Diagnosing And Treating Breast Cancer Bengali Uk

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Diagnosing and treating breast cancer

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FaJ TfaáTá ZKzP~ kzPf kJPr ßxA ãofJr pJYJA TrJ y~ oJAPâJPÛJPkr KjPY FA ßTJwPT krLãJr oJiqPoÇ FaJr jJo yPuJ ßV´KcÄÇ pUj TqJ¿Jr ßTJw vrLPrr Ijq \J~VJ~ ZKzP~ kPz fUj F ßrJV IJPrJ oJrJ®T yP~ kPzÇ FaJPT fUj muJ y~ ßxPT¥JrL ˜j TqJ¿JrÇ

IJPrJ krLãJxoNy IJkjJr KmPvw ßTJj TqJ¿Jr x’Pº IJPrJ \JjJr \jq FmÄ IJkjJr \jq xmPYP~ nJPuJ KYKT“xJ KjKÁf TrJr \jq Km˜JKrf krLãJ TrJ yPf kJPrÇ Fr ßnfPr Ijqfo èÀfôkNet yPuJ yrPoJj KrPx¡r (yrPoJj V´yeTJrL) krLãJÇ xJ\tJKrr kPr TqJ¿Jr ßTJPw FUj FA krLãJ Kj~Kof TrJ y~Ç vrLPrr APˆsJP\j FmÄ ßk´JPVPˆrPj (oKyuJPhr yrPoJj) FA TqJ¿Jr ãKf TrPZ KTjJ fJ \JjJr \jq FA krLãJ TrJ y~Ç pKh krLãJr luJlPu irJ kPz ßp FaJ ãKf TrPZ fJyPu fJr oJPj yPuJ ßp TqJ¿Jr ßpj IJr jJ y~ fJ ßbTJPjJr \jq FA yrPoJj ßgrJkL CkTJPr IJxPf kJPrÇ (20 j’r kOÔJ~ yrPoJj ßgrJkL mqJUqJ TrJ yP~PZ)Ç

KYKT“xJr irj KjP~ IJPuJYjJ TrJ cJÜJPrr TJPZ xm fgq IJxJr kPr fJrJ IJkjJr \jq ßTJj KYKT“xJ xmPYP~ nJPuJ yPm ßxaJ KmPmYjJ TrPmjÇ FA xoP~ IJkKj KbT TrPmj ßp TfaáTá ßmvL IgmJ Tf To \Kzf yPf YJj IJkKjÇ xmJA IJuJhJÇ KTZM oKyuJ IJPZj pJrJ fJPhr IxMU x’Pº xmKTZM \JjPf YJj FmÄ fJr ßTJj irPjr KYKT“xJ TrJ yPm fJ KbT TrJr mqJkJPr xKâ~nJPm \Kzf gJTPf YJjÇ IjqrJ fJPhr ßrJV x’Pº kMPrJkMKr ImVf yPf YJj KT∂á ßTJj irPjr KYKT“xJ TrJ yPm ßxA Kx≠J∂ ßjS~Jr hJK~fô cJÜJrPhr yJPf ßZPz KhP~ fJrJ UMvLÇ ßTC IJPZj KpKj pfaáTá x÷m To \JjPf YJj FmÄ KmPvwùPhr CkPr xm Kx≠J∂ ßZPz ßhjÇ IJkKj ßpA Kx≠J∂ Kjj jJ ßTj, IJkjJPT fJzJÉPzJ TPr ßTJj KYKT“xJ ßhS~J yPm jJÇ IJkKj IJxPu KT YJj fJ nJmJr \jq IJPrJ TP~TaJ mJzKf Khj xo~ KjPu FmÄ IJkjJr ˝JoL, kKrmJr, mºM IgmJ K\Kkr xJPg KYKT“xJ k≠Kf KjP~ IJPuJYjJ TrPu KYKT“xJr IV´VKfPf mJiJ kzPm jJÇ

˜j TqJ¿Jr Kj„ke FmÄ fJr KYKT“xJ

9

ßp k´vú IJkKj TrPf kJPrj IJkjJr oPj UMm x÷mf KTZM k´vú IJPZ FmÄ pfaáTá fgq IJkjJr k´P~\j mPu IJkKj oPj TPrj fJr xmaáTá \JjJr \jq KjKÆtiJ~ k´vú TrPf kJPrjÇ FA k´Pvúr ßnfPr gJTPf kJPr: • FaJ ßTj IJoJr \jq xmPYP~ nJPuJ KYKT“xJ? • Ijq ßTJj KmT· KT IJPZ? • Fr x÷Jmq kJvõt k´KfKâ~J KT? • FaJ IJoJr \jq hLWt ßo~JPh KT \KaufJ mP~ KjP~ IJxPm? IJkKj pJ mM^Pf kJrPmj jJ, fJ IJkjJr KmPvwù hu fJ IJkjJPT mMK^P~ KhPmjÇ k´˜JKmf KYKT“xJ KjP~ ßmsˆ TqJ¿Jr ßT~Jr’x& ßy·uJAPjr TotLrJ IJkjJr xJPg TgJ muPf kJPrj, FxoP~ IJkKj YJAPu fJrJ IJkjJr nJwJr FT\j ßhJnJwLr xJyJpq KjPf kJPrjÇ fJrJ IJkjJPT IJPrJ fgq KhPf kJPrj IgmJ IJkjJr nJwJnJwL ßmsˆ TqJ¿Jr ßT~Jr ßnJPuK≤~JrPhr xJPg ßpJVJPpJV TKrP~ KhPf kJPrj pJPhr IJPV ˜j TqJ¿Jr yP~KZuÇ IJkjJPT ßp CkPhv ßh~J yPò ßxaJ ßoPj KjPf IJkKj mJiq jj, KT∂á oPj rJUPmj ßp IJkjJPT ßp KYKT“xJ KjPf muJ yPò ßxaJ yPuJ KYKT“xT hPur oPf ßxrJ KYKT“xJÇ FaJ KjP~ VnLrnJPm nJmMj FmÄ pKh oPj TPrj ßp IPjqr xJPg TgJ muPu CkTJr kJPmj fJyPu fJA TÀjÇ FTaJ Kx≠J∂ ßjS~Jr IJPV pfaJ x÷m xo~ KjP~ KY∂J nJmjJ TÀjÇ

KÆfL~ ofJoPfr \jq IjMPrJi TrJ ßp ßTJj kptJP~ IJkKj KÆfL~ ofJoPfr \jq IjMPrJi TrPf kJPrj, FaJ ßTJj xoxqJ jJÇ IJkKj IJkjJr K\KkPT IgmJ mftoJj ߸vJKuˆPT IjMPrJi TrPf kJPrj ßpj IJkjJPT Ijq KmPvwPùr TJPZ kJbJPjJ y~Ç FaJ oPj rJUJ \ÀrL ßp IJkjJPT k´gomJr ßp krJovt ßh~J yP~PZ fJr xJPg KÆfL~ krJoPvtr ßTJj kJgtTq jJS gJTPf kJPrÇ KÆfL~ ofJof \JjJr \jq ßp xo~ uJPV ßxaJ IJkjJr KYKT“xJr luJlPu ßTJj ãKf TPr jJÇ

KYKT“xJ KjPf rJ\L jJ yS~J ßTJj oKyuJ KYKT“xJ KjPf rJ\L jJS yPf kJPrjÇ Fr TJrj yPuJ fJrJ oPj TPr ßp FA KYKT“xJ fJPhr ßTJj CkTJPr IJxPm jJ IgmJ FaJ fJPhr mftoJj \LmjpJ©J~ oJrJ®T k´nJm ßluPm IgmJ fJrJ n~ kJPòÇ IJkjJPT ßh~J ßTJj FTaJ, IgmJ xmèKu KYKT“xJ jJ KjPf YJS~Jr

10

˜j TqJ¿Jr Kj„ke FmÄ fJr KYKT“xJ

kPrS xmtPvw Kx≠JP∂ IJxJr IJPV IJkjJPT xfTtfJr xJPg KY∂J TrPf muJ yPòÇ ßmsˆ TqJ¿Jr ßT~Jr’x ßy·uJAPjr TotLrJ IJkjJr KYKT“xJ k≠Kfr mqJkJPr IJkjJr xJPg IJPuJYjJ TrPf kJPrj FmÄ fgq S xJyJpq ßkPf xJyJpq TrJr \jq IJkjJPT Ijq ßTJj xÄ˙Jr TJPZ kJbJPf kJPrjÇ

KYKT“xJTJrL hu ßmsˆ ACKjPar KmPvwù hPur ßnfPr KjPYr ˝J˙q TotL S ßkvJ\LKmrJ gJPTj: • TjxJuPa≤ xJ\tj • TjxJuPa≤ ßoKcPTu IjPTJuK\ˆ (TqJ¿Jr KmPvwù) • TjxJuPa≤ KTîKjTqJu IjPTJuK\ˆ (ßrKcSPgrJkL KmPvwù) • TjxJuPa≤ ßrKcSPuJK\ˆ (Fé-ßr FmÄ ÛqJPjr oJiqPo ßrJV Kj„kPe KmPvwù) • ßmsˆ ßT~Jr jJxt • ßTPoJPgrJkL jJxt • TjxJuPa≤ KyPˆJkqJguK\/xJAPaJuK\ˆ (uqJmPraKrr krLãJ KmPväwPj KmPvwù) • cJ~VjKˆT ßrKcSV´JlJr (Fé-ßr FmÄ ÛqJKjÄ-F KmPvwù) • ßgrJkL ßrKcSV´JlJr (ßrKcSPgrJkL KYKT“xJ ßh~Jr mqJkJPr KmPvwù)Ç IJoJPhr KYKT“xJ YuJTJuLj xoP~ IJkKj KmPvwù hPur TP~T\j xhxqPT KmKnjú xoP~ ßhUPf kJPmjÇ k´P~J\j yPu FA hPur mJAPr IjqJjq ßkvJ\LKmPhrPT IJjJ yPm, ßpoj xJAPTJuK\ˆ, käJKˆT xJ\tj, xJAPTJPgrJKkˆ FmÄ lJotJKxˆÇ

