Breast Cancer

Symptoms & Diagnosis

Areas of Care

The specific cells that start growing abnormally and depending on their location determines the type of breast cancer. Most breast cancers begin from either the ducts, the lobules or at times the tissue in between the ducts and the lobules. The various types of breast cancer include:

• Ductal Carcinoma In Situ or DCIS
• Invasive Ductal Carcinoma or IDC with a subtype:
  • Cribriform Carcinoma of the Breast
• Invasive Lobular Carcinoma or ILC
• Lobular Carcinoma In Situ or LCIS
• Molecular Subtypes of Breast Cancer

Some rare types of breast cancers include:

• Tubular Carcinoma of the Breast
• Papillary Carcinoma of the Breast
• Medullary Carcinoma of the Breast
• Mucinous Carcinoma of the Breast
• Inflammatory Breast Cancer
• Paget's Disease of the Nipple
• Phyllodes Tumors of the Breast

If the breast cancer has spread to other body parts, it is known as:

• Metastatic Breast Cancer

Men are also prone to breast cancer, albeit it is rare occurrence. It is known as:

• Male Breast Cancer

With a committed team at the Fortis Bannerghatta, our goal is to identify your symptoms along, recommend the appropriate diagnostic testing in order to determine the type of breast cancer that you may be suffering from. We will discuss our diagnosis with you and your family members at length.

Signs and symptoms of breast cancer

You do not need any special methods or skills to check your breasts. As every breast is different, you should just have a normal feel to spot if there’s anything unusual.

The common symptoms of breast cancer are:

• If you feel a lump in your armpit
• If you observe changes in the shape or size of your breast
• If you notice any changes in your nipples
• If you experience a nipple discharge without having to squeeze it
• If you notice that the nipple discharge has blood on it

If the breast cancer has progressed to an advanced stage or has penetrated into other organs in the body, you may experience the following symptoms:

• If you experience pain in your bones
• If you have experienced a sudden bout of weight loss
• If you have constant nausea
• If you go through a severe loss in appetite
• If you are suffering from jaundice
• If you are experiencing shortness of breath
• If you have a persistent cough
• If you are having headaches quite frequently
• If are experiencing double vision
• If you are experiencing weakness in your muscles

In the majority of the cases the breast lumps are not malignant. However, its best to get them checked by a specialist to be absolutely sure.

Our Diagnostic Services

If you have felt an unusual lump in your breast and have experienced one or more of symptoms of breast cancer over a period of time, then go for an immediate examination with your gynaecologist. If your doctor thinks that there is a need for further assessment to be done, then you may be referred to a specialist. A series of diagnostic tests will be prescribed by your specialist that may include:

If the breast cancer has spread to other organs of the body, then the specialist will recommend a secondary round of diagnostic screenings that may comprise of:

• Complete blood count (CBC)

  The CBC is more of general health test done as a preliminary check for the white and red blood cell count.

• MRI

  If the routine mammography is inconclusive, then an MRI is recommended in order to identify abnormalities.

• Diagnostic mammography:

  This procedure is more like and x-ray that’s utilises mini doses of radiation to get an image of the breast. This is usually recommended when the normal mammography or clinical breast examination results have shown abnormalities.

• Scintimammography:

  If the doctor finds any scarring of the tissues in the breast, then he may ask for a Scintimammography that takes pictures of the breast with a special camera along with an isotope.

• Ultrasound:

  The ultrasound will be able to detect the presence of a breast lump, a tumour or a cyst. It can also check if the cancer has spread to the liver or if the breast cancer has progressed to an advanced stage.

• Biopsy

  If the mammogram finds abnormalities, then a biopsy is recommended. This is a more accurate way of diagnosing breast cancer. There a multiple types of biopsies that may be used:

  • Fine needle aspiration(FNA)
  • Cone Biopsy
  • Stereotactic core biopsy
  • Wire localization biopsy
  • Surgical, or open, biopsy
  • Punch biopsy
• Hormone receptor status testing:

  The hormone receptor assay identifies if the estrogen and progesterone hormones are stimulating the expansion of the breast cancer cells.

• HER2 status testing:

  If the breast cancer cells are producing more HER2 protein, then this diagnostic screening will be able to detect that.

• Blood chemistry tests

  In order to find out the stage of the breast cancer, specific blood chemistry tests will be done. They are:

  • Blood urea nitrogen (BUN) and creatinine
  • Alanine aminotransferase (ALT) and aspartate transaminase (AST)
  • Alkaline phosphatase
• Tumour marker tests

  If the breast cancer has progressed to an advanced stage, then tumour marker tests will be used. They are of two types:

  • cancer antigen 15-3 (CA15-3)
  • carcinoembryonic antigen (CEA)
• Bone scan

  If the breast tumour is bigger than 5cm, then a bone scan has to be done.

• Ductography:

  This is type of an x-ray that can examine the breast ducts in order to find the cause of the nipple discharge. It can also assist in diagnosing an intraductal papilloma.

• X-ray:

  If the cancer has penetrated to the lungs, an x-ray will be able to pinpoint to the exact location.

• Lymph node biopsy:

  If your specialist suspects that the breast cancer cells may have spread to the lymph nodes, then a lymph node biopsy will be prescribed. There are two types of lymph node biopsies done:

  • Sentinel lymph node biopsy (SLNB)
  • Axillary lymph node dissection (ALND)

Once you have the outcome of all the diagnostic tests, it may still be a difficult decision for you to finalise a route of treatment. With the results of the screenings available to your specialist at Fortis, you and your family members, can now further deliberate, communicate and be well-informed of the health position that you are currently in in order to determine the next course of action.

Treatment Options

Treatments for breast cancer has had some real breakthroughs over the last few years. With such encouraging results, now patients have a wide range of treatment options to choose from. Hence, depending on your individual health condition, these treatment options may be recommended to you by your specialist at Fortis.

• Surgical Therapy includes lumpectomy, mastectomy, lymph node dissection, prophylactic surgery and breast reconstruction.
• Chemotherapy uses a combination of special medication to kill the cancerous cells in the body.
• Radiation Therapy will use high energy rays to destroy the cancer cells.
• Hormonal Therapy includes several drug groups that may consist of ERDs, SERMs and aromatase inhibitors.
• Targeted Therapy will use a combination of drugs.
• Immunotherapy triggers the body’s immune system to attack the cancerous cells.

When you first hear the words ‘Breast Cancer’, it can be one of the most painful moments of your life. It is a challenge dealing with such a health condition for you and for family. For many women, treatment of breast can also mean surgically removing their breast which can be very upsetting for many patients. It is best to let your feelings out and talk about your concerns with your team of specialists at Fortis. Our guidance counsellors will help you cope both physically and mentally through this treatment process.

Our Team that cares

The Department of Breast Cancer at Fortis Bannerghatta has all the necessary facilities and cancer experts like radiation oncologists, surgical and medical specialists under one roof. Once you begin the process of treatment at Fortis, we will have regular review sessions of your condition and in collaboration with specialists like pathologists and specialist nurses, present an evaluation along with therapy recommendations. Only after the team has reached a consensus on the best route of treatment for you, we will meet you and your family to discuss it at length.

Treating your breast cancer is not where end our responsibility at Fortis. Concentrating on a patient first approach, we aim to heal you physically and mentally. Our trained and skilled support staff are available to hand-hold you through entire treatment journey, so that you can only concentrate all your positive energies in getting better soon.