Breast Cancer Specialist in Delhi | Breast Cancer Treatment in Delhi | ब्रैस्ट कैंसर का पक्का इलाज
The best breast cancer treatment in Delhi by Dr Vineet Govinda Gupta, DM (Medical Oncology) Gold Medallist (AIIMS), breast cancer specialist in Delhi, Gurgaon, Noida, Faridabad. Previously at AIIMS New Delhi for more than 12 years. Scientific, ethical, affordable breast cancer immunotherapy, chemotherapy, targeted therapy and hormone therapy. More information here.
What is Breast Cancer?
Cancer describes a process where the normal cells of the body start growing and dividing uncontrollably and gain the ability to spread to other organs. Breast cancer is cancer affecting the breasts, and it is the most common type of cancer in the world (Also the most common type of cancer in Delhi).
My relative has recently developed breast cancer, does this increase my risk of developing cancer?
Yes. Breast cancer has a familial component, and around 5-10% of all breast cancer cases are inherited. If someone in your close family developed breast cancer, you may have a high risk of developing breast cancer or other cancers in the future. Testing can be done to determine if you need to take specific measures to prevent breast cancer.
What are some common risk factors for breast cancer?
The most important risk factors for breast cancer include:
- Increasing age
- Family history (as discussed above)
- Radiation exposure to the breasts
- Early menarche or late menopause
- Nulliparity (being childless)
- Having one’s first child at an older age (above 35 years)
- Non-breastfeeding of children
- Some specific benign breast diseases
- Obesity after menopause
Can breast cancer spread from a patient to his family members?
Breast cancer is not contagious and cannot spread from person to person.
What is mammography?
Mammography is a way to look at disease in the breast using X-ray radiation. Various breast lesions can be seen and identified as benign or malignant. There are two main uses for mammography:
- In case of suspected cancer, to look for extent of disease and plan therapy
- In patients without cancer, to detect it early before it becomes advanced (Screening mammography)
Interpretation of mammography is an important part of breast cancer treatment in Delhi. A breast cancer specialist can help you best interpret a mammogram.
There is a lump in my breast, can it be cancer?
While the majority of breast lumps are not cancer (benign), any lump in the breast may potentially be breast cancer. Thus, a doctor’s opinion should always be taken if you notice a lump in your breast. A qualified doctor can assess the lump and order tests to make sure you do not have breast cancer. Breast lumps should not be ignored as cancer can increase in size and spread rapidly.
How is breast biopsy performed? Is it risky? Can cancer spread due to taking of breast biopsy?
In a biopsy, a small amount of tumor is removed from the body and checked under a microscope. Breast biopsy is commonly done using a thin needle to extract tumor tissue. Breast biopsy is generally not a risky procedure if done in expert hands. Generally, breast biopsy does not lead to “spread of cancer” and is considered safe from an oncological point of view.
Breast cancer must be treated in expert hands. Consult an expert for appropriate therapy.
What are axillary lymph nodes? Is axillary surgery a part of breast cancer treatment?
Axillary lymph nodes are lymph nodes of the armpit. Usually, they are the first and most common place cancer spreads to from the breast. Your oncologist will carefully check your axilla to see if these lymph nodes are enlarged. He may also order tests like ultrasound, CT or PET-CT scan, if needed.
Axillary lymph nodes are important because they need to be addressed during breast cancer treatment, by surgery with or without radiotherapy. The type of surgery can be discussed with your oncosurgeon – some patients require lymph nodes to be surgically removed (known as axillary lymph node dissection) while others may simply have a few lymph nodes removed and tested and the rest left intact (sentinal lymph node biopsy). Your oncologist can help you decide which surgery is best for you.
How is breast cancer treated?
Breast cancer can be cured. Even in cases where it cannot be cured, it can be controlled for long periods of time. The treatment of breast cancer uses a combination of several modalities:
- Surgery to remove the cancer
- Chemotherapy: Chemotherapy uses special chemicals to kill cancer cells while sparing normal organs
- Immunotherapy: Harnessing the body’s own immune system to kill cancer cells
- Radiotherapy: Radiotherapy uses powerful, invisible beams to burn and destroy cancer
- Targeted therapy: Targeted therapy inhibits cancer cells specifically without affecting normal organs
- Hormone therapy: Hormone therapy stops growth of cancer by modulating the hormonal signals they need
All of these treatment options are readily available in Delhi. For the best treatment of breast cancer in Delhi, these modalities have to be integrated by a breast cancer specialist to determine the best treatment approach.
Will I have to lose my breast if I have breast cancer?
