Self-examination saves woman from cancer

The 85-year-old Tanzania resident discovered a painless lump in her breast and immediately went to Fortis Hospital in Delhi for treatment

Tanzania resident Mary Peter Mrema (85) had a tough last month. During routine breast self-examination, she discovered a lump in her left breast. Though painless, the lump gave Mrema many sleepless nights. Immediately, she sought medical consultation in Tanzania, where a fine needle aspiration cytology (FNAC) test proved that she was suffering from ductal carcinoma. She was then admitted to Fortis, where further examinations were done.

"This particular case indicates how self-examination is important, especially in case of breast cancer and how women can avert the complications associated with the disease by getting the right treatment at the right time. Mrema came to us exactly on the right time," said Dr Randeep Wadhawan, additional director, Minimal Access and Bariatric Surgery, Fortis Hospital, Vasant Kunj. All three levels of lymph nodes were removed and drains were put. The patient is recovering well now.

'Out of danger'
"The lump has been completely removed. But sadly, the cancer has slightly spread in the area, so she will have to go through chemotherapy. As her age is a big factor, we have taken permission of her family members for chemotherapy and they have agreed," said Dr Wadhawan.

 Doctors say awareness regarding the disease is extremely low, and women generally don't go for self- examination and consult the doctor at a stage when it is difficult to treat the disease. "Women are slightly reluctant in going to a doctor. Recently, we met a woman who belonged to a good educated family, but never went for even regular testing. When she came to us, she already had stage 4 cancer. Sadly, we couldn't help her in anyway," he added," said the doctor.

Stay safe
Breast cancer is usually treated with surgery and then possibly with chemotherapy or radiation, or both. A multidisciplinary approach is preferable. Hormone positive cancers are treated with long term hormone blocking therapy. Treatments are given with increasing aggressiveness according to the prognosis and risk of recurrence.
>> Stage 1 cancers (and DCIS) have an excellent prognosis and are generally treated with lumpectomy and sometimes radiation. HER2+ cancers should be treated with the trastuzumab (Herceptin) regime. Chemotherapy is uncommon for other types of stage 1 cancers.
>> Stage 2 and 3 cancers with a progressively poorer prognosis and greater risk of recurrence are generally treated with surgery (lumpectomy or mastectomy with or without lymph node removal), chemotherapy (plus trastuzumab for HER2+ cancers) and sometimes radiation (particularly following large cancers, multiple positive nodes or lumpectomy).
>> Stage 4, metastatic cancer, (i.e. spread to distant sites) has poor prognosis and is managed by various combination of all treatments from surgery, radiation, chemotherapy and targeted therapies. 10 year survival rate is 5% without treatment and 10% with optimal treatment.

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