of underarm lumps. Lymph nodes are present all over the body and they serve as filters. Breast drains into armpit (axillary) lymph nodes. Therefore, if there is any cancer/ infection in the breast, it can lead to enlargement of these nodes. In such situations, we get an ultrasound of the breast and underarm region to confirm the enlargement. Diagnosis is confirmed by a needle test known as FNAC (fine needle aspiration cytology) or lymph node biopsy in some cases.

Another common cause of enlargement of these nodes is after shaving/ waxing of  underarm hair. This can lead to momentary enlargement of these nodes (reactive  lymphadenopathy), which usually settles down with time or with a course of antibiotics.

  • Accessory axillary tissue – ladies usually come with a large lump in the underarm region but give a history that it has been present over a long period of time or has increased in size post-pregnancy or after breast feeding. This is due to extra breast tissue present in the armpit region, which increases after pregnancy and lactation. For most ladies, it is a cosmetic problem because of which they are unable to wear cut sleeves clothes. Some ladies might complain of pain in the swelling as well. An ultrasound should be done to rule out any other condition and surgery can be done to get rid of this problem.

 

Accessory axillary tissue

Accessory axillary breast tissue

 

  • Sebaceous cyst in the underarm – This is a lump which forms due to a blocked hair follicle duct. It can remain painless till it becomes infected. It is a superficial lesion which can be managed with a simple removal of the lump. If the lump is infected, it can initially be managed with antibiotics before surgical removal

 

sebaceous cyst

Sebaceous cyst in underarm region

 

  • Breast cancer – Cancerous lumps can primarily develop in the underarm region or cancers can present as lymph nodes in the underarm region. In either case, an ultrasound/ mammogram is required, followed by a biopsy to confirm the diagnosis. Proper staging of the breast cancer is important before management

 

Primary & nodes

Malignant axillary lymph nodes on mammogram

 

  • Breast tuberculosis – is a common diagnosis in India. It will either present as an abscess in the underarm region or enlarged lymph nodes (covered earlier) in the axillary region. Diagnosis can be made by a needle test or lymph node biopsy. Treatment usually involves taking anti-tubercular drugs for a period of 6-9 months, depending on response.

 

As I have highlighted above that breast cancer is just one of the causes of axillary lumps. Having said that, it is best that you visit a breast unit whenever you notice a lump in the breast or underarm region. After taking a history and carrying out clinical examination, the breast surgeon will order an imaging test, which would either be a mammogram or ultrasound or both. This would be followed by a tru-cut biopsy/ FNAC to confirm the diagnosis. In some cases a lymph node biopsy might be required to clinch the diagnosis.

 

For further information or to book an appointment, please contact

Dr. Rohan Khandelwal

Breast Cancer Surgeon

CK Birla Hospital, Gurgaon

rohankhandelwal@gmail.com

 

Breast Cancer – Facts & Figures (Hindi Video)

Breast Cancer is now the most common cancer amongst Indian women. Approximately 1 in 22 Indian women suffer from this disease during their lifetime. A high incidence has also been noticed in parts of North India like Gurgaon, Delhi NCR, Punjab.

Breast cancer is curable if defected early. If breast cancer is detected at an early stage, another advantage is that mastectomy or full removal of the breast might not be required.

In this patient education video, Dr. Rohan Khandelwal (Breast Cancer Surgeon in Delhi NCR) talks about some common facts and figures regarding Breast cancer in India. In this Hindi video, he talks in detail about the risk factors and the best way to detect this disease at an early stage.

It is important to realise that the most common presentation of breast cancer is in the form of a painless lump in the breast (not painful).

If you have any further queries regarding breast cancer, please reach out to

Dr. Rohan Khandelwal

Breast Cancer Surgeon, CK Birla Hospital for Women

+91 79-88252759

Mastectomy for Breast Cancer Treatment – Things to Know

Mastectomy is one of the most common surgical approaches for breast cancer management.