No! Breast cancer can be treated without removing the whole breast in several cases. This is called “breast conservation surgery” (BCS) and consists of removing the cancer alone while sparing the breast. If managed by an expert team, there is no difference in long-term survival between patients who have removal of the breast (mastectomy) and breast conservation surgery. However, radiotherapy is compulsory for patients who undergo BCS while it is only used for some patients who undergo mastectomy.
I have been told that my cancer has spread in my body. Can I be cured?
Breast cancer that has spread in the body is known as “metastatic” or “stage 4” breast cancer. Breast cancer commonly spreads to bones, liver, lungs and brain. Note that bone cancer is not the same as breast cancer with bone metastasis.
Even stage 4 breast cancer can be cured in some cases. In patients where the cancer cannot be cured, it can often be controlled for many years with proper treatment. In fact, even patients with incurable stage 4 disease can live long, productive lives with the cancer controlled inside their bodies.
Can breast cancer be treated without surgery?
In general, surgery is an integral part of treatment of stage 1-3 breast cancer and is necessary for cure. Patients with stage 4 breast cancer can avoid surgery in most cases.
I do not want to take chemotherapy! Do I have the option of avoiding it?
Yes! It has been found that a significant minority of patients with breast cancer do not require chemotherapy at all. These patients generally have disease which is very small in size, not spread beyond the breast, and expressing favourable markers or genetic profile. Such patients have an excellent prognosis without chemotherapy and in these cases, chemotherapy can be avoided.
Breast cancer treatment without chemotherapy (Hindi Video)
Is breast cancer chemotherapy “heavy” or difficult to take?
Modern breast cancer chemotherapy is very safe and the focus is on minimum side-effects and an excellent quality-of-life. While side-effects are often seen on chemotherapy, the most common side effects are mild. Serious side effects are actually uncommon. The majority of patients will complete their chemotherapy without facing any serious side effects.
Should chemotherapy for breast cancer be given before or after surgery?
Studies have shown that the order of chemotherapy and surgery in breast cancer and it does not affect the long-term outcome. Therefore, some doctors and patients may prefer to do chemotherapy before surgery. This approach (called neoadjuvant chemotherapy) has both advantages and disadvantages.
The key advantages include:
- Shrinkage in size of the cancer which may make surgery easier or allow a less deforming surgery (eg. breast conservation instead of mastectomy).
- Allows the oncologist to see the degree of benefit of chemotherapy which may help in choosing further treatment.
The key disadvantage includes:
- As discussed above, some patients may not require chemotherapy at all after surgery. If chemotherapy has already given before surgery, then this option is lost. However, this only applies to some early (stage I-II) cancers.
Ultimately, the precise order of chemotherapy and surgery needs to be individualized to each patient. Your medical oncologist can help you with these decisions.
What is the cost of breast cancer chemotherapy in Delhi?
Several different drugs are available for breast cancer chemotherapy. The cost of chemotherapy is guided mostly by the cost of chemotherapy drugs. Many older drugs are very cheap and allow very affordable breast chemotherapy in Delhi NCR. On the other hand, some newer drugs may be more expensive. It is important to remember that more expensive does not always mean better. In many cases, cheaper, older drugs may be as effective as expensive newer drugs. In this case, an expert opinion can help in designing the most cost-effective and most beneficial chemotherapy regimen.
What is meant by “HER2 positive Breast Cancer”?
HER2 positive breast cancer is a subtype of breast cancer which tests positive for “HER2 amplification”. This is seen in 20-30% of cases and all patients must be tested for HER2. The treatment of these patients differs significantly from HER2-negative breast cancer, since they can benefit from targeted therapies against HER2.
What is trastuzumab (Also commonly known as Herceptin)?
If you have HER2 positive breast cancer, your treatment will include a drug called trastuzumab. Trastuzumab is a targeted therapy, meaning that it is a treatment that specifically attacks cancer cells with HER2 abnormality (amplification). Trastuzumab leads to a large improvement in the prognosis of HER2 positive breast cancer and should be received by all patients with HER2 positive breast cancer. Additional drugs targeting HER2 are also available – these include pertuzumab, lapatinib and trastuzumab emtansine (Also known as Kadcyla or T-DM1). Not all drugs can be used in every patient. Your medical oncologist can help you navigate the complexity of HER2 positive breast cancer.
What is hormone therapy?
Breast cancer is typically a hormone-dependent tumor. This means that the growth of breast cancer is promoted by female hormones (estrogen and progesterone). Hormone therapy means manipulation of the body’s hormonal system to control cancer. It is one of the most effective therapies for breast cancer.
Only patients with “hormone-receptor positive” breast cancer respond to hormonal manipulation. This constitutes 60-70% of breast cancer and all patients must be tested for hormone receptors. If your cancer is hormone-receptor positive, you have the option of receiving hormone therapy. Some common examples of hormone therapy are tamoxifen, aromatase inhibitors (anastrazole, letrozole, exemestane), and fulvestrant.