˜j TqJ¿Jr Kj„ke FmÄ fJr KYKT“xJ

11

˜j TqJ¿JPr KYKT“xJr IJhvt rLKf IkJPrvJj xJiJrjf ˜j TqJ¿Jr IJPZ Foj oKyuJPhr \jq IkJPrvJj yPuJ k´go KYKT“xJÇ ßTJj ßTJj ßãP© KaCoJrPT ßZJa TPr ßluJr \jq ßTPoJPgrJkL IgmJ yrPoJj ßgrJkL ßh~J y~ pJPf TPr ßZJa IJTJPrr IkJPrvJj TrJ pJ~, IgmJ IPjT xo~ FPf TPr IkJPrvJj TrJ uJPV jJÇ FaJ TrJ y~ hs∆f mitjvLu KaCoJPrr ßmuJ~ ßpUJPj IkJPrvJj TrJr oJPjA yPuJ kMPrJ ˜jKa ßTPa ßlPu KhPf yPm KT∂á oKyuJ fJ YJj jJ FmÄ pKh x÷m y~ fJyPu jJ ßTPa KYKT“xJ TrJPf YJjÇ

IkJPrvJPjr irj k´iJef hMA irPjr IkJPrvJj IJPZ: • IJÄKvT oqJxPaTPaJKoÇ FaJ uJPŒTaKo ßgPT ÊÀ TPr ßTJ~JcsqJjPaTaKo (FUJPj ˜Pjr YJr nJPVr IJjMoJKjT FTnJV ßTPa ßluJ y~) kpt∂ yPf kJPrÇ uJPŒTaKo yPuJ mMPTr IPjT \J~VJ iPr ßTPa fáPu ßluJÇ FUJPj KaCoJrPT fJr IJPvkJPvr KTZM KaxMq xy fáPu ßluJ y~Ç • xŒNjt oqJxPaTPaJKoÇ FUJPj Kjku& ßgPT ÊÀ TPr kMPrJ ˜j ßTPa mJh ßh~J y~Ç FaJ FTaJ xru oqJxPaTPaJKo yPf kJPr, FPãP© ˜Pjr ÊiMoJ© KaxMq ßTPa mJh ßhS~J y~Ç FaJ kKrmftLf \Kau oqJxPaTPaJKo yPf kJPr ßpUJPj kMPrJ ˜j ßTPa mJh ßh~J y~, F xoP~ TUjS mMPTr I· FTaá oJÄxS ßTPa ßluJ y~Ç AjPnKxn TqJ¿JPrr \jq mVPur fuJr xmaáTá Kuœ V´∫L ßTPa mJh ßhS~Jr \jq krJovt ßhS~J y~Ç

Kuœ V´∫L krLãJ TrJ IJkjJr mVPur fuJr Kuœ V´∫LPf TqJ¿Jr ZKzP~ kPzPZ jJKT fJ krLãJ TPr ßhUJ IJkjJr cJÜJPrr \jq \ÀrL TJrj FaJ IJkjJr krmftL KYKT“xJPT k´nJKmf TrPmÇ IJkjJr cJÜJPrr IjMvLuPjr CkPr Kjntr TrPm ßp TfèKu Kuœ V´∫L fáPu ßluJ yPuJÇ 12

˜j TqJ¿Jr Kj„ke FmÄ fJr KYKT“xJ

IPjT \J~VJ iPr ßTPa fáPu ßluJ

xru oqJxPaTPaJKo

ßTJ~JcsqJjPaTaKo

kKrmftLf \Kau oqJxPaTPaJKo

˜j TqJ¿Jr Kj„ke FmÄ fJr KYKT“xJ

13

IkJPrvJPjr xo~ Kk´-ßoPjJkxJu oKyuJPhr fJPhr oJKxT xsJPmr KÆfL~ nJPV oKyuJPhr vrLPr APˆsJP\j oJ©J To gJPTÇ fUj fJPhrPT IkJPrvJj TrJ nJPuJ KTjJ ßxaJ FTaJ VPmweJr oJiqPo \JjJr ßYÓJ TrJ yPò (IJkjJr Efá Yâ ÊÀ y~ IJkjJr oJKxPTr k´go Khj ßgPTA)Ç KT∂á FUj kpt∂ F mqJkJraJ kKrÛJr jJ FmÄ FA VPmweJr luJlu \JjPf yPu IJPrJ TP~T mZr ßTPa pJPmÇ

ßTJj& IkJPrvJj? Ijqfo mz ßp Kx≠J∂ IJkjJr KjPf yPm fJ yPuJ ßTJj irPjr IkJPrvJj IJkjJr yPm ßxaJ KjitJreÇ ßTJj oKyuJPhr ˜j xÄrãe IkJPrvJj (˜Pjr IÄv KmPvw ßTPa ßluJ) IgmJ oqJxPaTPaJKor k´˜Jm ßh~J yPmÇ k´JgKoT kptJP~r ˜j TqJ¿JPrr IPitT ßmvLPT ˜j xÄrãe IkJPrvJPjr oJiqPo xJrJPjJ pJ~, FaJ xJiJref ßrKcSPgrJkLr oJiqPo TrJ y~Ç VPmweJ~ ßhUJ pJ~ ßp ˜j xÄrãe IkJPrvJj FmÄ oqJxPaTPaJKo hMPaJPfA hLWt Khj ßmÅPY gJTJr yJr xoJjÇ IJkjJr mqKÜVf \LmPj IJkjJr kZPªr KT k´nJm kzPm ßxaJ KjP~ F xoP~ ßmsˆ ßT~Jr jJPxtr xJPg TgJ muPu IJkKj CkTJr ßkPf kJPrjÇ IJkjJr ßTJj irPjr IJÄKvT oqJxPaTPaJKo TrJ yPm fJ Kjntr TrPm TqJ¿JPrr ire, KaCoJPrr IJTJr, KaCoJrKa ˜Pjr ßTJgJ~ IJPZ FmÄ IJPvkJPvr TfaáTá KaxMq fáPu ßluPf yPm fJr CkPrÇ IJkjJr ˜Pjr IJTJPrr CkPrS FaJ Kjntr TrPmÇ xJ\tj IJkjJPT xmPYP~ nJPuJ TxPoKaT ßxmJ FmÄ TJptTJrL xJ\tJKr KhPmjÇ Fr oJPj yPuJ IJmJr TqJ¿Jr yS~Jr IJvÄTJ mOK≠ jJ TPr IJkjJr ˜Pjr pfaáTá x÷m KaKTP~ rJUJÇ Foj xo~ IJPZ pUj xJ\tjrJ IJkjJr kMPrJ ˜j ßTPa ßluJr krJovt KhPmjÇ xŒNet oqJxPaTPaJKo TrJ nJPuJ pUj: • KaCoJrKa FPTmJPr oJ^UJPj FmÄ Kjku& Fr FTho ßkZPj IJPZ • ˜jKa ßZJa FmÄ IJÄKvT oqJxPaTPaJKo TrPu ˜jKa jÔ yP~ pJPm • ˜Pj IJPrJ TP~TKa TqJ¿JPrr oPfJ IgmJ TqJ¿JPrr ^áÅKTkNet \J~VJ IJPZ • oKyuJ YJPòj ßpj fJr kMPrJ ˜jKa ßTPa ßluJ y~Ç

14

˜j TqJ¿Jr Kj„ke FmÄ fJr KYKT“xJ

jj-AjPnKxn TqJ¿JPrr IkJPrvJj k´oJe kJS~J ßVPZ ßp jj-AjPnKxn TqJ¿Jr hLWtTJu iPr gJTPu AjPnKxn TqJ¿JPr kKref y~ ßpaJ KTjJ IJPrJ oJrJ®TÇ pKh jj-AjPnKxn TqJ¿JrPT oqJxPaTaKo ÆJrJ KYKT“xJ TrJ pJ~ fJyPu xŒNet IJPrJVq uJPnr xMmet xMPpJV gJPT FmÄ IJmJPrJ TqJ¿Jr yS~Jr WajJ UMm To WPaÇ Fr oJPj yPuJ FaJ xmxo~A oqJxPaTaKo ÆJrJ KYKT“xJ TrJ y~Ç cJÜrrJ FUj jj-AjPnKxn TqJ¿Jr x’Pº IJPrJ nJPuJ TPr \JPjj, pJr oJPj yPuJ oqJxPaTaKo xmxo~ IkKryJpt j~Ç IKiTJÄv ßãP© ßrKcSPgrJkLr kPr G \J~VJr IPjT \J~VJ iPr ßTPa fáPu ßluJA pPgÓÇ

