1. Stages of Breast Cancer: There are five stages of breast cancer, numbered 0 to IV. Stage 0: This is also known as carcinoma in situ, and it is the earliest stage of breast cancer. At this stage, the cancer cells are confined to the milk ducts and have not yet spread to surrounding tissue. Stage I: The cancer is still confined to the breast and has not spread to the lymph nodes or other parts of the body. The tumor is typically 2 centimeters or smaller in size. Stage II: The cancer has grown larger than 2 centimeters and may have spread to the lymph nodes under the arm. It may also be present in the breast tissue. Stage III: The cancer has spread to the surrounding tissue and may have invaded the chest wall and/or the skin of the breast. It may also be present in the lymph nodes in the neck or under the arm and the breast tissue. Stage IV: The cancer has spread to area outside the breast and the regional lymph nodes and has metastasized to distant sites. This is also known as metastatic breast cancer. It is important to note that the stage of cancer will help determine the appropriate treatment, and the stage of the cancer may change after diagnosis and treatment.   2. Treatment Modalities in BC There are several treatment modalities for breast cancer, which may be used alone or in combination depending on the stage and type of the cancer, as well as the patient's overall health. The main treatment options for breast cancer include: • Surgery: This is often the first line of treatment for breast cancer. Surgery options include lumpectomy (removal of the tumor and a small amount of surrounding tissue) or mastectomy (removal of the entire breast). • Radiation therapy: This uses high-energy X-rays to destroy cancer cells and shrink tumors. It may be used after surgery to reduce the risk of the cancer returning. • Chemotherapy: This uses drugs to kill cancer cells and shrink tumors. It may be used before or after surgery, or in combination with radiation therapy. • Hormonal therapy: This uses drugs that block the effects of hormones, such as estrogen and progesterone, on cancer cells. It is often used to treat cancers that are hormone-receptor-positive. • Targeted therapy: This uses drugs that target specific molecules on the surface of cancer cells to stop them from growing and spreading. • Immunotherapy: This uses drugs that help the immune system recognize and attack cancer cells. Other treatments that may be used in breast cancer include bone-directed therapy, if cancer has spread to the bones, and palliative care, which aims to improve quality of life and manage symptoms in advanced breast cancer. It is important to note that treatment plan should be individualized to patient's specific needs and tailored to the type and stage of cancer, as well as the patient's overall health and personal preferences.  3. Breast cancer risk factors: The exact causes of breast cancer are not fully understood, but certain risk factors have been identified that may increase a person's likelihood of developing the disease. • Genetics: A family history of breast cancer, particularly in a parent, sibling, or child, increases the risk of developing the disease. Inheriting certain genetic mutations, such as BRCA1 and BRCA2, also increases the risk of developing breast cancer. • Age: The risk of breast cancer increases as a woman gets older. • Hormones: Long-term exposure to certain hormones, such as estrogen, can increase the risk of breast cancer. Hormone replacement therapy (HRT) used during menopause, menstrual and reproductive history, such as starting menstruation at a young age or going through menopause at an older age, can also affect the risk. • Lifestyle factors: Certain lifestyle factors can also increase the risk of breast cancer, such as alcohol consumption, lack of physical activity, being overweight or obese, and exposure to environmental toxins. • Breast tissue: Women with dense breast tissue have a higher risk of developing breast cancer than those with less dense breast tissue. It is important to note that having one or more of these risk factors does not mean that a person will definitely develop breast cancer. Also, many women who develop breast cancer have no known risk factors. 4. Granulomatous Mastitis Granulomatous mastitis is a rare inflammatory condition of the breast that primarily affects women of childbearing age. It is characterized by the formation of granulomas, which are clusters of inflammatory cells, in the breast tissue. The exact cause of granulomatous mastitis is not well understood, but it is thought to be an immune response to an infection or injury. Symptoms of granulomatous mastitis can include breast pain, breast lumps or masses, breast tenderness, and skin thickening or dimpling. The breast may also appear swollen and red. Granulomatous mastitis is often mistaken for breast cancer, but it is a distinct condition with different treatment options. It can be diagnosed by a physical examination and a breast biopsy. Treatment for granulomatous mastitis typically involves the use of antibiotics, anti-inflammatory medication, and in some cases, surgery. The antibiotics are used to treat the underlying infection, if present, and to reduce inflammation. Surgery is used to remove the affected tissue and to confirm the diagnosis if it is not clear. It is important to note that granulomatous mastitis can be a chronic condition and may recur even after treatment. Close monitoring and follow-up care are important to ensure that the condition is properly managed. 