Doctor’s blog

The role of water in health and nutrition is universally known and acclaimed. Drinking pure water is the basic of healthy living as the water can be carrier for large number of water borne diseases. Water purification is must, as impure water can cause not only transmission of diseases, but also it can cause ingestion of harmful chemicals. These harmful chemicals may be poisons; heavy metals etc. and can cause heavy metal poisoning. To maintain good health and nutrition water purification is must and integral part of healthy living.

Water purification is more important if you are going out of your home for jungle safari or for hiking in the mountains. In these types of outdoor activities the water purifiers are very useful. But you should select a reputed brand as not selecting of a quality brand can lead to lots of problems during outdoor activities. Steripen water purifiers are one of such trusted and reputed brand which can be used during outdoor activities for purifying portable water. Steripen water purifiers use UV (ultra violet) rays for purifying water or for killing the germs that may be present in the drinking water during hiking, traveling and many more outdoor activities.

Steripen adventurer water purifier is very useful for water purification during adventure sports and also for adventurous tours. Many travelers like this water purifier because of its easy to use, faster purification and its size (very small and can be carried easily). This steripen adventurer water purifier has 2 disposable batteries, users’ guide, and nylon carry case which makes this purifier more acceptable to the travelers.       

Benign breast tumors are very common in females, as only 1 out of 5-10 biopsies of breast lump leads to diagnosis of cancer. Remaining 8-9 biopsies of breast lump are of benign type. There is a large variation in the positive biopsies for breast cancer in different countries and in the same country in different regions, of the world. These variations in positive findings may be related to interpretation, medico legal considerations, and availability of mammograms facility etc.

Most of the benign breast lumps are due to “fibrocystic” disease (small fluid filled cysts and modest epithelial cell and fibrous tissue hyperplasia). Fibrocystic disease is a histological diagnosis but not a clinical diagnosis. The problem with breast biopsy is that, the chance of development of breast cancer increases after biopsy to many folds among those who has benign breast lump or fibrocystic disease. These women who has undergone biopsy has four fold increased chance of developing breast cancer (ductal or lobular cell proliferation (about 30% of patients), particularly the small fraction of about 3% with atypical fibrous tissue hyperplasia) than those women who has not been biopsied. This four fold increase in chance of getting breast cancer goes up to nine folds in women who have a first degree relative with breast cancer. So it is very important to follow up these patients with benign breast cancer biopsy. In compared to the above, the women without atypical fibrous tissue hyperplasia in biopsy has very little if any increase chance of getting breast cancer in later life. So women without atypical fibrous tissue hyperplasia in biopsy can be followed up as usually done for general population.

Ideally every breast lump that is biopsied should be removed surgically to avoid the increased chance of getting breast cancer.    

Breasts are common site of potentially fatal cancer in women as well as in men though rarely (approximately 1% of the breast cancers are seen in men). Frequently breast lumps provides a clue to underlying systemic disease, the evaluation of breast lumps are essential. But many doctors unfortunately do not examine breasts during medical check up and they miss diagnosis of a potentially fatal condition. Both female and male breasts should be examined (especially if the male patient is obese or overweight). Most of the doctors think the duty to examine the breasts during routine physical examination as that of a gynecologist. But this is not true and all the physicians should make it a habit of examining breasts for lumps or any other abnormality during routine examination (like checking blood pressure in routine examination).

Examination of breasts for lump is very important because there is clear association of survival and early detection of breast cancer. The earlier the detection of breast cancer the better is the outcome of the treatment of breast cancer. So it becomes a duty for every doctor to diagnose breast lump (?cancer) and other breast abnormality and institute a diagnostic workup for proper and timely detection and diagnosis of breast cancer.

Women also should be trained in self examination of their breasts regularly (at least once a month). In fact breast self examination is more important in detecting early cancer that examination by doctors.

Male breast or gynecomastia (some time it can be unilateral and asymmetric) should also be given equal importance as that of female breast and should be taken and examined as that of females. Unilateral breast lump in obese males are very important and should be examined. Though breast cancer is unusual in males, but gynecomastia in men should be evaluated in the same manner as that is done in females.

Diagnosis of breast cancer is done by biopsy of the nodule detected by mammogram or by palpation.