kMj”KjotJj ˜j kMj”KjotJj uãq yPuJ ˜jPT FojnJPm ‰frL TrJ ßpj ßxaJ ßhUPf FmÄ IjMnm TrPf pfaJ x÷m IJxu ˜Pjr oPfJ ßhUJ~Ç pKh IJkjJr oqJxPaTaKo yS~Jr TgJ gJPT fJyPu IJkjJPT FTA xJPg ˜j kMj”KjotJPjr k´˜Jm ßh~J yPmÇ FaJ IJÄKvTnJPm Kjntr TrPm ˜j TqJ¿JPrr ire FmÄ nKmwqPf IJkjJr ßp KYKT“xJ hrTJr yPf kJPr fJr CkPrÇ IJkKj pKh KTZM IPkãJ TPr ßhUPf YJj ßp IkJPrvJPjr kPr ßToj uJVPZ fJyPu IJkjJr KmPvwùPT \JjJjÇ oKyuJrJ xJiJref kPr Kx≠J∂ ßj~ ßp fJrJ ˜j kMj”KjotJj TrJPmÇ IjqJjqrJ FTaJ ˜j ZJzJ gJTPf Inq˜ yP~ kPz FmÄ fJrJ ˜j kMj”KjotJj jJ TrJr Kx≠J∂ ßj~Ç ˜j kMj”KjotJj FTaJ mz oJPkr IkJPrvJj FmÄ FaJ xfTtfJr xJPg KmPmYjJ TrJ CKYfÇ TP~T irPer kMj”KjotJj IkJPrvJj IJPZ FmÄ IPjT KTZM KmPmYjJ TrJ CKYfÇ FA Km˜JKrf KjP~ ßp xJ\tj IkJPrvJj TrPm fJr xJPg IJPuJYjJ TrPf kJPrj FmÄ KfKj Fr IJPV ßp IkJPrvJj TPrPZj fJr ZKm ßhUPf YJAPf kJPrjÇ IJkKj IJkjJr ßmsˆ ßT~Jr jJPxtr xJPg F mqJkJPr TgJ mPu ßhUPf kJPrj IgmJ Foj ßTJj FT oKyuJr xJPg TgJ muJr \jq IJkjJPT krJovt ßh~J yPm pJr F irPer ˜j kMj”KjotJj IkJPrvJj yP~PZÇ

˜j TqJ¿Jr Kj„ke FmÄ fJr KYKT“xJ

15

IJkjJr IkJPrvJPjr kPr FPTT\j FPTTnJPm k´KfKâ~J mqÜ TPr KT∂á FUJPj ßp uãe metjJ TrJ yP~PZ fJ xmJr ßnfPr y~Ç ßpoj, ßTJj ßTJj oKyuJrJ IkJPrvJPjr kPr IxM˙ ßmJi TPrÇ FaJ Imv TrJr kJvõtk´KfKâ~J FmÄ FaJ hMA KhPj ßTPa pJ~Ç (IJkKj pKh \JPjj ßp FqJPjP˙Kv~J IJkjJPT IxM˙ TPr ßh~ fJyPu KpKj FqJPjP˙Kv~J ßhj fJPT FaJ \JjJj pJPf TPr IKfKrÜ FqJPjP˙Kv~J k´KfPrJiL Hwi ßh~J y~Ç) mMT FmÄ mJÉr KjY kpt∂ K^ÅK^Å irJr IjMnëKf, \ôuMKj, Imv nJm IgmJ ÉÅu ßlJaJPjJ IjMnëKf k´J~vA y~ FmÄ fJ TP~T x¬Jy ßgPT oJx ImKi YuPf kJPrÇ TJaJ \J~VJaJPf aJj kzPf kJPr FmÄ mqJgJ gJTPf kJPrÇ F Im˙J pUj YPu fUj IJkjJr kPã msJ IgmJ Foj KTZM pJ CkPrr KhPT YJk ßh~ fJ krJ x÷m jJS yPf kJPrÇ FUJjTJr IjMnëKf IJP˜ IJP˜ TPo ßpPf gJTPu TJaJ kMPrJkMKr xJrJr IJV kpt∂ IJkjJr mMPTr IJTíKf láKaP~ ßfJuJr \jq FTaJ yJuTJ ßk´JxPgKxx (TíK©o ˜j) krPf kJPrjÇ IJkjJr ßp kJPv IkJPrvJj TrJ yP~PZ ßxA kJPvr mJÉ FmÄ TJÅi TP~T x¬JPyr \jq IJzÔ gJTPmÇ kMPrJkMKr jzJYzJ TrPf xJyJpq TrJr \jq ßmsˆ ßT~Jr jJxt, xJ\tj IgmJ KlK\SPgrJKkˆ IJkjJPT mqJ~Jo TrPf ßhPmjÇ ßxPr SbJr k´Kâ~Jr IÄv KyxJPm IJkKj mJzLPf YPu pJS~Jr kPr FaJ YuPf gJTPmÇ pKh FA mqJ~Jo TrJ TÓxJiq y~ fJyPu ßkAjKTuJr fJ ToJPf xJyJpq TrPf kJPrÇ pKh IJkjJr ßrKcSPgrJkL YuPf gJPT fJyPu Ijq ßTJj CkJP~ I∂f hMA mZr FA mqJ~Jo èPuJ TPr pJS~J \ÀrLÇ ßmsˆ TqJ¿Jr ßT~Jr ßgPT FéJrxJA\ IJlaJr ßmsˆ TqJ¿Jr jJPo FTaJ ßkJˆJr/mMTPua IJkKj kJPmjÇ

KuPœJKcoJ FKzP~ YuJ IJkjJr mJÉr KjPYr ßgPT KTZMaJ IgmJ kMPrJaJ Kuœ jJuL ßTPa mJh KhPu fJ IJkjJr KuPœKaT mqm˙J~ k´nJm rJUPf kJPrÇ Fr lPu \oJa ßmÅPi ßpPf kJPr FmÄ Fr lPu IJkjJr mJÉr KaxMqPf fru \oPf kJPrÇ FPT KuPœJKcoJ muJ y~Ç pKh IJkjJr xm Kuœ ßTPa ßluJ y~ fJyPu FA KuPœJKcoJr IJvÄTJ ßmPz pJ~Ç mVPur fuJ~ ßrKcSPgrJkLr lPu FTA k´nJm ßhUJ ßpPf kJPrÇ

16

˜j TqJ¿Jr Kj„ke FmÄ fJr KYKT“xJ

ßpKhPT IkJPrvJj TrJ yP~PZ ßxKhPTr yJf IgmJ mJÉ pKh láPu pJ~, fJ pf ToA ßyJT jJ ßTj fJyPu fJzJfJKz fJ IJkjJr KmPvwù IgmJ ßmsˆ ßT~Jr jJxtPT \JjJjÇ FaJ KYKT“xJr TP~T oJx FojKT mZrUJKjT kPrS ßhUJ KhPf kJPrÇ KTZM kNmt xfTtfJoNuT mqm˙J V´yPer oJiqPo KuPœJKcoJr IJvÄTJ ToJPjJ ßpPf kJPr ßpoj, ßpKhPT IkJPrvJj yP~PZ ßxKhPTr yJf S mJÉ jJ YMuTJPjJ FmÄ ßTPa ßpj jJ pJ~ ßxKhPT uãq rJUJr oJiqPoÇ

TíK©o Iñ mJZJA TrJ IJkjJr ˜j pKh kMjrJ~ ‰frL TrJ jJ y~ fJyPu IJkKj FTaJ TíK©o Iñ krJr TgJ nJmPf kJPrjÇ FjFAYFx F IJkKj ßTJj k´TJr mJzKf aJTJ jJ KhP~A FTaJ ˙J~L IgmJ I˙J~L TíK©o Iñ kJS~Jr IiLTJr rJPUjÇ IJkjJr ßmsˆ ßT~Jr jJxt IgmJ yJxkJfJPur FqJkäJP~¿ IKlxJr IJkjJr \jq fJ IJKjP~ KhPf FmÄ kKrP~ KhPf kJPrjÇ yJxkJfJPu pKh xLKof xŒh gJPT fJyPu IJkjJr VJP~r rÄ Fr xJPg Kou ßrPU mÉ irPjr TíK©o Iñ mJZJA TrJr \jq KmKnjú xrmrJyTJrLPT TqJaJuV kJbJPf kJPrjÇ

˜j TqJ¿JPrr IjqJjq KYKT“xJ IkJPrvJPjr kPr IJkjJr IJPrJ KYKT“xJr hrTJr yPf kJPrÇ Fr ßnfPr IJPZ ßrKcSPgrJkL, ßTPoJPgrJkL FmÄ yrPoJj ßgrJkLÇ IJkjJr KmPvwù Fxm KYKT“xJr FTaJ IgmJ xmèPuJ IJkjJPT ßj~Jr krJovt KhPf kJPrjÇ

ßrKcSPgrJkL FPãP© IkJPrvJPjr kPr KaCoJPrr \J~VJr IJPvkJPv ßTJj TqJ¿Jr ßTJw gJTPu ßxaJ ±Äx TrJr \jq I· oJ©J~ ßf\KÙ~ mqmyJr TrJ y~Ç

˜j TqJ¿Jr Kj„ke FmÄ fJr KYKT“xJ

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ßTj ßpPTJj irPjr IJÄKvT oqJxPaTaKo TrJr kPr ßxA FTA ˜Pj TqJ¿Jr ßpj IJr KlPr IJxPf jJ kJPr ßxaJ mº TrJr \jq xJiJref oqJxPaTaKo TrJ y~Ç FTaJ oqJxPaTaKo TrJr kPr TUjS IJPrJ FTaJ oqJxPaTaKo TrJ y~Ç mVPur KTZM Kuœ V´∫L IJâJ∂ yPu IgmJ ßTPa mJh KhPu ßxUJPj FaJ ßh~J y~Ç pKh xm Kuœ V´∫L ßTPa mJh ßh~J y~ fJyPu FaJ IJr mVPu ßh~J y~ jJÇ

