 Hello friends, welcome to the seventh episode of Health Wives of Manipal Hospitals. So friends today we will be discussing about a very serious medical condition breast cancer. In India over 1,50,000 women are diagnosed with breast cancer every year with 70,000 deaths being reported every year. And these numbers are increasing every month, every day, every minute and every second. So my dear friends we all know that this month October is named as breast awareness, breast cancer awareness month. So to create awareness and to understand what exactly breast cancer is we have with us a very well known reputed and leading medical oncologist of Manipal Hospitals Dr. Poonam Patil. Dr. Poonam Patil has played a very important role in spreading awareness regarding breast cancer in this region. So I would like to welcome Dr. Poonam Patil on this show. Good afternoon. So starting with the basic question what exactly breast cancer is? Actually breast cancer is just the name given to the organ where the cancer has started. If the cancer starts in the breast it is known as breast cancer. So naturally breast cancer is where cancer has originated in the breast and then either it continues to stay in the breast for some time or it can later eventually spread to various organs also. But when the cancer originates in the breast it is known as breast cancer. And what are the symptoms and signs of breast cancer? Most of the times women present with a lump seen in the, in the breast actually and this is more so when they are doing regular breast self examinations which is very important. In that they pick up that there is some lump felt which was not felt earlier and then they visit the clinic and then when we examine them and do further tests and make sure that it is either it's investigated properly and we confirm cancer or we rule out cancer. Okay. Okay Dr. one more question. Whom does this breast cancer affect? Is there any particular age group or does it affect all the women? Breast cancer obviously being the organ for women. Breast cancer most of the times affect women but yes sometimes it can even affect men. Breast cancer is more seen after the age of 50 years and as we grow old the risk of breast cancer developing increases over a period of time. But younger women also can get breast cancer. So if there is a lump which is highly suspicious in younger women also it should not be left unattended and it should be investigated. So moving towards the questions sent from our viewers the first question is can physical activity reduce the risk of breast cancer? Yes physical activity reduces the risk of breast cancer in an indirect way that obesity is a risk factor for breast cancer. So if you are physically active you are obviously reducing the risk of obesity and thereby reducing your risk of breast cancer. So if you are obese there is also risk of breast cancer. Yes. Okay so this is one add on for all the people who are obese. So next question is can a healthy diet help to prevent breast cancer? Not directly so for breast cancer but it's like a health tip for reduction of all cancers that you should have a healthy diet which is rich in vegetables, rich in fruits and drink lots of water and avoid oily stuff, avoid fast foods, eat organic foods. So all these things are healthy tips to reduce the risk of many diseases including cancer. Okay but in this age all foods I had treated can't assure of diet food and healthy food. Yes that is why we have to see that. I guess that is also one of the factors which has affected the increase in the cases of breast cancer. Yes it's not just breast cancer. Any other disease also. Many illnesses including breast cancer. Okay. And there is one interesting question does smoking cause breast cancer? Again smoking tobacco itself contains many cancer creating agents. So smoking is one of the risk factors for many cancers and not as much for breast cancer but more so for lung cancers, for throat cancers, for pancreatic cancers, for urinary bladder cancers, for cervix cancers. Yes breast cancer also comes in the list but much lower time. So viewers I have always been telling this in my show that smoking is injurious to health and one cigarette in a day reduces 5 minutes of your life. This is basic everyone knows but still everyone tends to smoke. So viewers don't smoke it's really injurious to health. So moving towards the next question that is can drinking alcohol increase the risk of breast cancer? Again alcohol has been a co-factor in many cancers not so in breast cancer but again as I told you earlier a co-factor also along with tobacco it increases the risk of lung cancers, it increases the risk of food pipe cancers, it also increases the risk of liver cancers and so also breast cancer but again breast cancer comes lower in the list. How often should I do a breast self-exam does a family history of breast cancer put someone at a higher risk? Family history of breast cancer may increase the risk of breast cancer in an individual and it is usually so when say the mother has had a breast cancer at a younger age or the sister has had a breast cancer at a younger age or there are many women in the family especially from the maternal side who have had breast cancer or ovarian cancer at a younger age. So there the risk of developing breast cancer is a little higher in the individual. However breast self-examination when regarding this question it has to be done by every woman after the age of 20 years the girl should be able to understand how the