InstItute of teachIng & ReseaRch In ayuRveda

(InstItute of natIonal ImpoRtance)

DEPARTMENT OF PHARMACOGNOSY

Compilation work
on
Modern view and Ayurvedic
Aspect of Breast Cancer

Guided by: Submitted by:

Dr. Jignesh Kevalia Sisodiya Sakshi

H.O.D. Pharmacognosy B.Pharm IV year 2022-23

I.T.R.A. Jamnagar
 InstItute of teachIng and ReseaRch In ayuRveda -
phaRmacy
(InstItute of natIonal ImpoRtance)
Ministry of Ayush, Government of India, New Delhi
A.K. Jamal Building, Guru Nanak Road, Jamnagar +91 0288 2555746
-www.itra.ac.in

ceRtIfIcate
This is to certify that
has satisfactorily completed the project work on the
Compilation work on modern view and Ayurvedic aspect of breast cancer
given by the Department of Pharmacognosy, Institute of Teaching
and Research In Ayurveda - Pharmacy, Jamnagar in B. Pharma Final
Year Course During the academic year 2021-2022.

Dr. Jignesh Kevalia Vaidya Joban Modha

H.O.D. Pharmacognosy. Deputy Director

BReast canceR
 AIM AND OBJECTIVES

o Abstract
o Introduction to cancer
o Worldwide health conditions
o Modern Physiology of Breast Cancer

 What is cancer
 Symptoms
 Stage

o Type of Cancer
o
o General Awareness to Breast Cancer
o Breast Anatomy
o Medicines Available in market for both Allopathy & Ayurveda

Ayurveda view of Breast Cancer (Arbuda)

o Introduction
o Definition
o Seat of Arbuda
o ARBUDA SWARUPA
o Development of Arbuda
o Nidana panchaka
o Samprapti of Arbuda
o Types of Arbuda
o Symptoms
o Diagnosis
o Ayurvedic concepts of chemotherapy
o Stana as per Ayurveda
o Stanya Arbuda
o Treatment
o Conclusion
o References
Abstract
Rigveda, an ancient Indian scripture compiled Five thousand year ago,
record the science of healing. A fatal Tumour in the throat is described in
Atharveda. Egyptians were first to realise that the tumour arise in different
part of the body, differ in their behaviour and therefore, should be treated in
different way. Cancer is the result of uncontrolled growth of abnormal cells
in the body caused by genetic and environmental factor. Modern lifestyle
changes, food choices genetic vulnerability, family history, oestrogen
exposure, age, late night working, hazardous chemical exposure, obesity in
the post-menopausal phase, exposure to high doses of radiation are some of
the main factors which increases the risk of breast cancer. Breast cancer is
the most frequent malignancy in women worldwide and is curable in ~70–
80% of patients with early-stage, non-metastatic disease. Advanced breast
cancer with distant organ metastases is considered incurable with currently
available therapies. It is the frequently diagnosed and leading cause of
cancer deaths in women in worldwide. This article presents a systematic
review of the Breast Cancer literature describing the risk factors, treatment
methods and preventive steps of breast cancer. Breast cancer treatment and
prevention are prominent issues in public health and medical practice. The
current approach to this disease involves early detection and treatment.
 Introduction to cancer
There is no universally accepted definition of cancer, but the one
enunciated by Willis, the famed British tumour pathologist, has become
universally popular. According to him, a tumour is an abnormal mass of
tissue, the growth of that exceeds and is uncoordinated with that of the
adjacent normal tissue and persists in the same excessive manner after
cessation of the stimuli that evoked the change initially, this definition
brings out three cardinal features of cancer:

A. That an abnormal mass of tissue is present and that the essential

component of a malignant tumour is made up of actively growing cells and
not of the supportive stroma or vascular network.
B. That the growth is in excess of and uncoordinated with normal tissue.
These attributes distinguish cancer from other proliferative processes such
as inflammation, repair and hyperplasia, which are orderly and coordinated.

