Dr. Waseem Abbas

Cancer Treatment Specialist
Director Research, Max Hospital, Shalimar Bagh

How to contact me

 Max Superciality Hospital, FC 50, C and D Block, Shalimar Place Site, Shalimar Bagh, New Delhi,    Delhi 110088
Phone: +91 98112 42729
Email: drabbasdoc@gmail.com

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Breast cancer treatment in Delhi, India | Breast Cancer Specialist in Delhi | Patient Education Resources

Latest advances in Breast cancer treatment

  1. Node preservation reduces lymphedema cases-Can be done by Sentinal lymph node biopsy.
  2. Genomic testing minimizes chemotherapy exposure-In detail described below.
  3. Better identification of hereditary cancer syndromes.
  4. An oral option for targeted therapy.
  5. New drug combination makes estrogen-blocking agents more effective.
  6. The next generation of monoclonal antibodies.
  7. Immunotherapy in Triple negative Breast cancer.

Breast cancer is a curable disease in majority of patients.

Before describing about treatment of breast cancer we need to not only look at the stage of breast cancer but also at different prognostic and predictive biomarkers.

Apart from the stage, these biomarkers tell us about the probability of relapse

So, we divide breast cancer according to stage and according to the hormone receptor status and genomics. (By looking at genes we can also say that what kind of genes are driving cancer and how aggressive these genes are).

 

Classification of Breast cancer

A, As per Stage- Stage I, Stage II, Stage III, Stage IV.

B, As per Biomarkers-

Estrogen Receptor (ER)
Progesterone Receptor (PR)
Her2 Neu
C, Genomic test for Breast recurrence score-That measures the expression of cancer related genes in patients tumor.

Oncotype DX Breast recurrence score

Mammaprint

PAM 50

EndoPredict

Breast cancer can be divided   into subtypes   that respond differently to various types of treatment.

Subtypes according to Hormone receptor status

A, Hormone receptor positive – Estrogen receptor positive (ER-Positive), Progesterone receptor positive (PR-Positive) and Her2 Neu receptor negative are good biology tumors where chances of recurrence are less because they are good biology tumors. These breast cancers are 98% curable if diagnosed at early stage.

Can we avoid chemotherapy for such patients suffering from breast cancer?

Does that mean treating breast cancer without chemotherapy-Yes but not for all breast cancer patients

Yes, more breast cancer patients can avoid chemotherapy. With the help of genomic recurrence scores in breast cancer we can tell now who will benefit from chemotherapy. Not only in early-stage breast cancer, we can avoid chemotherapy in node positive breast cancer as well. From last 3 years 30% of our patients did not not receive chemotherapy after surgery for breast cancer. Now we can have better informed discussion with patients explaining why they are unlikely to benefit from chemotherapy in early-stage breast cancer.

This allows women suffering from Breast cancer to get through their cancer treatment faster and back to their lives sooner.

Cost remains a concern for such tests but in coming times it would go down so everyone can afford these tests.

In young breast cancer patients with advanced stage who are high risk for relapse ovarian suppression

B, Her2Neu positive Breast cancer – These are more aggressive that hormone receptor positive breast cancers. Such types of breast cancers are driven by Her2 Neu gene.

How are breast tumors tested for HER2?

By simple method called immunohistochemistry-IHC

If the IHC result is 0 or 1+, the cancer is considered HER2-negative. These cancers do not respond to treatment with drugs that target HER2.

If the IHC result is 3+, the cancer is HER2-positive. These cancers are usually treated with drugs that target HER2.

If the IHC result is 2+, the HER2 status of the tumor is not clear and is called “equivocal.” This means that the HER2 status needs to be tested with FISH to clarify the result.

If IHC report is 2-equivocal, it should be confirmed with FISH- Fluorescent in situ hybridization.

How to treat Her2 Neu positive breast cancer?

Chemotherapy cannot be avoided for such type of breast cancer unless tumor is less that 1cm. These are aggressive types of breast cancer and need targeted therapy along with chemotherapy.

Now different types of targeted therapies are available for such type of breast cancer and prognosis has improved with  advent of targeted therapies like Trastuzumab, Pertuzumab, Trstuzumab Emtasine (TDM-1), Lapatinib, Fam-Trastuzumab, Tucatinib, Enhertu (chemical name: fam-trastuzumab-deruxtecan etc.