TUj IJkjJr IkJPrvJj yS~Jr TP~T x¬Jy kPr KYKT“xJ ÊÀ y~, FxoP~r ßnfPr IJkjJPT xJ\tJKr ßgPT ßxPr SbJr xo~ ßh~J y~Ç KYKT“xJr kKrT·jJr ßnfPr kJgtTq ßhUJ pJ~ KT∂á xJiJref Kfj ßgPT Z~ x¬Jy iPr x¬JPy kJÅY Khj ßrKcSPgrJkLr \jq IJkjJPT k´KfKhj yJxkJfJPu ßpPf yPmÇ FqJkP~≤Po≤ ßpj mJh jJ pJ~ ßxKhPT uãq rJUJ èÀfôkNet, KT∂á pKh IJkjJr ßTJj kJKrmJKrT hJK~fô IgmJ TJ\ gJPT fJyPu IJkKj IJkjJr xo~ xMPpJV IjMpJ~L xoP~r \jq IJPmhj TrPf kJPrjÇ

KT WPa IJkjJr ßrKcSPgrJkL ÊÀ yS~Jr IJPV ßrKcSPgrJkLˆ IJkjJPT KYKT“xJ mqJUqJ TPr KhPmj, KfKj IJkjJPT muPmj ßp ßTj IJkjJPT FaJ ßh~J yPò, KTnJPm FaJ TrJ yPm FmÄ IJkjJr KYKT“xJr xo~xNYL ßToj yPmÇ fUj IJkjJPT KTZMãe KxoMPuaJr ACKjPa gJTPf yPm, FUJPj ßrKcSV´JlJr IJkjJr TfaáTá \J~VJ \MPz KYKT“xJ TrJ yPm fJr oJk KjPmj FmÄ Fr kJPv hJV KhPmj pJPf TPr k´KfmJr ßxA FTA \J~VJ~ KYKT“xJ TrJ y~Ç FA hJVèPuJ KYr˙J~L j~ KT∂á IJkjJr KYKT“xJ YuJTJuLj xoP~ xfTt gJTáj ßpj FaJ ÊTjJ gJPT pJPf TPr FaJ oMPZ jJ pJ~Ç Fr KmT· KyxJPm FA \J~VJaJPf KYr˙J~L KkjKk´T aqJaá FÅPT ßh~J pJ~Ç

˝· ßo~JhL kJvõt-k´KfKâ~J xmJA FPT IPjqr ßgPT IJuJhJ, KT∂á ßrKcSPgrJkLr xJiJre KTZM kJvõtk´KfKâ~J yPuJ YJozJ~ k´KfKâ~J, ßpoj YMuTJKj, \ôuMKj FmÄ xNPptr fJPk kMPz pJS~Jr IjMnëKfÇ IJkjJr kJvõt-k´KfKâ~J IjMpJ~L ßTJj irPer pfú KjPf yPm ßx KmwP~ ßrKcSPgrJkL TotL IJkjJPT krJovt KhPmjÇ

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˜j TqJ¿Jr Kj„ke FmÄ fJr KYKT“xJ

KYKT“xJr ßvPwr KhPT IJkKj oJrJ®T hNmtu IjMnm TrPf kJPrjÇ TîJK∂r FA kJvõt-k´KfKâ~J IPjPTrA yP~ gJPT FmÄ FaJ TP~T oJx iPr YuPf kJPrÇ fJA FaJPT xy\nJPm ßoPj Kjj FmÄ ˝JnJKmT \LmjpJ©J YJKuP~ pJjÇ

hLWt ßo~JhL kJvõt-k´KfKâ~J hLWt ßo~JPh ßTJj oKyuJr KuPœJKcoJ yPf kJPr (F KmwP~ FA mMTPuPar k´gPo CPuäU TrJ yP~PZ)Ç KaxMq, ˚J~M IgmJ yJPz ßf\KÙ~fJr TJrPj IjqJjq xoxqJèPuJ IJPrJ IPjT mZr kPr ßhUJ ßpPf kJPr, pKhS IJiMKjT KYKT“xJ mqm˙J~ FirPer Kmw~èPuJ UMmA To ßhUJ pJ~Ç

ßTPoJPgrJkL ßTPoJPgrJkLr oJiqPo KmKnjú irPjr TqJ¿Jr k´KfPrJiL Hwi mqmyJr TPr kMPrJ vrLPrr KYKT“xJ TrJ y~ pJPf TPr TqJ¿JPrr ßTJwèPuJ ±Äx yP~ pJ~ FmÄ FA TqJ¿JPrr ßTJwèPuJ KaCoJPrr \J~VJ ßgPT rPÜ KVP~ KovPf jJ kJPrÇ FA HwièPuJ vrLPrr iojLPf AP†TvJPjr oJiqPo, iJrJmJKyT AjKlCvJj (ßlJÅaJr oJiqPo) IgmJ aqJmPuPar oJiqPo ßh~J y~Ç

ßTj KmKnjú KmwP~r CkPr Kjntr TPr IJkjJPT ßTPoJPgrJkL ßh~J yPf kJPr ßpoj, KaCoJr irPer FmÄ ßxaJ Tf mz FmÄ IJkjJr Kuœ ßTJwèKu Fr xJPg \Kzf KTjJÇ

TUj xJ\tJKrr kPr KT∂á ßrKcSPgrJkLr IJPV IJkjJPT ßTPoJPgrJkL ßh~J yPf kJPr, pKhS FaJ TUjS CPfiJ yPf kJPrÇ ßTJj ßTJj ßãP© FaJ CPfiJ TrJS y~Ç KTZM KTZM ßãP© xJ\tJKrr IJPV oKyuJPhr ßTPoJPgrJkL ßh~J y~ ßpj fJ mz KaCoJrPT ßZJa TPr ßlPu, IgmJ pKh ßhUJ pJ~ ßp KaCoJr UMm hs∆f mJzPZ fJyPu ßTPoJPgrJkL ßh~J y~Ç

KT WPa IJkJjJPT xJiJrjf FT\j KmPvwù ßTPoJPgrJkL jJPxtr ÆJrJ IJCaPkPv≤ KyxJPm ßTPoJPgrJkL ßhS~J yPmÇ ßTJj FTaJ KjKhtÓ xo~ iPr IJkjJPT CkPr mKetf ßTJj FTaJ CkJP~ Hwi ßUPf ßh~J yPmÇ ˜j TqJ¿Jr Kj„ke FmÄ fJr KYKT“xJ

19

kJvõt k´KfKâ~JxoNy ßTJj ßTJj oKyuJPhr ßnfPr ßTPoJPgrJkLr TJrPj KTZM kJvõt k´KfKâ~J ßhUJ pJ~ KT∂á IjqPhr ßnfPr FaJ IJPrJ ßmvL ßhUJ pJ~Ç HwPir KmKnjú kJvõt k´KfKâ~J IJPZ FmÄ FTA oJPkr Hwi KmKnjú oKyuJPhr ßnfPr KmKnjú oJ©J~ k´nJm rJUPf kJPrÇ oMPUr ßnfPr IJuxJr, IxM˙PmJi TrJ, mKo TrJ FmÄ YMu kPz pJS~J yPuJ UMmA xJiJrj KTZM kJvõt k´KfKâ~JÇ FA kJvõt k´KfKâ~JèPuJr ßTJj ßTJjKaPT ToJPjJ ßpPf kJPrÇ ßpoj, FA IxM˙fJ FmÄ mKo nJm ToJPjJr \jq IJkjJPT Hwi ßh~J yPf kJPrÇ IJkjJr KYKT“xJ YuJTJuLj xoP~ YMu kzJ ToJPjJ \jq IJkjJPT FTaJ ßTJfl TqJk krJr k´˜Jm ßh~J yPf kJPrÇ (ßTJfl TqJk YMPur ßVJzJ~ rPÜr k´mJy TKoP~ ßh~, pJr Igt yPuJ YMPur ßVJzJ~ HwPir k´mJyS TPo pJ~)Ç ßTPoJPgrJkL xM˙ rÜ ßTJwPT k´nJKmf TrPf kJPr, Fr lPu IJkjJr ãf FmÄ FqJKjKo~J (I· xÄUqT rÜ TKjTJ) yPf kJPrÇ FTJrPj k´KfmJr KYKT“xJr IJPV FTmJr TPr IJkjJr rÜ krLãJ TrJ yPmÇ IJkjJr KmPvwù IgmJ ßTPoJPgrJKkˆ jJxtPT ßTJj kJvõt k´KfKâ~J x’Pº muMj, FPf TPr fJrJ IJkjJPT ßhS~J Hwi kKrmftj TPr KhPf kJPrÇ

yrPoJj ßgrJkL yrPoJj yPuJ ˝JnJKmT FTaJ Kmw~ pJ vrLPrr xM˙ ßTJwèPuJr TJptâo FmÄ mOK≠PT Kj~πe TPrÇ IKiTJÄv ˜j TqJ¿Jr oKyuJPhr yrPoJj APˆsJP\Pjr CkPr k´nJm rJPU, FA APˆsJP\j ˜j TqJ¿JPrr ßTJPwr mOK≠Pf xyJ~fJ TPrÇ FèPuJPT muJ y~ APˆsJP\j V´yjTJrL kK\Kan KaCoJrÇ APˆsJP\j V´yjTJrL kK\Kan ˜j TqJ¿JPrr KYKT“xJ TrJr \jq TP~TaJ yrPoJj HwiPT mqmyJr TrJ y~Ç IJkjJr KaCoJr pKh APˆsJP\j xÄPmhjvLu jJ yP~ gJPT (APˆsJP\j V´yjTJrL ßjPVKan) fJyPu yrPoJj ßgrJkL xJiJref TJ\ TPr jJÇ

