 Hello everyone, greetings from KMC Hospital Ambedkar Circle Mangalore. This is breast awareness month and we'll have a very brief topic that's breast cancer awareness. Breast cancer has become quite common among women these days but it's a very much addressable issue it's a superficial cancer which can be detected easily and can be managed easily when detected early. So we'll speak very briefly about it to know as a social awareness how to deal about it and what to do about it. So cancer numbers are increasing and in the 20 years this is going to increase by more than 50 percent so that is why we are having more and more awareness. In a developed society one in eight women can suffer from breast cancer throughout through her lifetime but in India the situation is slightly better where the suffering is 1 in 25 but on as the Indian population is very huge we are addressing a bigger problem or a bigger number to be precise so that's why we have every four minute an Indian woman is diagnosed with breast cancer and every 13 minutes a woman dies of breast cancer that's the magnanimity of this problem so we have a very common issue and a common problem to face. So what causes breast cancer it's a balance between the environmental factor and the host factor so the host factor comprises the immunity and environmental factor is the insult to the human immunity that is a reason behind this cancer so that is why we have to speak on how to prevent cancer that is like improve your lifestyle improve and better your body mass index improve the exercise increase fruits or antioxidants in your diet so that's the way forward. So when we are speaking about breast cancer we should also speak about the other benign issues so actually when it's any lump in a woman is not actually breast cancer but we have to other problems that's like benign problems like Andy that is like aberration in normal development on evolution actually what happens is like because of the continuous hormonal change there can be differences in the tissue development and evolution so that's why in a young woman the chances of benign fibroidinomas are more in the middle age woman the chances of fibroidinosis are more but the age increases the chances of cancer also increases the main thing in a breast tumor is to rule out malignance so how does this tumors present so one of the common or like dangerous science faced by patient is nipple discharge so any blood in the nipple please go to your nearest doctor or your family doctor and share your issues then one of the most common problem is the which is easily missed is the lump in the breast so there will be painless lump lump is a swelling so people have this wrong thought that cancer is very painful but actually to start with cancer is not very painful in stage one or two it can it need not be painful so don't wait for a cancer to become or a tumor to become painful so pick up early lump and present to your cancer doctor as soon as possible retraction that's a recent retraction of nipple and the nipple retracted recently that's another evidence for cancer so those are the early cancer issues but as the days goes by as it progresses what happens is there will be ulcer and there can be edema in the breast so this ulcer and edema in the breast so that can cause further problems so it is better to treat the patient early when the patient is treated early the results are also better so in stage one or two the five-year survival is as high as 90 to 95% in stage four in stage three and four the results are or the five-year survival is as low as 30 to 50% the science has advanced what was very radical if you ask a century ago any tumor in the breast has to have to be operated and the surgery was very morbid a large tissue has to be removed and it would cause a morbid issue or a morbid scar to the patient but as we have progress it has become more and more sensitive we have reduced the radicality of surgery increase the survival of the patient by adding chemotherapy increase the survival also we have added the cosmetic effect we are doing breast conservations so that is only tumor is removed now nowadays we do not remove the whole breast we remove only the tumor and we add the cosmetic effect to it so we try to get back the shape and contour of the breast so this is possible only when the tumors are picked up in a stage one or two so that's what you are seeing here so like a tumor which is done properly we are we have operated only the only the tumor so and we have added central node biopsy that is like we nowadays we are picking up we are not removing all the lymph nodes en masse but we choose we choose on a patient whether that patient needs a complete lymph node dissection or only a single lymph node testing and if it is negative we don't do further axillary dissection so that that is a way we reduce the chances of the morbidity that is the reduced the chances of lymph edema so after breast conservation excellent result we can almost retain the shape of the breast so this is one more conservation it was in a tumor was in a little difficult situation or a difficult position but we have done a very good cosmetic effect so one more aspect when we are speaking about breast cancer what we have to speak is the screening screening means to pick up the breast cancer early that is in stage one and two so how do we screen we ask for a screening mammogram so we request all those patients who are above 40 to undergo annual mammogram so annual mammogram can pick up cancers as early as stage one or stage two by showing indirect evidences so this is how the mammogram is done myths and facts about cancer so like always see like we have people thinking that once a cancer it runs through the genetic it's not always so it is as slow as three to five percent with the cancers which run genes so don't have that thought and one more thing is like cancer is not curable it's not so I keep repeating that don't have this nihilistic approach in stage one and two actually we can have a survival as high as 90 to 95 percent is almost like having a cure so no cure is a very wrong thought and the wrong idea so how to prevent cancer I already told maintain a very healthy lifestyle healthy food habits exercise regularly maintain a very average body mass index that's a way out so how do we treat cancer breast cancer the most important modality of treatment is definitely surgery but we have also to time the surgery so sometimes the patients do well or the scientifically the prognosis is better when we give chemotherapy and then operate and sometimes after surgery we need chemotherapy and radiation so that depends on the patient's type of cancer and also the type of immune markers that's how we decide on the further treatment so it's not that all cancers are same we treat patients on an individual basis so to conclude breast cancer is a superficial disease and screen detectable cancer and all attempts have to be made to detect cancer and treat better so complete work up with core needle biopsies to be done so before concluding whether things the tumor is benign or malignant we have to do a core cut biopsy and prove the cancer and also the type of cancer then all attempts have to be made to increase the chances of breast conservation so nowadays we have reduced the chances of MRM we are doing more and more breast conservation we are cosmetically preserving the breast so that has to come as an awareness to the people so don't be scared to go to a doctor and get treated as early as possible so always get treated with a very good scientific approach then the patient's survival will be better and the patients do better thank you