The growth of a fertilised ovum into a child and of a new born child to an
adult is totally regulated. During life, epithelial surfaces (e.g. The
endometrium) and the haemopoietic cells are constantly being replenished,
when they age and die, through balanced growth by division of other cells.
In malignancy there is a loss of this normal phenomenon of apoptosis.
That such excessive growth persists, even after cessation of the initial
stimuli. This distinctive characteristic of cancer makes it such a formidable
disease.
 In 2020, there were 2.3 million women diagnosed with breast cancer and
685 000 deaths globally. As of the end of 2020, there were 7.8 million
women alive who were diagnosed with breast cancer in the past 5 years,
making it the world’s most prevalent cancer. There are more lost disability-
adjusted life years (DALYs) by women to breast cancer globally than any
other type of cancer. Breast cancer occurs in every country of the world in
women at any age after puberty but with Increasing rates in later life.

Breast cancer mortality changed little from the 1930s through to the
1970s. Improvements in survival began in the 1980s in countries with early
detection programmes combined with different modes of treatment to
eradicate invasive disease.
When genes work properly, they tell cells when it is the right time to grow
and divide. When cells divide, they make exact copies of themselves. One
cell divides into 2 identical cells, then 2 cells divide into 4, and so on. In
adults, cells normally grow and divide to make more cells only when the
body needs them, such as to replace aging or damaged cells. But cancer
cells are different. Cancer cells have gene mutations that turn the cell from
a normal cell into a cancer cell
evelopment of cancer cell

These gene mutations may be inherited, develop over time as we get

older and genes wear out, or develop if we are around something that
damages our genes, like cigarette smoke, alcohol or ultraviolet (UV) radiation
from the sun.

A cancer cell doesn’t act like a normal cell. It starts to grow and divide out of
control instead of dying when it should. They also don’t mature as much as
normal cells so they stay immature.

Although there are many different types of cancer, they all start because of
cells that are growing abnormally and out of control. Cancer can start in any
cell in the body, the second and final step in the development of cancer is
promotion. Agents that cause promotion, or promoters, may be substances in
the environment or even some medications, such as sex hormones (for
example, testosterone taken to improve sex drive and energy in older men).

Unlike carcinogens, promoters do not cause cancer by themselves. Instead,

promoters allow a cell that has undergone initiation to become cancerous.

Promotion has no effect on cells that have not undergone initiation. Some
carcinogens are sufficiently powerful to be able to cause cancer without the
need for promotion.
o For example, ionizing radiation (which is used in x-rays and is
produced in nuclear power plants and atomic bomb explosions) can cause
various cancers, particularly sarcomas, leukaemia, thyroid cancer, and breast
cancer.

Cancer can grow directly into (invade) surrounding tissue or spread to

tissues or organs, nearby or distant. Cancer can spread through the lymphatic
system. This type of spread is typical of carcinomas
o For example, breast cancer usually spreads first to the nearby
lymph nodes in the armpit, and only later does it spread to distant sites.
Cancer can also spread via the bloodstream. This type of spread is typical of
sarcomas.
Cause of cancer
pathological aspect of cancer
classIfIcatIon

Tumours can be classified on and aetiological, anatomical, functional,

histological or behavioural basis. Aetiological classification is impractical, as the
causes of most tumours are yet poorly understood.
The function of a tumour cell is possible but only for a limited number of
tumours particularly those of the endocrine organs, such as the insulinoma,
gastrinoma, etc.
Classification according to the behaviour of a tumour is into benign, borderline and
malignant; further a malignant lesion is classified into low grade, intermediate grade
and anaplastic (Grades I, II, III).
Such grading has therapeutic relevance and is incorporated into all modern
schemes of classification. The most satisfactory one is based on the histogenesis of
a tumour,

e.g. fibrosarcoma (from fibroblasts), rhabdomyosarcoma

(from skeletal muscle), dysgerminoma (from the germ cells), etc. This system of
classification has now been universally adopted.
 Symptoms

Symptoms of cancer depend on the type and location of cancer. For

example, lung cancer can cause. coughing, shortness of breath, or
chest pain. Colon cancer often causes diarrhoea, constipation and
blood. Some cancers may not have any symptoms at all. In certain
cancers, such as pancreatic cancer, symptoms often do not start until
the disease has reached an advanced stage.