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˜j TqJ¿Jr Kj„ke FmÄ fJr KYKT“xJ

kJvõt k´KfKâ~JxoNy yrPoJj KYKT“xJr kPr IPjT oKyuJPhr kJvõt k´KfKâ~J ßhUJ ßh~Ç Fr ßnfPr IJPZ ßoPjJkxJu uãe ßpoj Vro nJk uJVJ, S\j mJzJ, ßpJjL kg KhP~ xsJm yS~J, oPjJxÄPpJV jJ TrPf kJrJ FmÄ ßTJj Kmw~ Kj~πPe jJ IJjPf kJrJr IjMnëKfÇ IJkKj pKh kJvõt k´KfKâ~JxoNPyr TJrPj yrPoJj KYKT“xJ mº TrPf YJj fJyPu FA Im˙J k´gPo IJkjJr cJÜJr FmÄ IJkjJr ßmsˆ ßT~Jr jJPxtr xJPg IJPuJYjJ TÀj TJre Foj IjqJjq Hwi gJTPf kJPr pJ IJkjJr xJPg nJPuJ oJjJPmÇ

FAYIJrKa FmÄ ˜j TqJ¿Jr KTZM oKyuJ IJPZ pJPhr TqJ¿Jr irJ kzJr kPr ßoPjJkxJu uãe ßhUJ ßh~, fJPhr ßnfPr IPjPT yrPoJj KrPkäxPo≤ ßgrJkL (FAYIJrKa) ßjjÇ VPmwjJ~ ßhUJ pJ~ ßp FAYIJrKa ßjS~Jr lPu ˜j TqJ¿JPrr ^áÅKT xJoJjq ßmPz pJ~, ˜j TqJ¿Jr IJPZ Foj TJCPT FAYIJrKa ßjS~J mº TPr ßhS~Jr krJovt ßhS~J y~Ç IJkjJr ßnfPr ßoPjJkxJu uãe ßpoj Vro nJk uJVPf kJPr TJrj IJkKj y~PfJ FAYIJrKa ßjS~J mº TPr KhP~PZj IgmJ FaJ IJkjJr KYKT“xJr lPu WaPZÇ oPj rJUPmj ßp ßmsˆ ßT~Jr jJxt IgmJ K\Kkr xJPg TgJ muPu IgmJ ßmsˆ TqJ¿Jr ßT~JPrr ßy· uJAPj ßlJj TrPu Foj K\Kjx \JjPf kJrPmj pJ IJkjJPT xJyJpq TrPf kJPrÇ

˜j TqJ¿Jr Kj„ke FmÄ fJr KYKT“xJ

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VPmweJr \jq IjMKÔf jfáj krLãJ-KjrLãJ VPmwTrJ ˜j TqJ¿JPrr KYKT“xJ CjúKfr \jq FTaJjJ ßYÓJ TPr pJPòjÇ F TJrPj IJkjJPT KTîKjTqJu asJ~JPu (VPmweJr \jq IjMKÔf jfáj krLãJKjrLãJPf) IÄv KjPf muJ yPf kJPrÇ ßTJj FTaJ KmPvw Im˙Jr ßxrJ KYKT“xJ ßmr TrJr \jq FA KTîKjTqJu asJ~JPur VPmweJ TrJ y~Ç FaJ ßTJj jfáj HwPir krLãJ TrJ IgmJ Ijq ßTJj KYKT“xJ ßpoj Ijq irPjr xJ\tJKr, Knjú oJ©Jr ßrKcSPgrJkL FmÄ KYKT“xJr ßnfPr kJgtTq ßmr TrJr \jq TrJ y~Ç IJkjJPT CkpMÜ ùJe FmÄ IJkjJr xÿKf ZJzJ IJkjJr ßTJj k´TJr KYKT“xJ ÊÀ TrJ yPm jJÇ Fr oJPj yPuJ FA KYKT“xJr CP¨vq IJkjJPT ßmJ^JPjJ yPm, ßTj IJkjJPT FA KYKT“xJ TrJ yPm fJ \JjJPjJ yPm FmÄ IJkjJPT \JjJPjJ yPm ßp FaJr lPu IJkjJr KT yPmÇ IJkjJPT KuKUf IJTJPr kMPrJ fgq \JjJPjJ yPm FmÄ kptJ¬ xo~ IJkjJPT ßh~J yPm pJPf TPr IJkKj KmT· KjP~ IJPuJYjJ TrPf kJPrjÇ IJkjJPT pKh ßTJj FTaJ KYKT“xJ k≠Kfr \jq oPjJKjf TrJ y~ FmÄ IJkKj fJ V´yPe I˝LTJr TPrj fJyPu FaJ oPj TPr n~ kJPmj jJ mJ IjMPvJYjJ TrPmj jJ ßp IJkjJr cJÜJrrJ IJkjJPT KnjúnJPm KYKT“xJ TrPmÇ IJkKj IJPVr oPfJA pfú FmÄ KYKT“xJ kJPmjÇ Kx≠J∂ kMPrJkMKr IJkjJr CkPr Kjntr TPrÇ

Fr xJPg IJjMxKñT ßgrJkLxoNy Fr xJPg IJjMxKñT ßgrJkLxoNPyr ßnfPr IJPZ KmKnjú irPjr k≠Kf pJ xJiJrj KYKT“xJr xJPg k´P~JV TrJ y~Ç FA ßgrJkLxoNy oOhM FmÄ k´JTíKfT FmÄ FèPuJ vJKrKrT FmÄ oj˜JKfôT CkTJPr IJPxÇ FèPuJ TqJ¿JPrr ßrJVLPhr fJPhr \LmPjr CkPr IJPrJ ßmvL Kj~πe KjP~ IJxPf xJyJpq TPrÇ FqJPrJoJPgrJkL, Kv~J“xM FmÄ IjqJjq irPer yJuTJ oqJxJ\ UMm IJrJohJ~T yPf kJPrÇ k´JgtjJ FmÄ ßoKcPavJj IJPmVVf TÓ ßgPT Kj˜Jr ßkPf xJyJpq TPrÇ IxM˙fJ, mqJgJ FmÄ ßajvJj ToJPjJr \jq IJTákJÄYJPrr xJyJpq ßj~J ßpPf kJPrÇ IJ~MPmtKhT Hwi ˝J˙q nJPuJ TrPf xJyJpq TPrÇ FèPuJ ßTJj ßTJj ßgrJkL yrPoJj ßgrJkLr TJrPj xOÓ oPjJkxJu xoxqJr xoJiJPj xJyJpq TrPf kJPrÇ 22

˜j TqJ¿Jr Kj„ke FmÄ fJr KYKT“xJ

F KmwP~ IJPrJ fgq \JjJ FKv~Jj TKoCKjKar \jq ßxmJxoNy KmPvwnJPm FKv~Jj TKoCKjKar \jq xJrJ ßhv\MPz ßk´JP\Ö IJPZÇ IJkjJr FuJTJr ßTJj ßxmJ x’Pº \JjJr \jq IJkjJr ßmsˆ ßT~Jr jJxtPT K\ùJxJ TÀj IgmJ ßmsˆ TqJ¿Jr ßT~Jrx& ßy·uJAPj 0808 800 6000 j’Pr ßlJj TÀj (vsmj k´KfmºLPhr \jq ßaéa&PlJj j’r yPuJ 0808 800 6001)Ç

k´P~J\jL~ KbTJjJxoNy TqJ¿Jr KmFKxACKk (CancerBACUP) 3 Bath Place Rivington Street London EC2A 3JR

IKlx: 020 7696 9003 TqJ¿JPrr mqJkJPr mJÄuJ~ fgq FmÄ krJovt kJS~Jr lsLPlJj ßy· uJAj: 0808 800 0131

l∑LPlJj ßy·uJAj (ßpPTJj nJwJ~ TqJ¿Jr KmwP~ fgq): 0808 800 1234 (ßxJo ßgPT ÊâmJr, xTJu 9 aJ ßgPT xºqJ 7 aJ) APoAu: [email protected] SP~mxJAa: www.cancerbacup.org.uk TqJ¿Jr KmFKxACKk yPuJ TqJ¿Jr IJâJ∂ mqKÜPhr fgq S xyJ~fJ k´hJPjr \jq FTKa k´iJj xÄVbjÇ FA ßxmJr ßnfPr IJPZ ßy·uJAj, FPhr ßnfPr IJPZ TqJ¿Jr fPgqr CkPr KmPvwù jJxt, FTaJ SP~mxJAa, TqJ¿Jr fPgqr CkPr mMTPua FmÄ FuJTJr fgq ßTªsÇ TqJ¿Jr KmFKxACKk Fr xm ßxmJ TqJ¿Jr IJâJ∂ ßuJTPhr \jq KmjJoNPuq ßh~J y~Ç

˜j TqJ¿Jr Kj„ke FmÄ fJr KYKT“xJ

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oqJTKouJj TqJ¿Jr KrKul (Macmillan Cancer Relief) 89 Albert Embankment London SE1 7UQ

ßaKuPlJj: 020 7840 7840 oqJTKouJj TqJ¿JruJAj: 0808 808 2020 ßaéa&PlJj: 0808 808 0121 APoAu: [email protected] SP~mxJAa www.macmillan.org.uk oqJTKouJj TqJ¿Jr KrKul ßxxm ßuJTPhr xJyJpq TPr IJxPZ pJrJ TqJ¿Jr KjP~ ßmPÅY IJPZ FmÄ pJPhr UMm TPr mJ˜KmT FmÄ IJPmVVf xJyJpq hrTJrÇ KmPvwù ßxmJr ßnfPr IJPZ oqJTKouJj jJxt FmÄ cJÜJr, TqJ¿Jr ßTªs, KmKnjú irPjr TqJ¿Jr fgq FmÄ xrJxrL IJKgtT xJyJpqÇ hqJ oqJTKouJj TqJ¿Jr uJAj fgq FmÄ IJPmVVf xJyJpq KhP~ gJPTÇ ßaéa&PlJj TrJ pJ~Ç