Hormone therapy is very easy to take, usually has only mild side effects and many of the drugs are cheap. Patients who can receive hormone therapy often live significantly longer than patients who cannot or do not receive it.
What are palbociclib and ribociclib?
Palbociclib (Ibrance/Palbace) and Ribociclib (Kisqali/Kryxana) are two new drugs for breast cancer that fall in the category of CDK inhibitors. CDKs are a group of molecules within cells that regulate the cell cycle (which basically means the different phases of a cell’s life). The division of cancer cells is dependent upon moving from one cell cycle phase to another and these processes are controlled by CDKs. By blocking the effect of CDKs, the growth of cancer can be halted. These drugs are currently used in combination with hormone therapy for selected patients to improve disease control.
What is meant by “Triple Negative Breast Cancer” (TNBC)?
Triple negative breast cancer constitutes around 15-25% of breast cancers, and includes patients which lack both hormone receptors (ER, PR) and HER2. Traditionally, triple negative breast cancers are more difficult to treat than other cancers, and the prognosis of these patients is worse than hormone receptor-positive or HER2-positive patients. This is an active area of research and several new options are emerging to improve the outcome of these cancers.
What is olaparib? Where is it used? Is it available in Delhi, India?
Olaparib is a “PARP inhibitor”. It is a new class of drugs which is specially used in a special type of stage IV breast cancer. Olaparib works by stopping the DNA repair process in cancer cells, thereby causing them to die due to excessive DNA damage. It is consumed as an oral tablet and may be more effective than chemotherapy in selected patients.
What is immunotherapy? Is immunotherapy useful in treating breast cancer?
Immunotherapy is a new way to treat breast cancer. Immunotherapy implies that instead of killing breast cancer cells directly, drugs are used to stimulate the body’s own immune system so that they seek out and kill the cancer themselves.
Recent data has shown dramatic results with immunotherapy in a subset of metastatic (stage 4) breast cancer patients. It can even induce remissions in disease that is resistant to all other modalities. This is an exciting area of active research. Learn more here
Get a free E-consultation – click here or Whatsapp to +919013812875
What is the prognosis of breast cancer?
The exact prognosis of breast cancer depends upon the stage, type of breast cancer and the quality of treatment received. Luckily, the prognosis of breast cancer has been improving dramatically over the last decades and currently, the majority of patients can expect long, cancer-free lives. Patients with stage I-III breast cancer are generally considered curable and successful cure implies that the patient will live her normal lifespan free of cancer.
Even the patients with stage 4 “incurable” disease experience long periods of disease control, and the majority of patients can expect to live for many years with proper treatment. In recent trials, the median (“average”) survival of a patient with metastatic stage IV breast cancer has been somewhere between 3–5 years. However, this is the average, and includes patients who did much better (even living for a decade or more) and much worse (living for a few months). A lot depends on:
- The exact subtype of the breast cancer, and sites of disease
- The fitness level of the patient
- The kind of therapies received and the response to those therapies
- Additional prognostic factors
Why is it important to consult a breast cancer specialist in Delhi?
Delhi is one of the best cities in India for treatment of breast cancer, with great availability of specialists and infrastructure for treatment of this complex disease. Breast cancer treatment is complex and two patients of the same age, each presenting with a breast lump, may require drastically different treatment to achieve the best outcome. Recently, there has been a massive influx of new drugs, genetic tests and personalized therapy. An expert is needed to navigate this complexity.
Dr Vineet Govinda Gupta is a medical oncologist based in Delhi NCR with expertise in the treatment of breast cancer. He has received his entire training from the apex medical institute of the country (AIIMS New Delhi) and been there for more than 12 years. He has received numerous awards including AIIMS Gold Medal for best medical oncologist and published research in cutting-edge journals. More information here
I want to learn more about breast cancer treatment in Delhi…
You can access more information using various sections of this website. Some common topics of interest are linked below. For other topics you can use the menu above or the search box. If you cannot find your topic of interest, you can send me a free E-consultation using the form below.
- Information about breast cancer immunotherapy
- Information about chemotherapy
- Hindi video – treatment of breast cancer without chemotherapy
- Information about targeted therapy
- Prostate cancer – another cancer that is commonly treated with hormone therapy
- Trastuzumab is also used in the treatment of other cancers like stomach cancer, gall bladder cancer, colorectal cancer and uterine cancer
Free E-consultation with a breast cancer specialist in Delhi
If you have additional questions not answered by the above section, use the form below to send me your queries and we will get back to you shortly. You can also Email me at email@example.com. or whatsapp me on +919013812875.