C, TNBC-Triple negative Breast cancer- Tumor which is ER Negative, PR Negative and Her2Neu negative are called triple negative breast cancer. Triple negative Breast cancer is an aggressive cancer and has more like spread at the time of diagnosis and is more likely to come back after treatment.

In early stage 5 year survival rate is 90%, for breast cancer patients who are locally advanced (Stage II, Stage III) 5 year survival is 60% and for stage IV triple negative breast cancer patient 5 year survival is 10%.

These cancers are usually associated with BRCA 1 and BRCA 2 genes and other hereditary syndromes as well. So such breast cancer patients are diagnosed at early age. Some body diagnosed with Triple negative breast cancer should be screened for Hereditary syndromes after proper genetic counselling.

Treatment has not changed much as no targeted therapy is available for treatment of TNBC breast cancer patients. Immunotherapy is a new tool which is showing promise.

Immunotherapy for Triple negative Breast Cancer-Immunotherapy has changed the way we look at triple negative breast cancer. Different drugs called immune checkpoint inhibitors are available and are in early phase trials, have shown promising results

Immunotherapy for breast cancer can be combined with chemotherapy especially for locally advanced breast cancer. In neo adjuvant settings   it has shown good results in disease control for the first time in history. Research is going on and different clinical trials are addressing this issue.

Sofa we have seen more complete pathological responses with this approach.

C, TNBC-Triple negative breast cancer;-  Tumor which is ER-Negative,PR-Negative and Her2Neu-Negative.  -Aggressive type of breast cancer with high relapse rates .Now different drugs are available to cure this type of cancer. Immunotherapy is now a major tool to fight breast cancer.

Treatment of metastatic Breast cancer

Stage 4 breast cancer means that it is not curable, but that does not mean that breast cancer patients do not survive longer.

With newer drugs, better diagnostic techniques and better imaging modalities majority patients with stage 4 breast cancer survive beyond 5 years .

Again before starting treatment, we need to look at Estrogen receptor, Progesterone receptor and Her2Neu receptor status.

For ER, PR positive cancer patients and HerNeu negative   there is no need for chemotherapy, these patients can forgo chemotherapy and can be treated with hormonal therapy (Tamoxifen, Letrazole, Anastrazole, Exemestene) and other newer drugs called CDK4,6 Inhibitors (Palbociclib, Abemaciclib, Everolimus, Fulvestrant  etc) .

For Her2 Neu metastatic breast cancer patient newer drugs have shown promise in increasing survival.

For TNBC -Triple negative breast cancer survival remains poor and immunotherapy has shown promising results and more research is needed in this field.

Getting diagnosed with Breast cancer is the most difficult phase of life for anyone. However, a ray of hope is presented by the fact that Breast cancer can actually be cured using appropriate treatment measures.

If you are looking to get the best Breast Cancer Treatment in Delhi or Delhi NCR, then contact us and book your appointment from our experienced doctors and medical professionals. Our doctors have worked in remarkable medical institutions and are here to help you with their extensive knowledge in different therapies and surgeries.

Understanding Breast Cancer

There are a lot of myths surrounding breast cancer and how we can address it. Actually, breast cancer can be very easily defined as the abnormal growth of breast cells in the body. This condition can be cited as the most common type of cancer in Delhi NCR and the world, in general. The abnormally growing cells have a tendency to grow more rapidly than the other healthy cells present in the body. Thus, they spread quickly from one body tissue to another, slowly impacting the entire organ, and sometimes, body systems.


Risk Factors for Breast Cancer

Breast Cancer can be caused by numerous reasons and risk factors, many of which we might indulge in without being aware. Here are some of the risk factors that you should barr from indulging in, if you want to keep breast cancer away:

  • As human beings age, their chances of getting exposed to breast cancer also increases.
  • The most common cause of breast cancer is inherited, or genetic vulnerabilities. More than 10% of breast cancer causes come from a family history of cancer.
  • Exposing your breasts to harmful radiations is another reason for developing breast cancer.
  • Early onset of menstruation (menarche) or late termination of menstruation (menopause) is also a contributor to the development of breast cancer in women.
  • Deciding not to have any child, also known as nulliparity is also a significant factor that exposes women to the risk of breast cancer.
  • If a woman decides to have her first child at an older age (that is, at 35 or above), it also increases the risk of Breast cancer in them.
  • Resorting to the condition of not breastfeeding children also causes breast cancer.
  • If someone suffers from certain and benign diseases of the breast, it can be a major reason for breast cancer.
  • Once the menopause has set in, it is very important to follow a healthy lifestyle. Not doing so, results in obesity, which increases the chances of acquiring breast cancer.