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˜j TqJ¿Jr Kj„ke FmÄ fJr KYKT“xJ

ßTªsL~ IKlx ßmsˆ TqJ¿Jr ßT~Jr (Breast Cancer Care) Kiln House 210 New Kings Road London SW6 4NZ ßaKuPlJj 020 7384 2984 lqJé 020 7384 3387 APoAu [email protected]

ßTªsxoNy ßmsˆ TqJ¿Jr ßT~Jr ÛauqJ¥ ßaKuPlJj 0141 221 2244 APoAu [email protected] ßmsˆ TqJ¿Jr ßT~Jr KxoÀ ßaKuPlJj 029 2023 4070 APoAu [email protected] ßmsˆ TqJ¿Jr ßT~Jr jgt FqJ¥ KocuqJ¥x& ßaKuPlJj 0114 276 0296 APoAu [email protected] ßmsˆ TqJ¿Jr ßT~Jr u¥j FqJ¥ xJCg ßaKuPlJj 020 7566 5880 APoAu [email protected] xTu irPer ˜j TqJ¿Jr IgmJ ˜Pjr ˝J˙q x’Pº \JjPf yPu 0808 800 6000 j’Pr IJoJPhr \JfL~ ßy·uJAPj ßlJj TÀj (ßaéa&PlJj 0808 800 6001) IgmJ IJoJPhr SP~mxJAa kKrhvtj TÀj www.breastcancercare.org.uk.

ßmsˆ TqJ¿Jr ßT~Jr fJPhr ßrJVLPhr KmjJoNPuq ßxmJ ßhS~Jr \jq \jVe ßgPT kJS~J IjMhJPjr CkPr Kjntr TPrÇ IJkKj pKh ßTJj aJTJ KhPf YJj fJyPu IjMV´y TPr IJkjJr ßYT FA KbTJjJ~ kJbJj: Breast Cancer Care, Freepost Lon 644, London SW6 4BR. IgmJ IjuJAPj IJoJPhr KjrJkh xJAPar oJiqPo IjMhJj KhPf kJPrj: www.breastcancercare.org.uk.

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INFORMATION

• SUPPORT

Diagnosing and treating breast cancer

BENGALI

Diagnosing and treating breast cancer

Contents Introduction

2

Part one – Referral to a breast clinic

Part two – Treating breast cancer Introduction

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After diagnosis

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Breast clinic appointment

3

Types of breast cancer

What to expect

3

Further tests

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Mammogram

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Discussing treatment options

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Ultrasound scan

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Questions you may want to ask

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The treatment team

11

Standard treatment for breast cancer

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Fine needle aspiration cytology (FNAC) and core biopsy

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Further tests

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Getting your results

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Surgery Additional treatments for breast cancer

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12 17

Radiotherapy

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Chemotherapy

19

Hormone therapy

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Clinical trials

22

Complementary therapies

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Finding out more

23

Services for Asian communities

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Useful addresses

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Diagnosing and treating breast cancer

1

Introduction In the UK, breast cancer affects a significant number of Asian women and a small number of Asian men. This booklet is about diagnosing and treating breast cancer. It is divided into two main parts. The information in the first part is for anyone who has been referred to see a specialist at a breast clinic. It tells you what to expect at the clinic and talks about the different tests you may have. You may be feeling very worried and anxious at this stage. We hope the booklet and the CD that goes with it will give you enough information to be able to talk to your GP or breast specialist about any questions or concerns you may have. The second part of the booklet and CD describes the range of treatments you may be offered if you have been diagnosed with breast cancer. We hope the information in this part will enable you to discuss your treatment fully with your doctors, and be aware of some of the side effects that may occur. Although we refer to ‘women’ throughout the booklet, most of the information applies also to men who have been diagnosed with the disease.

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Diagnosing and treating breast cancer

Part one Referral to a breast clinic Breast clinic appointment Once your GP refers you to a breast clinic you can expect to wait between two and ten weeks for an appointment. (Waiting times will vary depending on where you live.) If your GP feels the referral is urgent you will be seen within two weeks of her/him sending the referral letter. Even if you are referred urgently, it is important to remember that the problem may still turn out not to be breast cancer. You may also be referred to the breast clinic if a problem has been picked up on a routine mammogram (breast x-ray) that you have had as part of the NHS breast screening programme. In this case you will be sent a letter asking you to attend your local breast clinic for further tests.

What to expect A doctor or specialist nurse experienced in diagnosing and treating breast problems will see you first. The breast clinic staff may not all be female but they are all experienced in dealing with breast conditions and will do their best to ensure your privacy and dignity. If you have difficulty understanding English, the breast clinic staff may be able to book an interpreter for you. The doctor/nurse will ask you about your symptoms. You may be asked to fill in a short questionnaire with questions

Diagnosing and treating breast cancer

3

about any family history of breast problems and any medication you are taking. This will be followed by a breast examination. The doctor/nurse will check both your breasts while you are sitting and when you are lying down. After checking your breasts, s/he will usually examine the lymph glands in your armpits. You may then need to have further tests. These will usually include a mammogram and/or an ultrasound scan followed by fine needle aspiration cytology (FNAC) and/or core biopsy. (See below for more information about these tests.) The breast examination, mammogram/ultrasound and FNAC/core biopsy are known as triple assessment. Sometimes all these tests can be done on your first visit with the results available later that day. This is known as a one-stop clinic. In some hospitals this isn’t possible and you may have to make another appointment for further tests or to get your results. You may have to wait for about a week for your test results. This will vary with each breast clinic.

Mammogram A mammogram is a breast x-ray. The radiographer (expert in taking breast x-rays) will ask you to undress to the waist and stand in front of the mammography machine. She or he will then rest each breast in turn between two x-ray plates so that it is compressed and flattened. Two images of each breast will be taken so that it can be seen from two different angles. Some women may find this uncomfortable or even painful, but it only lasts a few seconds. Mammograms are usually only done on women over the age of 35, as younger women’s breast tissue is generally too dense to produce a good image.

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Diagnosing and treating breast cancer

Ultrasound scan An ultrasound scan uses high-frequency sound waves to produce an image of the breast. You will be asked to lie on a couch with your arm above your head. Some gel will be spread on your breast and a scanning probe will be moved around it. This is the same technique used to look at babies in the womb during pregnancy. An ultrasound scan is painless and only takes a few minutes to do. This is more suitable for women under the age of 35. Regardless of age, sometimes an ultrasound scan may be done as well as a mammogram when there is an area on the x-ray that needs to be looked at more closely.

Fine needle aspiration cytology (FNAC) and core biopsy If a lump or an abnormal area is found a sample will be taken. This can be a fine needle aspiration (FNAC) or a core biopsy. Both these tests can be done with or without using ultrasound for guidance.

FNAC FNAC is where cells are drawn off using a fine needle and syringe. The sample is then sent to the laboratory where it is looked at under a microscope. The specialist will use the result to help her/him decide what further tests or treatment are needed.

Core biopsy A core biopsy uses a larger needle to obtain a sample of tissue. The specialist may take several samples at the same time. The tissue samples are sent to the laboratory where they are looked at under the microscope to confirm a diagnosis.

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You will be given a local anaesthetic to numb the area. Once this wears off you will probably find that your breast aches and it may also be bruised. You may need to take painkillers if the area is tender or painful.

Further tests A triple assessment is usually all that is needed to make a diagnosis but sometimes you may need further tests. You can call Breast Cancer Care’s helpline (using an interpreter if you like) to find out more about any tests you may be having.

Getting your results It may be a good idea to have another adult with you when you get your results. That way you can be sure of support if you need it. If your results show that you have cancer you may feel all sorts of emotions such as fear, anger and helplessness, and you may find it hard to take in what you are being told. Having someone with you who can listen carefully or ask questions can be very helpful. You will also be put in contact with a breast care nurse who will talk to you about your diagnosis and treatment. Information can help you understand what is happening. As well as reading this booklet or listening to the CD that goes with it, you might find it helpful to call Breast Cancer Care’s helpline and talk in your own language to a nurse or a volunteer who has had breast cancer.

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Part two Treating breast cancer Introduction Breast cancer is not one single disease. There are several types of breast cancer. It can be found at different stages of development and can grow at different rates. But having breast cancer doesn’t automatically mean that you are going to die. It is difficult to predict what course the disease will take and what treatment you will have. Factors such as your age and your general health will all be considered by your specialists when they are working out the best treatment for you. The ‘best treatment’ may involve surgery, radiotherapy, chemotherapy or hormone therapy, either given alone or in any combination or order. You will see that we refer throughout the booklet to ‘your doctors’. This is because it is recommended that breast cancer treatment is carried out by different specialists who work together as a team (see page 11). So it is important that your GP refers you to a specialist breast unit from the start. If your local hospital doesn’t have such a complete team of specialists you can ask to be referred to a specialist breast unit elsewhere. Most hospitals have a breast care nurse who is a very important member of the team of specialists. There should be opportunities for you to discuss your treatment options with the breast care nurse or your doctors, and to raise any issues or concerns. If you need an interpreter the hospital should provide one. Or you can take along a family member or Diagnosing and treating breast cancer

7

friend to translate for you. You can also ring our free helpline to get up-to-date information and support from our specially trained nurses, using an interpreter if you want to talk in your own language. They won’t tell you what to do, but they will help you consider your options and suggest questions you may want to take back to your doctors. Similarly, after treatment, our helpline nurses and volunteers are there to discuss any concerns you may have.

