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.

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Fibroadenoma – clinical presentation & surgery

Fibroadenomas are the most common cause of a breast lump, especially in young ladies. Due to increased awareness, more and more ladies are getting scans done, on which fibroadenomas are detected. In this video, I have explained the presentation and the surgical management of fibroadenomas in Hindi.

 

If these breast lumps are very small, they can be managed conservatively (without surgery) but if they are causing pain, increasing in size or there is a family history of cancer, it is best to get these lumps removed by a minor breast surgery.

As these lumps occur in young patients, it is important that the surgeon removes them without leaving a scar behind. In case you are detected with a breast lump, which is suggestive of a fibroadenoma, it is best to consult an expert breast surgeon, who is routinely performing such surgeries.

For more details regarding fibroadenoma surgery, please click here

 

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.

 

 

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.

 

Interesting Mammogram #5

41 year old lady with a left breast lump since last 6 years with rapid increase in size since the last 4 months. Patient was concerned that she is suffering from breast breast cancer and therefore got a mammography done and presented to my clinic.


A tru- cut biopsy was done and it revealed it to be a phyllodes tumor, which after resection turned out to be a malignant phyllodes tumor with Liposarcomatous differentiation. 

Case uploaded by:

Dr. Rohan Khandelwal

Breast Cancer Surgeon

W Pratiksha Hospital, Gurgaon 

Interesting Mammogram #4 

47 year old lady with complaints of bilateral breast pain since 3 months. Pain was non cyclical and relieved by oral paracetamol. She had a hysterectomy 6 years back and she was a known asthmatic.

On examination, she has multiple tender nodules in both the breasts, localised in the peri-areolar region. 

Mammogram revealed multiple, well defined, rounded densities in both the breasts with a rim of calcification around them (refer to figures). 

Multiple round densities in the breast


Ultrasound done revealed dense fibroglandular tissue with multiple sub-centimetric cysts in the breasts. 

Differential – 1. Multiple oil cysts with calcification 

2. Cysts secondary to fibroadenosis

Case managed by:

Dr Rohan Khandelwal

Consultant, Department of Breast Diseases and Cancer Care

W Pratiksha Hospital, Gurgaon  

Wire Guided Localisation of Non Palpable Breast Lesions

With the increase in opportunistic screening of Breast Cancer in India, more and more impalpable breast lesions are being detected. Wire guided localisation is one method to surgically deal with these lesions.

This video highlights the operative steps of wire guided localization and also the use of a specimen mammogram.

 

Dr. Rohan Khandelwal

Consultant, Breast Onco-surgeon

W Pratiksha Hospital