Symptoms of Breast Cancer

If you feel that you or your loved one is predisposed to the fatal condition of breast cancer, here are some of the symptoms that you should look for:

  • A lump in the breast
  • A discharge of blood from the nipple
  • Frequent changes in the texture of the nipple or the breast, as a whole
  • Discomfort in the breasts
  • Inverted breast nipples
  • Redness near the breast region
  • Sudden puckering of the skin, or thickening of the skin near the breast region
  • Rapid swelling of the lymph nodes

Can Breast Cancer be inherited?

Unfortunately, breast cancer can be inherited. In fact, it is one of the most common causes of breast cancer in the world. If any of your blood relatives or distant ones get diagnosed for breast cancer or any other cancer for that matter, you should set an appointment with your doctor and get a medical diagnosis done.

How to diagnose Breast Cancer?

The most significant diagnosis of breast cancer is definitely the one that has been done medically, under the supervision of professionals. But, one can also perform self-diagnosis from time to time just to be sure. Here are all the diagnosis options available for breast cancer:

Mammography

Mammography is the most common diagnosis method for breast cancer, or any disease of the breast. It uses the X-ray radiations to bring about a detailed picture of the breast composition. Undergoing mammography helps medical professionals to look at varied breast lesions more clearly, thus helping them tell the entire picture.

Self-diagnosis

In order to self diagnose yourself for breast cancer, all you have to do is do a breast examination once a day and look for any lumps or unusual developments in your breasts or armpits.

Treating Breast Cancer

A sigh for relief for everyone who was searching for a way to treat breast cancer. As mentioned earlier, Breast cancer can be cured and here are some of the treatment options that one can go for if they are looking for Breast Cancer Treatment options in Delhi NCR.

Breast Biopsy

Breast biopsy is a treatment option in which a specific small amount of tumor is carefully searched for and removed from the body. A thin needle is used in the process. Certain myths surrounding this option is that it is risky and leads the cancer to spread. However, if done under the right circumstances, this is not how it turns out.

Axillary Surgery

This is a rare treatment surgery for Breast Cancer which involves operating on the axillary lymph nodes in the armpit. However, this is only done if the lymph nodes in the armpit appear to be the are of primary risk for breast cancer.

Chemotherapy

Chemotherapy is undoubtedly the most widely used treatment option for breast cancer that focuses on killing the problematic cells in the breast while not giving any harm to other body organs.

Immunotherapy

Immunotherapy is a creative treatment option for breast cancer that uses the strength of the body’s immune system against the harmful and abnormal body cells in the breasts.

Targeted Therapy

Very similar to chemotherapy, the targeted therapy focuses on inhibiting the cancer cells of the targeted organs without disturbing other body organs.

Hormone Therapy

This breast cancer treatment option in Delhi NCR analyses the needs of the body organs affected by cancer and harnesses specific hormone signals to meet the appropriate requirements.

Other Treatment Options

These are not the only breast cancer treatment options. Radiotherapy and surgery are also the least commonly used procedures that have successfully established themselves as breast cancer treatment options.

Is Breast Cancer only prevalent in women?

No, breast cancer is common in women but men also get affected by breast cancer. One cannot neglect their health issues in the only hope that breastcancer does not affect men.

Can I treat Breast cancer without losing my breasts?

Yes, losing breasts is not mandatory for treating breast cancer. There are cases in which professionals can opt to treat your breast cancer without having to remove the whole breasts. Also known as breast conservation surgery, there are no additional complications in the process.

Can breast cancer be spread to the body?

Unfortunately, the answer to this question is affirmative Breast cancer cells, if not treated on time, can spread to other parts of the body, making the situation even worse. This usually occurs when the disease enters the 4th stage. Some of the body regions where breast cancer cells can spread include brain, lungs, liver, and bones. With the right intervention, one can cure Stage 4 breast cancer as well.

