Dr Rohini Patil (Obstetrician and Gynecologist) has worn many hats in her enriching career of more than 25 years, including that of a private practitioner, gynecologist, chief surgeon, lecturer, medical officer, cancer awareness speaker, and mentor. She has training in Palliative Care with the Indian Association of Palliative Care. Ans she also has specialization in Operative Laparoscopy, Hysteroscopy, Vaginal Surgeries, Ultrasound and Fetal heart rate monitoring, and CDT (Complete decongestive therapy) for Lymphedema. She is also a Breast Cancer survivor and has spearheaded a movement called Knitted Knockers India, which provides patient-friendly knitted/crocheted breast prosthesis to cancer survivors for free.

Can you tell us a bit about Knitted Knockers India?

During my awareness sessions and screening sessions, I met many survivors and found that mastectomy had affected them a lot. Mastectomy affects the survivor physically, mentally, psychologically, and emotionally. Mastectomy impacts the psychological set-up; the patients have a negative body image, and they also seclude themselves from social gatherings.

So I started Knitted Knockers India, where we provide handcrafted prosthesis. The financial constraints are taken care of, and these prostheses are free of charge to everyone who needs it. We always say that we gift the prosthesis to the one who needs it. Initially, we were just three people, but now we have a group of volunteers who make the prostheses. We now have sub-centers in Pune, Banglore, and Nagpur and send prosthesis all over India free of charge. When I give it to government hospitals, the ladies are in tears; they say we never thought that someone would think of this for us. Everybody wants to be their previous natural self. It gives me much happiness when I see the joy on people's faces when they take the breast prostheses.

What is the importance of having regular sonography or a mammogram, and how often should one do it?

Mammography and sonography screening plays an essential role. Everyone is aware that the best protection is early diagnosis because we don't have any Breast Cancer vaccination. We cannot prevent breast cancer, but early detection will give the best chances of cure. Regular screening goes a long way to help in early detection. When a lump or nodule is not palpable and detected early, we have treatment options that could give an effective and successful outcome.

Every woman above 20 should do breast self-examination. It's essential to know what is breast self-examination because until and unless you know what is normal for yourself, you will not know what is wrong with yourself. You should know how your breast feels, and then only you would be able to point out if there are any changes in your breast. The self-examination should be preferably on the 7th or 8th day of menses. Post-menopausal women should fix-up one day of a month to examine themselves, and the same applies to pregnant ladies; they should also not miss breast self-examination. Many studies put forward that after 40 years of age, every woman should go for mammography once a year.

Does radiation exposure during sonography and mammogram lead to cancer?

That is a myth that radiation exposure during sonography or mammography would cause malignancy in the breast. One should understand that the amount of radiation we expose ourselves to during mammography is very low, and we are within the medical limits. One should know that the background radiation is also there, and two months of background radiation is equivalent to one mammography radiation exposure, and we are doing it only once a year. Therefore, the benefits of mammography hugely outweigh the minimal radiation effects it brings. So radiation through mammography does not lead to breast cancer; it is always beneficial for early detection. 

Skincare products contain paraben, which leads to Breast Cancer. So how to avoid such products and choose the right one?

Parabens are there in almost every product we are using, like shampoos, soaps, conditioners, face lotions, and cosmetics. Doctors apply these parabens to the skin, and they have a weak estrogenic activity. Estrogen is a female hormone that causes more proliferation of breast tissue, and it causes some changes called mutagenic change, which increases the risk of having Breast Cancer. These parabens have a weak estrogenic activity, and if we apply it to the skin, then these parabens absorb and can be found in breast tissues during the examination. An effortless way is checking the contents of the products you are using and avoiding those containing paraben.

How obesity and Breast Cancer have connections?

Obesity is a risk factor for the development of Breast Cancer. It also affects prognosis, reoccurrence, survival, and metastasis. From the risk of having Breast Cancer to the survival rate, each and everything has connections to obesity. First and foremost, one should know that when we speak of obesity, we are talking about the fat percentage in the body. Fats cells have an enzyme called Aromatase that helps in the production of estrogen. So more the fat cells, more estrogen produces, which increases the risk of having Breast Cancer. One can control obesity by following a good exercise routine and diet, thereby reducing the risk of Breast Cancer. 

What are the types of surgeries in Breast Cancer treatment?

There are two main types of surgeries in Breast Cancer treatment; Mastectomy, i.e., removal of the complete breast and Lumpectomy, also called breast conservating Surgery Skin sparing mastectomy is done in some cases, where it will benefit to give a more natural look after the reconstruction Surgery. In lumpectomy, doctors only remove the lumps, but this is not in use in advanced Breast Cancer stages. Lymph nodes are also sent for Biopsy to diagnose whether the cancer has spread.

What is the Treatment for Breast Cancer during pregnancy?

Breast Cancer can occur in pregnancy, and generally, is more common between 30 to 38 years of age. Typically, around 3000 women have Breast Cancer during pregnancy. It is challenging to palpate the lump or nodule because the breasts are already in under the effect of hormones, and they are in preparation for lactation. So sometimes we miss the early detection in pregnancy.

The treatment depends upon the stage of the malignancy and the trimester of the pregnancy. For the first and second trimester of the pregnancy, mastectomy is the Surgery option, and Chemotherapy is not given in the first trimester. But in the second and third trimester, we do have chemotherapeutic agents that can be given. Radiation therapy is not given, but in the third trimester, the patient can go in for breast conservation Surgery. After the surgery, we have to provide the radiation to the breast. It is important to note that Breast Cancer does not harm the baby in any way, but we should take care of the medications and drugs used.

How to differentiate between the breast tissue and lump?

Women should examine breasts with the flat of the fingers. The flat of the fingers is to be placed on the breast, then the tissue should be moved against the ribs, and that is where one can differentiate between the lumpiness of the breast and the lump or a nodule. When you move the breast tissue against the ribs, you can very clearly palpate a lump or a nodule, and you will not find the lumpiness of the breast tissue. 

How do you think that ZenOnco.io is working for the betterment of patients when it comes to Breast Cancer or any other cancer?

ZenOnco.io and Love Heals Cancer is with the patients, survivors, and caregivers holistically. They provide tremendous support right from the diagnosis to the treatment, awareness about the diagnosis and the treatment, and being with them. They understand that patients and caregivers need a lot of psychological support, and that is where ZenOnco.io and Love Heals Cancer is making a difference. If the patient wants a second opinion, then ZenOnco.io is there; it supports and respects the decision of the patients.

They help them have a second opinion, but they make them aware of the treatment, what will be done, and what they have to expect after the treatment. If the patient wants to take the alternative treatment, then ZenOnco.io gives them complete insight into what the alternative therapies are and how they can go ahead, but at the same time, they tell that you have to be with the time tested medicines and the line of treatment. They also provide insights into how nutrition makes a difference, what all you should be doing or not doing during the treatment, and the importance of Intermittent fasting.