It is predicted that by 2020 there will be 10 million new cancer cases yearly in the developing world of which 6 million will die (WHO). In india alone it is estimated that 1.5 million new cancer cases will occur yearly at the start of this century. The incidence of cancer is increasing due to change in lifestyle, diet, again population, greater awareness coupled with improving diagnostic facilities.

Only cancer of breast , cervix, head & neck, skin colon and rectum can be detected by screening . In women , breast and cervical cancer are the most frequent. Cancer of the breast is most common followed by cervix among women in Delhi with incidence rates of 29.5 per lakh and 25.4 per lakh respectively (Delhi Cancer Registry). It is estimated that 1 in 30 women in Delhi will develop breast cancer at some point in their lives.

Aims & Objectives of Clinic
Early detection is the best defense against breast cancer. For early detection Mammography, physician's examination and breast self-examination are the most common and cost effective. Ultrasound help in indeterminate or suspicious masses.

It is a well - known fact all over the world that improved outcomes of cancer treatment are associated with specialised care of both uncommon and common cases. I is highly recommended that surgeons who specialised in it should carry out surgical management of breast cancer.

Facilities Available
1. Indraprastha Apollo hospital has dedicated breast specialists (Breast cancer Surgeons) who are trained in managing all aspects of breast diseases, be it benign or malignant. The four doctors managing the clinic are -
Dr. Ramesh Sareen Sr. consultant (Surgical Oncology)
Dr. Sameer Kaul, Sr. Consultant (Surgical Oncology)
Dr. Feroz Pasha,Sr Consultant (Surgical Oncology)
Dr. Rohit Nayyar,Sr Consultant (Surgical Oncology)
Dr. V.P Singh,Sr Consultant (Surgical Oncology)

2. Indraprastha Apollo hospital has the largest state -of-art high resolution film screen mammography unit and high resolution Ultrasound with Doppler attachment.

3. Cytology services i.e. Fine Needle Aspiration Cytology or Exfoliative cytology from nipple discharges are among the best Lab services. Fine Needle Aspiration of breast lumps are done by one dedicated cytologist and reported within 4-6 hrs.

4. Facilities for teaching of Breast Self-examination by trained doctors exist in the clinic.

5. Pamphlets about what one should know about breast cancer exist.

6. Patients who are at high risk are advised about the care of their breast.

Who should visit the Clinic?
Any woman or man who has -
1. A breast mass (painful/painless).
2. Persistent breast pain not responding to simple measures
3. Nipple discharges or eczema
4. Skin of the breast or nipple tethering
5. Request for assessment by a woman with a strong family history of breast cancer.
6.Any abnormality in the mammography, if already done.
7.Women above the age of 40 for screening of breast.
8. Women below the age of 40, with any one of the "risk factors".

Established risk accosiation of female breast cancer

Factor	Relative risk	High Risk Group
Age	>10	Elderly
Age at menarche	3	Menarche at age 11
Age at menopause	3	Menopause>age 54
Age at first full pregnancy	3	Ist child >35yrs of age
Family histroy	>3	Breast cancer in Ist degree relative <age 50 80-85%life time risk
Carrier of Mutant BRAI/BRCAII (Inherited genes account for only 5-10% of breast cancer cases)
Benign Breast disease	2	Cystic disease, sclerosing adenosis/ Atypical hyperplasia withoutfamily histroy

Early Sign of Breast Cancer Painless breast mass Persistent breast pain Nipple discharge Skin tethering Distortion of breast Breast Cheq Package Complete physical examination by specialised breast surgeons. High resolution mammography Ultrasound of both breast FNAC/exfoliative ytology (if required) Distortion of breast