I do not want to undertake surgery for treating breast cancer. Is it possible?

Yes, it is possible. While surgery for treating breast cancer is only one of the many options available, many people choose to skip it and go for other conventional treatment measures. However, if you want results, surgery is a vital requirement for patients who suffer between stage 1 and stage 3 of breast cancer. Stage 4 cancer patients however, can totally skip it.

Is Chemotherapy necessary for treating breast cancer?

It totally depends on your condition. In some patients, chemotherapy is the most viable option available to treat breast cancer. In others, however, chemotherapy might not be required at all. When patients have an excellent prognosis, they can choose to avoid chemotherapy for their breast cancer treatment.

Is Chemotherapy a safe option for Breast Cancer Treatment? What are its side effects?

Amidst all the myths surrounding the safety of chemotherapy, afact emerges that it in fact is a safe option to treat breast cancer. With the advent of modern technology, chemotherapy today focuses on bringing the minimum side effects while ensuring that the problem is taken care of.

Is Chemotherapy expensive in Delhi NCR?

There is no single answer to this question. The price of chemotherapy for breast cancer treatment in Delhi NCR depends on the average price of drugs that would go in the treatment. In Delhi NCR, you can find the best medical professionals guiding you towards using older drugs that are comparatively cheaper in price and equal to (if not more) the quality provided by modern day drugs.

How is HER2 positive Breast Cancer different from Breast Cancer?

Breast cancer, which we hear about in our general lives, is cancer that results from the abnormal action of cells. The HER2-positive breast cancer, however, is a specific subtype of breast cancer that places its emphasis on breast cancer caused by HER2 amplification. The etiology of this type of breast cancer is 20-30%.

What is the role of Herceptin in HER2 positive Breast Cancer?

As you might expect, Herceptin is a drug that has been found useful to treat HER2-positive breast cancer. It is also known as trastuzumab and is a form of targeted therapy given to HER2-positive patients.

I often hear the words palbociclib and ribociclib. What is their role in Breast Cancer Treatment?

palbociclib and ribociclib are CDK inhibitor drugs that have been newly introduced with the hope of treating Breast cancer more effectively than traditional drugs. These drugs aim to put a halt to the growth of cancer cells, thereby restricting it from spreading further.

Is Olaparib available as a breast cancer treatment in Delhi NCR?

A form of PARP inhibitor, Olaparib is another conventional class of drugs that is referred to people in Stage 4 breast cancer. It acts on the DNA to damage it, thereby leading the cancer cells to die. Infact, professionals believe that a certain class of people might find Olaparib more helpful than chemotherapy sessions.

Is hormone therapy a safe option for Breast Cancer Treatment?

By far, hormone therapy is the safest, easiest, and the most convenient treatment option for breast cancer treatment in Delhi NCR. It has mild side effects and is very easy to register.

What is Triple Negative Breast Cancer?

Like HER2 positive breast cancer, Triple Negative Breast cancer is also a subtype of breast cancer that is seen in approximately 20% of the population with breast cancer. These patients exhibit a more serious stance since they are not only devoid of essential hormone receptors, but also of HER2, which we talked about earlier. As one might expect, Triple Negative Breast cancer is comparatively difficult to treat than other breast cancer conditions.

How useful is Immunotherapy in treating Breast cancer?

As mentioned earlier, modern technology is introducing new and safer treatment options to take care of Breast Cancer patients. Immunotherapy is one such breast cancer treatment option that has proven to be useful especially for Stage 4 breast cancer patients. It creates a significant effect by reducing disease remissions.

How important is it to consult a doctor for Breast cancer Treatment in Delhi NCR?

While doctors in every state and country would more or less give the same diagnosis and treatment options, Breast Cancer Treatment in Delhi NCR offers greater quality. Consulting a doctor in NCR ensures that you are diagnosed correctly, and are offered the most appropriate treatment plans according to your condition.

I want to know more about getting Breast Cancer Treatment in Delhi NCR?

Breast cancer Treatment in Delhi NCR is considered by many people pan India, majorly because of the good quality of treatment and medical assistance received here. Additionally, many government hospitals, like AIIMS, offer the best medical treatment at an affordable price that people yearn for. If you care about your loved ones and their health, Breast Cancer Treatment in Delhi NCR is the best option.