Over the years, the technique of mastectomy has undergone a lot of change. This patient education video summarises the current role of mastectomy in treating breast cancer, along with the post- surgery care required by the patient.

This video also covers points to prevent lymphedema (swelling of the arm) following breast cancer surgery.

This information has been provided by Dr. Rohan Khandelwal, who is a Breast Cancer Surgeon with more than 8 years of experience. He is currently heading the department at CK Birla Hospital for Women, Gurugram.

The Breast Centre at CK Birla Hospital for Women

After successfully running a Breast Cancer unit for the last 5 years at Gurgaon, me and my team have taken up the challenge to set up another Breast Cancer unit at CK Birla Hospital for Women, Gurugram.

At the Breast Centre, we would be providing comprehensive breast services ranging from non cancerous to cancerous disorders. Everything from state of the art surgical facilities to an aesthetically designed chemotherapy lounge will be available under one roof.

For appointments, you can contact –

Shantanu – +91 79-88252759

or contact Dr. Rohan Khandelwal, Breast Cancer Surgeon in Gurgaon – rohankhandelwal@gmail.com

World Cancer Day 2018

On the occasion of #worldcancerday, I would like to share the picture of the youngest #breastcancer patient I have treated till now.

She is a 25 year old, mother of a 2 year old who came to me with a small breast lump which she picked up after reading a Hindi article on breast cancer.

Few things which I would like to highlight through this case:

1. Age at diagnosis is reducing. This was my third patient in the 20’s over the last 3 months. Majority of my breast cancer patients are in their 30’s.

So, if anyone you know is suffering from a breast lump, please get it checked.

2. Awareness is increasing, which is an excellent thing. I am seeing a lot of patients with stage 1 and 2 disease, which leads to better survival.

To help create more awareness, each one reading this post should tell one more person about breast cancer and it’s symptoms (painless breast lump, recent change in shape of the breast, bloody discharge from the nipple)

3. Another heartening point is the change in the society’s attitude towards these patients. Friends and family members are becoming more accommodating towards the needs of cancer patients.

Please share this message to create more awareness.

This message has been shared in public interest by Dr Rohan Khandelwal, who is a Breast Cancer Surgeon at Gurgaon / Delhi NCR

Types of Breast Cancer – Invasive vs Non invasive

Breast cancer is the most common cancer amongst Indian women. Majority of these cancers arise from the 15-20 ducts present in the breast. These cancers can be of two types, invasive and non invasive. These terms are often mentioned in the pathology report after the breast cancer surgeon does the biopsy. This simple patient information video explains these terms and their practical implications.

If the patient is diagnosed with an invasive cancer, then the patient often requires chemotherapy, whereas, if the patient has non invasive cancer (ductal carcinoma in situ), chemotherapy can be avoided.

To diagnose the type of breast cancer, a breast biopsy is required (tru-cut or core needle biopsy). FNAC (fine needle aspiration cytology) is not useful in distinguishing between the two types of cancers.

This information has been provided by Dr. Rohan Khandelwal, Breast Cancer Surgeon at W Pratiksha Hospital, Gurgaon & Delhi NCR.

Importance of Breast Cancer Support Groups

The incidence of breast cancer in India is increasing at an alarming rate and more and more ladies are being detected with this disease in their 30’s and 40’s. 

Breast cancer not only affects the physical appearance of the patient but also has a huge impact on their mental and psychological well being. In addition to the patient, the family also becomes part of the treatment.

Once patients finish their treatment, it is important for them to get back to their daily routine, so that they can keep their mind off the disease. Family, friends and strong support group play a huge role in this aspect of a breast cancer warrior’s journey.

To celebrate these warriors, we recently organised a support group meeting at W Pratiksha Hospital, Gurgaon, which was well attended by many breast cancer patients and their families. 

Breast Cancer Treatment Completion

We don’t remember days, we remember moments

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It’s always a delightful moment to see the smile on a patient’s face, when they conquer breast cancer.

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.