normal breast structure is and she should do regular breast self-examination every month in the first week after her periods. So this practice should continue as long as they are healthy and they are able to do it breast self-examination does not cost anything it is just a matter of self-awareness. So self-examination must be done every month. So moving to the next question how often should I go to my doctor for a checkup? If you are between 20 and 40 years of age then it should be done once in 3 years but after 40 years of age it should be done annually because as we grow older the risk of breast cancer also increases so after 40 years of age the risk of breast cancer goes up much more compared to younger than 40 years of age. If a breastfeeding mother has cancer can she pass on the cancer to the child? No cancer doesn't go through breast milk but if the mother has breast cancer and she is on some kind of treatment such as chemotherapy definitely she should not breastfeed the child because these drugs can be passed on to the baby when she is breastfeeding and they can cause serious adverse events in the baby. So here is a description of one of the medical condition like she has asked there are two dimples on the outer side of my left breast like finger, poke, marks there have been no changes over one year and no lumps what could this be? This may be her normal breast texture if she says that this has not changed over last one year then I would not really worry about it but I think she should go once and check with her physician that there is no lump or anything underneath it doesn't seem to be a problem because it's kind of a static thing if it was something related to malignancy then these problems would have eventually worsened over a period of time but I think the better part would be advice would be that she should go and see with her physician and make sure that there is nothing there. Are red spots caused by breast cancer? Not really those small vessels that we see sometimes over skin including the skin of the breast they are not caused by breast cancer they are just benign spots but yes sometimes breast cancer can present as inflammation if there is redness if there is warmth of the skin if the skin is swollen and hard and painful sometimes breast cancer can present that way. So it's not just small red marks but if these signs are present on the breast also they should go and check with the doctor whether it's some kind of infection or it is a sign of breast cancer. How effective is hormone therapy for metastatic breast cancer? Hormone therapy is one way of managing metastatic breast cancer especially if the tumor expresses estrogen and progesterone receptors so there hormone therapy comes in one of the lines of management of the breast cancer. Moving to the next question is there an increased risk of getting breast cancer if you get fibrocystic breast disease? No fibrocystic breast disease is actually a benign breast disease but only problem there is that women often ignore any lump that develops as a part of fibrocystic disease. So if there is something different that they have felt they should always consult a doctor before just assuming it to be a part of fibrocystic disease. Fibrocystic disease doesn't really put them at a higher risk of developing breast cancers but where women often tend to ignore new lumps assuming that as fibrocystic. Doctor since it's October is a breast cancer awareness month I'm sure that our viewers would like to know how do you actually prevent we all know the number of cases of breast cancer are really increasing very drastically nowadays so how can we prevent? See we cannot really prevent a disease but we can probably reduce the risk of developing the disease. So as I said that improving your physical activity and not remaining obese that itself reduces the risk of developing breast cancer. Number two our diet, a diet which is rich in fresh fruits and vegetables, lots of water, no fast food, no oily stuff. So these are diet rich in antioxidants reducing the alcohol intake, no smoking. So these are also some things which reduce the risk of cancer especially breast cancer. So that is one thing and as I said that we may not be able to prevent it but if we can detect it early we are going to be in the better prognosis subgroup. So we should see also that even if I am following a very healthy lifestyle it doesn't mean that I can never develop cancer. So I have to look after myself and keep doing the screening tests as advised by my doctor to detect cancer. So in case of breast cancer it is always awareness which is really very important. Yes. What is the sonogram in breast cancer detection? Sonogram is an ultrasound of the breast and that is what is known as real time ultrasound. Real time ultrasound is the doctor who is doing it, whatever the doctor is seeing at that time he will record or he or she will record it and give the images and give the report. Whereas mammogram is an X-ray of the breast and that is much more important because you have a view which can be compared with the last year's mammogram and it always is a baseline reference for future mammograms also. So I think both have their own importance in their places but mammogram is more important or more useful because I can compare with last year's mammogram real time. Okay. This is one question, my mother has had a breast cancer twice. I am a male with sensitive gynecomastia, should I ask a doctor about removing the tissue? If mother has had breast cancer