After diagnosis Before your doctors discuss your treatment with you, they will need to know as much as possible about the tumour to help them decide the best treatment options for you.

Types of breast cancer There are two main types of breast cancer – non-invasive cancer and invasive cancer.

Non-invasive cancer This means there are cancer cells in your breast tissue that are growing and dividing abnormally. They are only in the breast ducts (milk ducts) in the breast and have not spread either within or outside the breast. Some doctors may describe it to you as a non-invasive (non-spreading) cancer while others may call it a pre-cancerous condition.

Invasive cancer This is what is generally meant by the term ‘breast cancer’. With invasive cancer, the cells are no longer confined to the breast ducts. They are growing elsewhere in the breast and have the potential to spread to other parts of the body. This potential for spread is measured by looking at the cells under

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Diagnosing and treating breast cancer

a microscope. This is known as grading. When cancer cells spread to other parts of the body the disease becomes more serious. This is known as secondary breast cancer.

Further tests Further tests may be done to find out more about your particular cancer and to help make sure you get the most suitable treatment. One of the most important is called a hormone receptor test. This test is now routinely carried out on the cancer cells following surgery. It is done to find out whether a cancer is sensitive to oestrogen and progesterone (female hormones) in the body. If the test result is positive it means that hormone therapy may be particularly helpful in preventing the cancer coming back. (Hormone therapy is explained on page 20.)

Discussing treatment options Once your doctors have all the information together they will consider the best treatment for you. This is the point where you can decide how much, or how little, involvement you want. Everyone is different. Some women want to know everything they can about their disease and expect to be fully involved in making decisions about their treatment. Others may want to be well informed about what is going on but are happy to leave the treatment choices to their doctors. Some may want to know as little as possible and leave all the decisions to the specialists. Whatever you decide, you don’t have to be rushed into treatment. A few extra days to think about what you really want, and a chance to discuss your options with your husband, family, friends or GP will make no difference to the progress of the disease.

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Questions you may want to ask You will probably have some questions and you should feel free to ask for as much information as you feel you need. Questions might include: • Why is this the best treatment for me? • Are there any other options? • What are the possible side effects? • Are there any long-term implications for me? Your specialist team will be able to explain anything you don’t understand. Breast Cancer Care’s helpline staff can also talk to you about your proposed treatment, using an interpreter who speaks your own language if you wish. They may be able to provide you with more information or put you in touch with a Breast Cancer Care volunteer who speaks your language and has had breast cancer. You don’t have to accept the advice you are offered, but remember that the treatment recommended to you is the best option in the opinion of the treatment team. Think about it carefully and talk it over with other people if you feel this would help. Take as much time as you need before making a decision.

Asking for a second opinion You can ask for a second opinion at any stage and this shouldn’t be a problem. You can either ask your GP or your current specialist to refer you to another consultant. It is important to remember that the second opinion may not be different from the one you have already had. The time taken to get a second opinion should make no difference to the outcome of your treatment.

Declining treatment Some women may consider not having any treatment. This may be because they think the treatment will do them no

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Diagnosing and treating breast cancer

good or that it will seriously affect their quality of life, or they may simply be scared. Even if you think you don’t want to accept one, or all, of the treatments being offered, do consider the alternatives carefully before making a final decision. Breast Cancer Care’s helpline staff can discuss your options and refer you to other organisations and sources of information and help.

The treatment team The specialist team in a breast unit will usually include the following health professionals: • consultant surgeon • consultant medical oncologist (cancer specialist) • consultant clinical oncologist (radiotherapy specialist) • consultant radiologist (specialist in diagnosing disease through x-rays and scans) • breast care nurse • chemotherapy nurse • consultant histopathologist/cytologist (specialist in analysing laboratory tests) • diagnostic radiographer (specialist in x-rays and scanning) • therapy radiographer (specialist in giving radiotherapy treatment). You will see several members of the specialist team at different times during your treatment. Other professionals outside the team may also be brought in if needed, such as psychologists, plastic surgeons, physiotherapists and pharmacists.

Diagnosing and treating breast cancer

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Standard treatment for breast cancer Surgery Surgery is usually the first treatment for most women with breast cancer. In some cases chemotherapy or hormone therapy may be offered first to shrink the tumour so that surgery can be less extensive, or even avoided altogether. Such cases might include fast-growing tumours or where surgery would mean removing the whole breast and a woman feels very strongly about keeping her breast if at all possible.

Types of operation There are two main types: • a partial mastectomy. This can range from lumpectomy or wide local excision (where the tumour is removed with a small amount of surrounding tissue) to quadrantectomy (where approximately a quarter of the breast is removed). • a total mastectomy, where all breast tissue is removed, including the nipple. This can either be simple mastectomy, which removes the breast tissue alone, or modified radical mastectomy where the whole breast is removed, and, occasionally, one of the small muscles on the chest wall. For invasive cancer it is recommended that some or all of the lymph nodes (glands) in the armpit are removed.

Checking the lymph nodes (glands) It is important for your doctors to find out whether the cancer has spread to the lymph nodes in your armpit because this will influence your further treatment. The number of lymph nodes removed will vary depending on the practice of your surgeon. 12

Diagnosing and treating breast cancer

Wide local excision

Simple mastectomy

Quadrantectomy

Modified radical mastectomy

Diagnosing and treating breast cancer

13

Timing of operation An ongoing study is looking at whether it may be better for pre-menopausal women to be operated on in the second half of their menstrual cycle when their oestrogen levels are lower. (Your menstrual cycle begins on the first day of your period.) As yet, the evidence is not clear and it will be several years before the results of this study are known.

Which operation? One of the first big decisions you may have to make may be the type of operation you have. Some women will be offered a choice between breast conserving surgery (removal of part of the breast) or a mastectomy. More than half of early stage breast cancers can now be treated by breast conserving surgery, usually followed by radiotherapy. Studies show that long-term survival is the same for breast conserving surgery as for mastectomy. This is a time when you may find it helpful to talk to your breast care nurse about the impact of your choice on your personal life. The type of partial mastectomy you have will be based on the type of cancer, the size of the tumour, where it is in the breast and how much surrounding tissue needs to be removed. It will also depend on how large your breasts are. The surgeon will want to give you the best cosmetic result possible as well as the most effective surgery. That means conserving as much as possible of your breast without increasing the risk of the cancer coming back. There are times when the surgeon will have good reasons for recommending the removal of the whole breast. Total mastectomy can be the better option when: • the tumour is in the centre of the breast or directly behind the nipple • the breast is small and would be distorted by a partial mastectomy

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Diagnosing and treating breast cancer

• there are several cancerous or pre-cancerous areas in the breast • the woman would rather have the whole breast removed.

Surgery for non-invasive cancer There is evidence that non-invasive cancer can develop over a period of years into invasive cancer, which is more serious. If non-invasive cancer is treated with a mastectomy the chances of complete cure are very high and recurrence is rare. This used to mean that it was always treated by mastectomy. Doctors now have a better understanding of non-invasive cancer, which means that mastectomy is not always necessary. In most cases a wide local excision followed by radiotherapy is sufficient treatment.

Reconstruction The aim of breast reconstruction is to make a breast that looks and feels as much like the natural breast as possible. If you are going to have a mastectomy you should be offered a breast reconstruction at the same time. This will depend partly on the type of breast cancer you have and any future treatment you may need. If you prefer to wait a while and see how you feel after surgery, then tell your specialist. It is quite common for women to decide later that they would like to have a reconstruction. Others find that they become used to living without a breast and eventually decide against a reconstruction. Reconstruction is major surgery and should be considered carefully. There are different types of reconstructive surgery and many issues to consider. You can discuss the details with the surgeon who is going to do the operation and ask to see photographs of the operations she or he has done. You might like to talk it over with your breast care nurse or ask to meet a woman who has had the same type of reconstruction.

Diagnosing and treating breast cancer

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After your surgery Everyone reacts differently but the symptoms described here are very common. For instance, some women feel sick after their operation. This is due to the anaesthetic and should pass within a day or two. (If you know anaesthetics make you sick tell the anaesthetist first as extra anti-sickness drugs can be given.) Pins and needles, burning, numbness or darting sensations in the chest area and down the arm on the operated side are quite common and can go on for weeks or even months. The scar may feel tight and tender. While this lasts you may not be able to wear a bra or anything that puts pressure on the area. As it becomes less sensitive you may choose to wear a lightweight prosthesis (an artificial breast) to help restore your shape until your scar heals completely. Your arm and shoulder on the operated side are likely to feel stiff and sore for some weeks. Your breast care nurse, surgeon or physiotherapist will give you exercises to help you regain full movement. This is part of the healing process which you should continue after you go home. If doing the exercises is painful, painkillers may help. If you have radiotherapy it is important to continue these exercises in a modified form, probably for at least two years. You can also get a poster/booklet from Breast Cancer Care called Exercises after breast surgery.

Avoiding lymphoedema Surgery to remove some or all of the lymph nodes under your arm may affect your lymphatic system. It can cause a blockage that results in a build up of fluid in the tissue of your arm. This is called lymphoedema. The risk of lymphoedema is greater if you have all your lymph nodes removed. Having radiotherapy to the armpit can have a similar effect.

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If you notice any swelling of the hand or arm on the affected side, tell your specialist or breast care nurse as soon as possible, however trivial it may seem at the time. This can happen months, or even years, after treatment. You may reduce your risk of developing lymphoedema by taking some precautions, such as avoiding scratching or cutting your hand and arm on the affected side.