5. Immunotherapy is a type of cancer treatment that uses the body's immune system to fight cancer cells. In breast cancer, immunotherapy can be used to help the immune system recognize and attack cancer cells. There are several types of immunotherapy that can be used in breast cancer, including: • Monoclonal antibodies: These are laboratory-made proteins that mimic the immune system's ability to fight off harmful invaders such as cancer cells. They can be used to target specific molecules on the surface of cancer cells, such as the protein HER2, which is found on the surface of some breast cancer cells. • Checkpoint inhibitors: These are drugs that block certain proteins on the surface of cancer cells that help them evade detection by the immune system. By blocking these proteins, checkpoint inhibitors can "unmask" the cancer cells and make them more visible to the immune system. • Cancer vaccines: These are treatments that help the immune system recognize and attack cancer cells by introducing a small piece of the cancer cell into the body. Immunotherapy is still considered a new treatment modality for breast cancer and is not yet widely used. However, it is being studied in clinical trials and may show promise as a treatment option for certain subtypes of breast cancer. It is important to note that immunotherapy is not suitable for all patients with breast cancer, and it may cause side effects such as fatigue, skin rash, and diarrhea. The decision to use immunotherapy in breast cancer treatment will depend on the stage of the cancer, the type of cancer and the patient's overall health.  6. How do we use indocyanine green or the Spy cam in surgery Indocyanine green (ICG) is a fluorescent dye that can be used in breast surgery to help identify and preserve the blood supply to the breast tissue. This can be particularly useful in breast-conserving surgery, such as a lumpectomy, where the goal is to remove the tumor while preserving as much of the healthy breast tissue as possible. During the surgery, ICG is injected into the breast tissue and then illuminated with a special light. The dye fluoresces when it comes into contact with blood, making it easier for the surgeon to identify and preserve the blood vessels that supply the breast tissue. This can help to reduce the risk of complications such as wound healing problems, and improve the cosmetic outcome of the surgery. ICG is also used in sentinel lymph node biopsy(SLNB) in breast cancer surgery, to help identify the lymph node(s) to which a tumor is most likely to spread. This can help to determine the stage of the cancer and guide the decision-making process for further treatment. It is important to note that ICG is considered safe and well-tolerated by most patients, and it is quickly eliminated from the body after the surgery. However, as with any medical procedure, there can be some risks and side effects associated with its use, and it should be used under the guidance of a qualified surgeon and a medical team. 7. Can breast implants cause cancer? Breast implants do not directly cause cancer. However, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare type of non-Hodgkin's lymphoma that has been linked to breast implants. This is a cancer that occurs in the scar tissue and fluid around the implant, rather than in the breast tissue itself. The risk of developing BIA-ALCL is very low, with an estimated incidence rate of 1 in 3, 000, 000 to 1 in 30, 000, 000 cases. The majority of cases are associated with textured implants, however, smooth implant also can be associated with the disease. It is important to note that breast cancer and BIA-ALCL are two distinct diseases. Women with breast implants should still follow recommended breast cancer screening guidelines, such as mammograms and breast exams, to detect any potential breast cancer. If you have breast implant and have any concern or symptoms such as swelling, lumps, or changes in the breast or armpit, it is important to consult with your surgeon or a qualified medical professional for assessment and investigation. 8. How does a chemoport work? A chemoport, also known as a "port-a-cath" or "port, " is a small device that is surgically implanted under the skin. It consists of a small plastic reservoir (the "port") and a thin catheter (tube) that is inserted into a large vein, typically in the chest. The port is typically placed under the skin on the chest, above the collarbone, or under the arm. The port is connected to the catheter, which is then threaded through a vein, usually the subclavian vein, and into the vena cava, which is the largest vein in the body, it is located near the heart. This allows the port to be connected directly to the bloodstream and provides easy access for the administration of chemotherapy and other medications. When it is time for treatment, a special needle is inserted through the skin and into the port. Medications are then administered through the port and into the bloodstream. The chemoport eliminates the need for repeated needle sticks and makes it more comfortable for patients to receive chemotherapy. It is important to note that the port may require flushing with heparin or other solutions to keep it open, and it must be checked regularly to make sure it is working properly and to prevent infection. Chemoport can be left in place for a period of time, and then removed after the treatment is completed.