Breast Cancer Awareness Month: What you need to know about your breast

Dr Pragnya Chigurupati Narra
October 17, 2020

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The breast is a mass of glandular, fibrous and fatty tissue. It is placed over the pectoral (chest) muscle and attached by ligaments called Cooper’s ligaments. Development of these parts of the breast begin at puberty and are dependent on hormones such as estrogen and progesterone. Women may have many changes in their breast during any point of their life. Some are dependent on their menstrual cycle. Others are linked to birth control pills, hormone replacement therapy, family history or lifestyle changes. Most breast conditions are not cancer. They arise from an abnormality in the normal development and ageing of breast tissue.

October is breast cancer awareness month. In a spirit of raising-awareness, we're giving you a two-part series on breast changes in - 1)Premenopausal women 2)Post-menopausal women

Part 1 - Premenopausal women

Breast pain

The most common complaint amongst younger women is pain linked to the menstrual cycle. This is called “Cyclical mastalgia”. It is almost always due to our hormones (estrogen and progesterone). As the pain does not always affect both the breasts, there might be other causes to pain in a single breast. This type of pain might begin at ovulation and last all though the menstrual cycle. Pain that involves both the breasts and is cyclical is generally not harmful. When the breast pain does not correlate with her menstrual cycle, it is called “Non-cyclical breast pain”. It is advisable to chart the breast pain to understand the link better. The pain might be minimal to so severe that you can’t wear tight clothes or move around freely.

When you experience such pain, wear a good bra with adequate support. Maintaining a healthy lifestyle but limiting alcohol, caffeine and increasing greens in your diet are helpful. Pain killers such as Paracetamol may be taken in recommended doses if the pain is severe. Vitamin E capsules and massaging breasts with EPO (Evening primrose oil) have shown some benefit in patients.

Fibrocystic breast changes

These changes are what you feel in your breast prior to your menstrual cycle, commonly in the third and fourth decades of life.  Breasts may feel heavy, sore or lumpy. These changes occur due to an overdrive of estrogen and a deficiency of progesterone. Although these are not cancerous, having certain pathologically proven lesions of the breast which fall under the “fibrocystic” category increase the risk of cancer three-fold.

Infections

Infections are common in breast feeding mothers, smokers and women with systemic illnesses. They may present with lumps, nipple discharge, pain or fever. It is very important to identify and treat these symptoms which may range from simple medical management to surgical treatment.

Cysts

Women who develop a cyst complain of a sudden development of a lump in the breast overnight. Cysts are fluid filled structures in the breast which occur due to a blocked duct or hormonal changes. They are most commonly benign. However, certain cysts may have a small component of a cancerous or precancerous lesion. They are generally seen in the third or the fourth decades of life.

They can be soft or hard. They may be felt by the hand or seen on imaging with a mammogram. They are generally observed or aspirated with a small needle.

Tumors (Benign)

Fibroadenomas (FA) are benign lumps that occur commonly in younger women, especially teens. They however can occur at any age group. They are mobile and slip when being felt. Women generally feel them when examining their breasts. If they are small and not growing, they maybe observed. However, if they are increasing in size or are symptomatic, simple removal is suggested. They very rarely turn cancerous (Complex fibroadenomas)

Phyllodes tumors are generally seen in the third and fourth decades of life and are prone to growing rapidly, changing the shape of the breast. The treatment is relatively complicated compared to a FA. Based on the nature of the tumor, radiotherapy might be required in certain cases and recurrences are common unless they are removed completely.

Breast Cancer

Currently, in India, the rates of cancer have increased in women between the ages of 25-40. The reasons for this might be lifestyle changes, similar to the West. If women under the age of 35 develop cancers, they tend to have a strong family history of ovarian or breast cancers. It is important to get counselled with a professional genetic counsellor.

Remember that ‘Breast Self-Examination” is the most important technique of identifying early breast diseases.  It has to be done every month. Make sure you reach out to a doctor if you find any abnormality in your breasts.

(This is this first article in a two-part series on breast changes)

Dr Pragnya Chigurupati Narra is a Breast Specialist & Oncoplastic Surgeon at American Oncology Institute

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News Network
October 19,2020

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Bengaluru, Oct 19: Many villages are still submerged in Kalaburagi, Vijayapura, Yadgir and Raichur districts of North Karnataka and over 36,000 people have been evacuated, as the flood situation remains grim with the Bhima river continuing to flow above the danger mark, officials said on Monday.

This is the third time Karnataka has been hit by floods in the past three months following heavy monsoon rains.

According to the Central water commission, the Bhima river has been in spate since October 14 due to torrential rain in Maharashtra and release of water from the dams there.

