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गुरुवार, 10 मार्च 2016

BREAST CANCER

BREAST CANCER
Breast cancer is a malignant proliferation of epithelial cells lining the ducts or lobules of the breast. Epithelial malignancies of the breast are the most common cause of cancer in women (excluding skin cancer), accounting for about one-third of all cancer in women.
Aetiology
Increased caloric intake contributes to breast cancer risk in multipleways: earlier menarche, later age at menopause, and increased postmenopausal estrogen concentrations reflecting enhanced aromatase activities in fatty tissues.
Moderate alcohol intake also increases the risk by an unknown mechanism. Folic acid supplementation appears to modify risk in women who use alcohol but is not additionally protective in abstainers.
Breast cancer is a hormone-dependent disease. Women without functioning ovaries who never receive estrogen-replacement therapy do not develop breast cancer.
Breast Examination
Women should be strongly encouraged to examine their breasts monthly.
Breast examination by the physician should be performed in good light so as to see retractions of nipple and other skin changes.
The nipple and areolae should be inspected, and an attempt should be made to elicit nipple discharge.
All regional lymph node groups should be examined, and any lesions should be measured.
Physical examination alone cannot exclude malignancy.
Lesions with certain features are more likely to be cancerous (hard, irregular, tethered or fixed, or painless lesions).
A negative mammogram in the presence of a persistent lump in the breast does not exclude malignancy.
Palpable lesions require additional diagnostic procedures including biopsy.
In premenopausal women, lesions that are either equivocal or nonsuspicious on physical examination should be reexamined in 2–4 weeks, during the follicular phase of the menstrual cycle. Days 5–7 of the cycle are the best time for breast examination.
A dominant mass in a postmenopausal woman or a dominant mass that persists through a
menstrual cycle in a premenopausal woman should be aspirated by fine needle biopsy or referred to a surgeon.
If nonbloody fluid is aspirated, the diagnosis (cyst) and therapy have been accomplished together.
Solid lesions that are persistent, recurrent, complex, or bloody cysts require
mammography and biopsy, although in selected patients the so-called triple diagnostic techniques (palpation, mammography, aspiration) can be used to avoid biopsy.
Ultrasound can be used in place of fine-needle aspiration to distinguish cysts from solid lesions.
Not all solid masses are detected by ultrasound; thus, a palpable mass that is not visualized on ultrasound must be presumed to be solid
Better mammographic technology, including digitized mammography, routine use of magnified views, and greater skill in mammographic interpretation, combined with newer
diagnostic techniques (MRI, magnetic resonance spectroscopy, positron emission tomography, etc.) may make it possible to identify breast cancers even more reliably and earlier. Screening by any technique other than mammography is not indicated; however, younger women who are BRCA-1 or BRCA-2 carriers may benefit from MRI screening where the higher sensitivity may outweigh the loss of specificity.
Not Recommended Test in Breast Cancer
Complete blood count
Serum chemistry studies
Chest radiographs
Bone scans
Ultrasound examination of the liver
Computed tomography of chest, abdomen, or pelvis
Tumor marker CA 15-3, CA 27-29
Tumor marker CEA
Ayurvedic Treatment that can be recommended in breast cancer is as follows:
Panchkarma: (Purificative Procedure) especially Vaman (Vomiting induced by medicine) will be very useful as a preventive as well as curative therapy.
Internal Medicines which havea role in Breast Cancer are as follows:
Vacha (Acorus calamus), Sweet Flag
Kutki (Picrorrhiza kurroa), Picrorrhiza
Shilajit (Bitumen),
Guduchi (Tinospora cordifolia), Tinospora
Bhallataka ghrit, (Semecarpus anacardium) Marking nut
External Application in the form of paste following drugs may be used:
Kombadnakhi ,
Shigru (Moringa pterygosperma), Drumstick tree.
Prof. Dr. Satyendra Narayan Ojha ,
MD (KC), Ph.D.
Director , Yashawant ayurveda college , Post graduate teaching and research center ,
Kodoli ,Panhala , Kolhapur..
 drsnojha@rediffmail. com   -

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