LA MIDAS BREAST CARE Program

Every year more than 160,000 new cases are being diagnosed. According to GLOBOCAN 2012," India is facing challenging situation due to 11.54% increases in incidence and 13.82% increase in mortality due to breast cancer. "i.e not only the number of women affected by Breast cancer has risen, no of women dying due to breast cancer have risen more. In Urbanareas, especially Delhi NCR 1 in 22 women are likely to be affected by breast cancer.

More than half of the cases are detected at advanced stage i.e. Stage III and above i.e. majority of women in India when they are diagnosed with Breast cancer, the cancer has already progressed to arm pit or it has involved the Breast skin or nipple. Out of the two women who are diagnosed with Breast cancer only one survives due to advanced stage of disease presentation. If the cancer is detected at early stage the survival increases to more than 80%.

1. Awareness and Screening

As the Breast cancer is taking form of an epidemic. We at La Midas are trying our bit to increase awareness around early detection.

During the present COVID times we advocate every women should continue doing self Breast Examination. The process and methodology can be learnt in the link given below.

If any lump or change is detected please feel free to visit us. Our team of doctors include lady physicians like Dr Bindu, Dr Pankhuri and Dr Nehawill assist u with Clinical Breast Examination.

Once the COVID situation gets better we'll be starting with theBreast Screening by visually impaired females, the technique in which breast is examined by trained visually impaired women known as TBE(Tactile Breast Examination). Dr Mandeep is the Clinical Director for the program in India.

We have in house Mammogram and Ultrasound for Breast Screening. We recommend women who are at high risk, i.e cancer survivors, family history of cancer especially Breast and/or Ovarian cancer, habitual smoker, etc get their yearly mammogram.

HBOC Services-Hereditary Breast Ovarian Cancer (HBOC) is certain component of Breast cancer which is Hereditary and can be passed from one generation to another or can happen in siblings. The data regarding hereditary component of Breast cancer is very limited. We are starting the first of its kind service in North India. The following women should seek our services.

• Women getting Breast Cancer before the age of 50 yrs.
• Women with Triple Negative Variety of Breast cancer
• Women with Ovarian cancer
• Men having Male Breast Cancer
• Families with history of Breast, Ovarian, Male Breast cancer, Pancreatic cancer and Melanoma

2. Diagnosis

For any patient who has felt either of the below mentioned sign & symptomsa)

• lump in Breast and/ or axillab)
• Discharge from nipple especially bloody or blood tinged dischargec)
• Changes in nipple or breast skin

should visit us, we suggest her to meet our expert Dr Mandeep. She might need evaluation in form of Mammogram, Ultrasound and depending on the reports she might further need MRI and/or a Biospy/FNAC.

La Midas ensures COVID free set up and also partnered with COVID free advanced diagnostic setups fro MRI and PET CT scan

3. Treatment

The treatment is planned according to the stage and profile of Breast Cancer.

PET CT scan or standard CT + USG + Bone scan is used for complete staging of the disease. We prefer PET CT because it is a single investigation and turns out to be more convenient and economical. For early stage PET CT is not required; for evaluating brain metastases MRI is preferred.

Core Biopsy is preferred over FNAC as it gives more accurate diagnosis and also profiling of cancer inform of its Estrogen (ER), Progesterone (PR) receptor status, Her 2 Neu positivity and Ki 67 index can be done.

Accordingly, if it is early stage and/or hormone positive disease Surgery is done first and further treatment i.e. chemotherapy, radiation and hormonal therapy will be planned on the final histopathology report. In case, the disease is advanced and / or hormone negative and / or Her 2 Neu positive with high Ki 67 index the systemic therapy is started first inform of chemotherapy with or without targeted therapy. Surgery is planned after assessing the response to systemic therapy.

• Modified radical mastectomy
• Nipple sparring mastectomy/skin sparring mastectomy with sentinel lymph node biopsy (SLNB)
• Breast Conservation Surgery (with or without SLNB)
• Oncoplastic breast preservation surgery
• Partial mastectomy with reconstruction
• Mastectomy with primary reconstruction

Dr Mandeep specializes in Oncoplastic Breast Surgery, his patient's do not lose breast and neither cancer control is compromised.
In early stages a limited tissue resection which include cancer with margin and Sentinel Lymph node removal for axillary lymph node evalution is usually done. The residual breast is reshaped into new breast, this is known as volume displacement oncoplasty.
In advanced stages or small volume breasts the greater tissue resection is required, in some occasions the whole breast is removed; the breast defect is recontructed by bringing in tissue from other sites of the body, this process is termed as volume replacement oncoplasty.

In La Midas the chemotherapy is planned by Dr Mandeep's friends in medical oncology fraternity. The chemotherapy is executed under the supervision of trained onco care team. We do offer economical packages for administering chemotherapy and even targetted therapy. For advanced or recurrent cases we provide the option of immunotherapy especially in triple negative cancers. Again we reiterate that LA Midas is COVID free setup and westrictly enforce COVID prevention protocols.

We have collaborated with radiation units across Delhi NCR both in private as well as public sector. Our endeavour is to provide our patients the best of radiation techniques at the best of prices.

We offer a complete package of rehabilitation pre and post Breast Cancer treatment. They are enlisted as under :
a. Psychological and emotional support
b. Energy healing
c. Post Breast Cancer surgery Yoga.
d. Custom made Brassieres.
e. Post Mastectomy Breast Reconstruction

Dr Mandeep S Malhotra