The river, which is a tributary of the Krishna, has wreaked havoc in Kalaburagi, Vijayapura, Yadgir and Raichur, which are experiencing intermittent heavy rain.

Karnataka State Natural Disaster Monitoring Centre (KSNDMC) officials said as many as 97 villages in the four districts are worst affected and people residing there have been shifted to safety.

"So far we have evacuated 36,290 people. We have opened 174 relief camps where 28,007 people are staying," a KSNDMC official said.

The Army and the disaster response force personnel are engaged in evacuating people from the flood-hit areas, according to sources.

Meanwhile, in Bengaluru, the heavy downpour since Sunday night resulted in waterlogging in some places.

According to the India Meteorological Department, the city recorded 39.6 mm rainfall at the Hindustan Aeronautics Limited based weather observatory in the 24 hour period ending 0830 am today.

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News Network
October 23,2020
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Bengaluru, Oct 23: The recovery count outnumbered fresh Covid cases in Karnataka for the 8th consecutive day. On Thursday, 13,550 patients were discharged, post-recovery, which is far higher than the 5,778 new cases that were reported.

This has taken the recovered count to 6,84,834. As on October 22, the state has 92,927 active carriers of the virus. A total of 74 new Covid deaths took the toll to 10,770.

Thursday’s case count has swelled the tally to 7,88,551 in the state.

Meanwhile, the positivity rate for the day remained at 5.38% while the case fatality rate for Thursday was 1.28%. Health and Medical Education Minister Dr K Sudhakar tweeted, “We conducted 1,07,354 tests across 155 labs in the state today out of which 86,501, (which accounts to more than 80%) are RT-PCR tests.” Bengaluru Urban accounted for 2,807 fresh cases, followed Mysuru 308, Bengaluru Rural 280, Chikakbalapur 237, and Ballari 218.

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Agencies
October 23,2020

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New Delhi, Oct 23: The Delhi High Court on Friday said Republic TV's editor-in-chief Arnab Goswami can use the tagline NATION WANTS TO KNOW' as part of his speech or presentation.

The high court noted in its order that Bennett Coleman and Co. Ltd, which has filed a suit against Goswami or ARG Outlier Media Pvt Ltd, which owns Republic TV, has submitted that the journalist is free to use the same as part of his speech/presentation of any news channel.

However, if Goswami or ARG Outlier Media Pvt Ltd choose to use NATION WANTS TO KNOW' as a trade mark regarding any of their goods/ services, they will have to maintain accounts for such usage and the accounts shall be filed in court regularly, it said.

Regarding the tagline NATION WANTS TO KNOW, no interim order is passed at this stage in favour of the plaintiff (Bennett Coleman). As submitted by the learned counsel for the plaintiff, defendant No. 2 (Goswami) is free to use the same as part of his speech/presentation of any news channel, etc, Justice Jayant Nath said.

Meanwhile, the court allowed an interim application of Bennett Coleman group and passed an interim injunction in its favour and against the defendants retraining them from using the trademark NEWSHOUR' or any other mark which is deceptively similar to the trade mark NEWSHOUR' of the Bennett Coleman.

The plaintiff has filed the suit seeking to restrain Goswami or ARG Outlier Media Pvt Ltd from using the trademark or title or tagline NEWSHOUR' and NATION WANTS TO KNOW' as it infringes its registered mark.

The plaintiff said Times Now' is a news channel operated by the plaintiff having several segments of programmes, one of which was launched in 2006 titled THE NEWSHOUR' pertained to discussions, panel discussions and debates on current topics.

It said Goswami, who was earlier associated with Times Now and resigned in 2016, launched his channel Republic TV' and website www.republicworld.com and they also filed trade mark applications for registration of the mark NATION WANTS TO KNOW', ARNAB GOSWAMI NEWSHOUR' and GOSWAMI NEWSHOUR SUNDAY' claiming proprietary rights.

The journalist told the high court that viewers of the two news channels are well informed, literate and can never associate or confuse between the shows or programmes aired on the respective news channels.

He claimed that the Bennett Coleman's animosity with the Republic TV is well known and publicised and hence, there is no question of any passing off in such circumstances and alleged that the proceedings have been initiated in the form of vendetta litigation and merely in a purported attempt to harass and arm-twist the defendants.

The high court said it was of the opinion that it is only after evidence has been led that it can be ascertained as to whether the plaintiff was using the aforesaid mark as a trade mark or it was merely being used as a form of speech in the course of conducting the news channel or in the course of carrying on interviews/presentations by defendant No. 2 (Goswami). These are aspects on which, prima facie, no view can be made at this stage based on the documents placed on record, namely, screen shots of various sites of Twitter, Facebook, etc.

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