Live Discussion with Dr. Sahil Bambroo
Questions doctors asked during the Jivo Masterclass on Diagnosis and Management of Breast Cancer, taught by Dr. Sahil Bambroo, Senior Consultant, Medical Oncology, BLK-Max Super Speciality Hospital, New Delhi, India, on . Written by Jivo Healthcare from the transcript of the session, drafted with AI assistance and edited by the Jivo team.
Speaking of biopsy, from which specific region should the tissue sample be taken, and what is the sampling technique?
Asked by Dr. Morris Kumwama
In early breast cancer, biopsy is usually a guided procedure taken directly from the lesion itself, using a simple technique: fixation of the tissue followed by histopathology, then immunohistochemistry to determine oestrogen receptor, progesterone receptor and HER2 status. If HER2 comes back equivocal on immunohistochemistry, a FISH test confirms it. In metastatic disease involving organs such as the lung, bone or liver, the biopsy is taken from whichever site is most accessible and least risky for the patient, often the liver or the lung. In patients too unwell for any other biopsy, such as those presenting with severe anaemia, a bone marrow biopsy can confirm metastatic breast cancer directly, including its subtype through immunohistochemistry on that same sample, allowing treatment to proceed with good results.
Answered by Dr. Sahil Bambroo
What are the causes and major signs of breast cancer?
Asked by Dr. Robert
The most common cause is advancing age; risk rises with it. Other contributing factors include early menarche, late menopause, never having children, having a first child after age 35, reduced breastfeeding, smoking, and alcohol consumption of any quantity. Genetic factors matter too: a first-degree relative with breast or ovarian cancer, or a positive result for high-penetrance genes such as BRCA1, BRCA2 or PTEN, raises risk. Chest radiation received for an earlier childhood lymphoma also raises the risk of breast cancer later in life.
Answered by Dr. Sahil Bambroo
Does an effective curative treatment for breast cancer really exist? If so, what is the therapeutic protocol, and if not, why are anti-cancer drugs used?
Asked by Dr. Morris Kumwama
Definitive, curative treatment absolutely exists for early breast cancer. In stage one and stage two disease we see results of close to 100%, with protocols based on the subtype, because the treatment protocol differs for every subtype and every stage. Treatment is further modified for the patient's condition, comorbid illnesses and what the patient can afford. Metastatic breast cancer cannot be cured as of now, but quality of life and survival have improved a great deal compared with a few years ago. Breast cancer is the most common cancer among women, although across men and women together, lung cancer causes the most cancer deaths. Even in stage four disease survival has improved considerably, and that is the rationale for treating these patients: their quality of life and their survival matter. A protocol cannot be stated in one line. For every age, every subtype and every disease condition, treatment has to be optimised and the plan built around the individual patient; this is what precision oncology means.
Answered by Dr. Sahil Bambroo
In This Series: Diagnosis and Management of Breast Cancer
- 1.Breast Cancer Management: A Medical Oncology Guide
- 2.Breast Cancer Warning Signs, Self-Examination and Biopsy
- 3.Breast Cancer in Young Women: Fertility and Survivorship
- 4.Live Discussion with Dr. Sahil Bambroo