twice, he is a male. So at what age the mother had breast cancer that is important if she was at a younger age group, yes the gene can also be present in men, it's not that men cannot have breast cancer. So I would say that let him go to a doctor and have it checked. Sensitive gynecomastia doesn't really mean breast cancer but if there is any nodule or anything that is on examination the doctor finds a nodule, it can always be tested and confirmed. So viewers we have come to the end of the questions, moving towards our next segment that is a myth buster segment. I have four myths which is related to breast cancer, every disease will have its own myth. So breast cancer has lots of myth but I have picked and chosen few myths to ask to a doctor. So myth number one is breast cancer affects only older women. No it is a myth and breast cancer can occur at any age group but yes as we age the risk is much higher and at the age of 80 years if you take 10 women 1 in 8 or 10 will have breast cancer. Will have. Will have breast cancer but if you come to the younger age group if at 50 years of age it would be probably 1 in 50 and if you come to even younger age group say 25 years of age maybe 1 in it would be in 1000s that may develop breast cancer. But as we grow old the risk increases but it doesn't mean that younger women cannot develop. We have seen a 19 year old girl in our department who presented with breast cancer. So myth number two is family history of breast cancer is most important risk factor. Again not really so that is truly a myth that if my mother didn't have breast cancer then I would not be at a risk or if my mother had breast cancer then I am certainly going to get no it's not so. It is one of the risk factors but as I said being a female and ageing itself is a bigger risk factor. Is it true that if someone in the family maybe our grandmother or someone in the family has breast cancer like are we in the risk of getting cancer someone in the next generations? Not necessary. Not necessary. Not necessary. So it also depends on the genes if we have inherited. There is something known as BRCA1 and 2 gene that is BRCA it is known as BRCA gene. So if that BRCA gene is mutated and that is carried on from the mother to the daughter then the risk does increase. So next myth is breast cancer even affects men. Yes breast cancer can affect men. If it affects what is the risk? How risky is it in men? It's the same outcome. It's like early stage is always better than advanced stage. When it comes to men how do we identify how is there any sort of effect on it? Not really but in men the breast cancer also presents the same way as a lump in the breast or as an ulcer in the breast and men sometimes think that they are not at risk of developing breast cancer. I am sure many of our viewers won't be knowing this. And that is why they ignore it and there is not much breast issue in men. So if the lump starts increasing it becomes relatively advanced cancer which compared to women. So the treatment, signs, symptoms everything remains the same. So the last myth is myth number 4 that is mammography is painful and not safe. Mammography is I would say it's painful in the sense it's a pain in the neck yes because it's a little uncomfortable procedure and that is how you get good views. Actually in mammogram the breast needs to be compressed well to get a good image. So if I want a good report there should be a good image and to get a good image the breast needs to be compressed. So that is what some women find uncomfortable and painful but see it's done once in a year so might as well do it off and have that discomfort for some time and it may last only for few minutes not more than that. The duration of mammography is this whole procedure? Maybe around 20-25 minutes. So 20 minutes in a year is not a big hectic job. So it's always good to be on safer side. So just come once in a year have the sticker mammography done and be on the safe side. So doctor we have come to the end of the show so I just want you to summarize everything and give some points and tips to our viewers so that they can always be on the safer side. Yes now the better part in breast cancer is that breast is such an external organ which every woman can see and feel every day. So that is where we find sometimes very we feel very sorry when women have seen changes when they have felt changes and they have not come immediately. They hesitate to come. Yeah they are hesitant to come and also they keep themselves lower in the priority list compared to the family members so they feel that after the exams we will go or after this marriage we will go and that is where they come in advanced stage and we feel so bad that it was something that they had seen and felt and if they would have come earlier naturally the diagnosis would have been at an earlier stage where the cure rates are much higher compared to the advanced stages. Okay doctor thank you. So on behalf of all of you I would like to thank you for coming to this show and enlightening us with lots of vital facts related to breast cancer. So my dear friends we all know that prevention is better than cure but when it comes to breast cancer it is always awareness. It is very important for us to identify the signs, the symptoms and to get it treated and cured in the early stage itself. So friends please share, like and comment on this post so that we can spread the word to the whole world. Thank you. Signing off Nishan. Stay fit. Stay happy. Stay healthy. Thank you.