Choosing a prosthesis If you don’t have a reconstruction you may want to wear a prosthesis. On the NHS you are entitled to both a temporary and a permanent prosthesis without having to pay for them. Your breast care nurse or the hospital’s appliance officer can fit you and order the one you choose. If the hospital has a limited choice, you can find out about the full range of prostheses, including ones matching your skin colour, by sending for catalogues from different suppliers.

Additional treatments for breast cancer You may need further treatment after your surgery. This may include radiotherapy, chemotherapy and hormone therapy. Your specialist may advise you to have one or all of these treatments.

Radiotherapy This uses radiation in small doses to destroy cancer cells that may remain in and around the site of the tumour after surgery.

Diagnosing and treating breast cancer

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Why Radiotherapy is usually recommended after any type of partial mastectomy to reduce the risk of the cancer coming back in the same breast. It is also sometimes given after a mastectomy. It may be given to the armpit if some lymph glands have been removed and are affected. It will not usually be given to the armpit if all the lymph glands have been removed.

When Your treatment will usually start a few weeks after your operation, giving you time to recover from your surgery. Treatment plans vary but generally you will have to go to the hospital for radiotherapy each day, usually five days a week for three to six weeks. It is important not to miss your appointments but you can ask for a time that suits you, for example if you have family commitments or are working.

What happens Before your radiotherapy begins the radiotherapist will explain the treatment, why you are having it, how it will be done and what your treatment schedule will be. You will then spend some time in a simulator unit where the radiographer will measure the area to be treated and draw lines around it so that exactly the same area is treated each time. These lines are not permanent, but try to keep the skin in that area dry during the period of your treatment to avoid smudging them. Alternatively the area might be marked with a permanent pinprick tattoo.

Short-term side effects Everyone is different, but a common side effect of radiotherapy is a skin reaction: itching, soreness and a feeling rather like sunburn. The radiotherapy staff will advise you on how to take care of your skin according to the type of reaction you have. 18

Diagnosing and treating breast cancer

You may feel extremely tired towards the end of the course of treatment. This feeling of fatigue is common and can last for months, so be kind to yourself and try to ease up on your commitments.

Long-term side effects In the long term, some women may develop lymphoedema (which was mentioned earlier in the booklet). Other problems can appear years later because of radiation damage to the tissues, nerves or bones, although with modern treatment this is rare.

Chemotherapy Chemotherapy treats the whole body with a combination of anti-cancer drugs to destroy cancer cells that may have spread from the tumour site into the bloodstream. The drugs may be given by injection into a vein, by continuous infusion (a drip) or by tablet.

Why Chemotherapy may be offered to you depending on different factors, for example the type and size of tumour and whether your lymph nodes are involved.

When You are most likely to be given chemotherapy after your surgery but before radiotherapy, although sometimes it may be the other way round. In some cases, women may be given chemotherapy before surgery to try and shrink large tumours, or if the tumour seems to be growing very fast.

What happens You will usually be given chemotherapy by a specialist chemotherapy nurse as an outpatient. You receive a course of drugs by one of the methods described above every three or four weeks for a specified period. Diagnosing and treating breast cancer

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Side effects Some women have few side effects from chemotherapy while others may not be so fortunate. Drugs have different effects and the same dosage and combination can affect women quite differently. Mouth ulcers, feeling sick, vomiting and hair loss are some of the more common side effects. Some of these side effects can be minimised. For instance, you can be given drugs to control the sickness and vomiting. You may be offered a ‘cold cap’ to wear before and during your treatment to help reduce hair loss. (A cold cap reduces the blood flow to the hair follicles, which means that the amount of drugs that reaches the hair follicles is also reduced.) Chemotherapy can affect the healthy blood cells, making you more prone to infections and anaemia (low red blood cells). This is why you will be given a blood test before each treatment. Tell your specialist or chemotherapy nurse about any side effects you have as they may be able to change your combination of drugs.

Hormone therapy Hormones are naturally occurring substances that control the growth and activity of normal cells in the body. Most breast cancers are sensitive to the female hormone oestrogen, which can promote the growth of breast cancer cells. These are called oestrogen receptor positive tumours. Several hormone drugs are used to treat oestrogen receptor positive breast cancer. If your tumour isn’t sensitive to oestrogen (oestrogen receptor negative) hormone therapy is not usually appropriate.

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Diagnosing and treating breast cancer

Side effects Many women have side effects from hormone treatment. These can include menopausal symptoms such as hot flushes, weight gain, vaginal discharge, inability to concentrate, and a general sense of not being on top of things. If you are tempted to stop hormone treatment because of side effects, discuss the situation first with your doctors and your breast care nurse, as there may be another drug that may suit you better.

HRT and breast cancer Some women will be going through the menopause when their cancer is diagnosed, and they may be taking hormone replacement therapy (HRT). As studies have shown that HRT slightly increases the risk of developing breast cancer, anyone diagnosed with breast cancer will be advised to stop HRT. You may have menopausal symptoms such as hot flushes either because you have stopped taking HRT or because of your treatment. Remember that there are things that can help and you can find out more by talking to your breast care nurse or GP or ringing Breast Cancer Care’s helpline.

Diagnosing and treating breast cancer

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Clinical trials Researchers are constantly trying to improve breast cancer treatments. This is why you may be asked to take part in a clinical trial. Clinical trials are studies to find out the best treatment for a particular condition. They may be to test new drugs or other treatments such as types of surgery, varying doses of radiotherapy and differences between treatments. You will not be entered into a trial without your knowledge and without giving your informed consent. This means fully understanding the purpose of the trial, why you are considered suitable for it and what it will mean for you. You should be given detailed written information and plenty of time to discuss your options. If you have been asked to take part in a trial and you decide not to, don’t feel guilty or worried that your doctors will treat you differently. You will continue to have treatment and care as before. The decision is entirely up to you.

Complementary therapies Complementary therapies include a wide range of approaches that can be used in addition to standard medical treatment. The therapies are mainly gentle and natural and their benefit can be psychological as well as physical. They can often help people with cancer feel more in control of their lives. For example, aromatherapy, shiatsu and other types of gentle massage can be very relaxing. Prayer or meditation may help you cope with emotional stress. Acupuncture can be used to ease sickness, pain and tension. Ayurvedic medicine can promote health and general well being. Some of these therapies can also help with menopausal symptoms caused by hormone therapy. 22

Diagnosing and treating breast cancer

Finding out more Services for Asian communities There are projects around the country specifically for Asian communities. For details of any services in your local area, ask your breast care nurse or call Breast Cancer Care’s helpline on 0808 800 6000 (textphone for deaf callers 0808 800 6001).

Useful addresses CancerBACUP 3 Bath Place Rivington Street London EC2A 3JR Office: 020 7696 9003 Freephone helpline for cancer information in Bengali: 0808 800 0131 Freephone helpline (for cancer information in any language): 0808 800 1234 (Mon-Fri, 9am-7pm) Email: [email protected] Website: www.cancerbacup.org.uk CancerBACUP is the leading national information and support charity for people affected by cancer. Services include a helpline, staffed by specialist cancer information nurses, a website, cancer information booklets and local information centres. All CancerBACUP services are free to people affected by cancer.

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Macmillan Cancer Relief 89 Albert Embankment London SE1 7UQ Telephone: 020 7840 7840 Macmillan CancerLine: 0808 808 2020 Textphone: 0808 808 0121 Email: [email protected] Website: www.macmillan.org.uk Macmillan Cancer Relief is helping people who are living with cancer through the provision of immediate practical and emotional support. Specialist services include Macmillan nurses and doctors, cancer centres, a range of cancer information and direct financial help. The Macmillan CancerLine provides information and emotional support. Textphone available.

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Diagnosing and treating breast cancer

Central Office Breast Cancer Care Kiln House 210 New Kings Road London SW6 4NZ Telephone 020 7384 2984 Fax 020 7384 3387 Email [email protected]

Centres Breast Cancer Care Scotland Telephone 0141 221 2244 Email [email protected] Breast Cancer Care Cymru Telephone 029 2023 4070 Email [email protected] Breast Cancer Care North & Midlands Telephone 0114 276 0296 Email [email protected] Breast Cancer Care London & South Telephone 020 7566 5880 Email [email protected]

For all breast cancer or breast health concerns, call our free, national helpline on 0808 800 6000 (textphone 0808 800 6001) or visit www.breastcancercare.org.uk.

Breast Cancer Care relies on donations from the public to provide its services free to clients. If you would like to make a donation, please send your cheque to: Breast Cancer Care, Freepost Lon 644, London SW6 4BR. Or donate online via our secure site at: www.breastcancercare.org.uk.

Breast Cancer Care is committed to equal opportunities and access for all. Registered charity no 1017658 Registered in England company no 2447182 Company limited by guarantee ISBN 1 870577 51 5 © Breast Cancer Care May 2004. All rights are reserved. No part of this publication may be reproduced, stored or transmitted, in any form or by any means, without the prior permission in writing of the publishers. Illustrations © Alexa Rutherford Design: SMD Design Bengali translation and typesetting: Newcom UK Ltd Print: Xxxxxxx Xxxxxxxx

Breast Cancer Care is the UK’s leading provider of information, practical assistance and emotional support for anyone affected by breast cancer. Every year we reach over 750,000 people with breast cancer or breast health concerns. All our services are free. If you have any breast cancer or breast health concerns you can talk to someone in English or in your own language by calling our helpline on 0808 800 6000 (textphone for deaf callers 0808 800 6001).