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

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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.

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.

 

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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Breast Conservation Surgery for Early Breast Cancer

Breast Cancer Surgery has undergone a lot of change in the last few years. Earlier, mastectomy (full breast removal) was the norm for breast cancer management, but nowadays if the cancer is detected early, Breast Conservation Surgery (BCS) can be carried out.

In breast conservation surgery (BCS), only the cancerous lump and some portion of normal breast tissue around it is removed, preserving the rest of the breast, thereby leading to a better cosmetic outcome for the patient. BCS is also psychological and physically better for a patient suffering from breast cancer. The overall survival, whether the patient undergoes BCS or mastectomy for breast cancer treatment, remains the same.

 

Breast conservation surgery should be carried out by a trained breast cancer surgeon (breast onco-surgeon). A frozen section analysis should be done at the time of surgery to confirm that the tumor has been adequately removed.

 

 

 

Information provided by:

Dr. Rohan Khandelwal

W Pratiksha Hospital

Gurgaon

 

Free Breast Cancer OPD – Early detection is the best protection!!

 

 

Early detection is your Best Protection!!

 

breast cancer

 

 

Initiative by:

Dr. Rohan Khandelwal

Department of Breast Diseases & Cancer Care

W Pratiksha Hospital, Gurgaon

Unique case of multiple ductal papillomatosis

31 year old  nulliparous lady presented with serous nipple discharge from right breast since 3 months. She had no co-morbid conditions and no family history of cancer.

o/e – she had serous nipple discharge from 3-4 ducts (3,8,10 o clock). There were no palpable lumps in either of the breasts or axillae.

Nipple discharge cytology as negative for malignancy

On USG a very interesting finding was observed – there were ductal papillomas seen in ducts present at 3,8 and 10 ‘o clock position and the 3’o clock duct showed multiple ductal papillomas (3 can be seen in the USG image)

 

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Considering the age of the patient, a decision was taken to carry out three microdochectomies and the HPE revealed benign papillomas in all ducts.

 

Reasons for highlighting this case:

  1. Ductal papillomas are the most common cause of bloody nipple discharge and they arise from the terminal duct lobular units. This patient presented with serous nipple discharge.
  2. Usually ductal papillomas are solitary. Only 10% of intra-ductal papillomas tend to be multiple. This patient had at least 4 papillomas on final HPE.
  3. Multiple papillomatosis are more frequently associated with hyperplasia, atypia, DCIS, sclerosing adenosis, and radial scar but in this case none of the findings were present.

 

 

 

Case by:

Dr. Rohan Khandelwal & Dr. Savita Chopra

Department of Breast Diseases & Cancer Care

W Pratiksha Hospital, Gurgaon