 The following symptoms can occur with most cancer

 Chills
 Fatigue Fever
 Loss of appetite
 Malaise
 Night sweats
 Weight loss
 Thickening or lump in the body
 Cough or hoarseness that does not go away Obvious
change in a wart or mole Changes in bowel or bladder habits
 Unexplained bleeding or discharge Any sore that does not
heal
 Unusual upset stomach or difficulty Swallowing
Pre-clinical Symptoms
Type of cancer
 On the basis of tissue affected

 On the basis of organ effecte

 Colorectal cancer
 Lung Cancer
 Liver Cancer
 Stomach Cancer
 Cervical Cancer
 Bladder Cancer
 Esophageal Cancer
 Non-Hodgkin Lymphoma
 Cancers of the Lip and Oral Cavity
 Naso pharyngeal Cancer
 Kaposi Sarcoma
 Screening
Screening: The term screening refers to the regular use of certain examinations
or tests in people who do not have any symptoms of cancer, but are at high risk
for developing certain types of cancer. For many types of cancer, progress in the
area of cancer screening has offered promise for earlier detection, which often
results in higher cure rates.

 Types of Screening Tests:

 Imaging Tests
 Laboratory Tests
 Other Testing Information

 Imaging Tests:

 Mammograms: A fact sheet that defines screening and diagnostic

mammograms and outlines mammography screening guidelines. Discusses
the benefits and some potential harms of screening mammograms.
 Computed Tomography (CT): Questions and Answers: A fact sheet that
describes the CT scan procedure and technology and its uses in diagnosis
and treatment.

 Laboratory Tests

 Interpreting Laboratory Test Results: A fact sheet that describes the role of
screening and diagnostic laboratory tests. Includes a brief discussion of
factors affecting the results.

 Pap and HPV Testing: A fact sheet that describes cervical cancer screening,
which includes the Pap test and HPV testing. The fact sheet includes
information about cervical cancer screening guidelines.
 Prostate-Specific Antigen (PSA) Test: A fact sheet that describes the PSA
screening test for prostate cancer and explains the benefits and limitations
of the test.

 Other Testing Information

 Understanding Cancer Series: Gene Testing: This tutorial illustrates what

genes are, explains how mutations occur and are identified within genes
and discusses the benefits of gene testing for cancer.
Treatment

T
0
Breast

The breast is a modified sweat gland.

Each breast has 15 to 20 sections, called lobes. They are arranged like the
petals of a daisy.
Each lobe has many smaller structures called lobules. These end in dozens of
tiny bulbs that can produce milk. The lobes, lobules, and bulbs are all linked by
thin tubes called ducts.
These ducts lead to the nipple in the center of a dark area of skin called the
areola.
Fat fills the spaces between lobules and ducts.
There are no muscles in the breast, but muscles lie under each breast and cover
the ribs.
Each breast also contains blood vessels and vessels that carry lymph. The lymph
vessels lead to small bean-shaped organs called lymph nodes. These lymph nodes
are found in clusters under the arm, above the collarbone, and in the chest. They
are also in many other parts of the body.
Breast cancer

 What Is Breast
Cancer? .

Breast cancer is a type of cancer that starts in the breast. It can start in one or both
breasts. Breast cancer occurs almost entirely in women, but men can get breast
cancer, too.
It’s important to understand that most breast lumps are benign and not cancer
(malignant). Non-cancer breast tumourss are abnormal growths, but they do not
spread outside of the breast. They are not life threatening, but some types of
benign breast lumps can increase a woman's risk of getting breast cancer.

 Type of breast cancer

 Angiosarcoma
 Ductal carcinoma in situ (DCIS)
 Inflammatory breast cancer
 Invasive lobular carcinoma
 Lobular carcinoma in situ (LCIS)
 Male breast cancer
 Paget's disease of the breast
 Recurrent breast cancer
 WheRe BReast canceR staRt
Breast cancers can start from different parts of the breast. The breast is an
organ that sits on top of the upper ribs and chest muscles. There is a left
and right breast and each one has mainly glands, ducts, and fatty tissue.
In women, the breast makes and
delivers milk to feed new born and infants. The amount of fatty tissue in
the breast determines the size of each breast. The breast has different
parts:
 Lobules are the glands that make breast milk. Cancers that start here
are called lobular cancers.
 Ducts are small canals that come out from the lobules and carry the
milk to the nipple. This is the most common place for breast cancer
to start. Cancers that start here are called ductal cancers.
 The nipple is the opening in the skin of the breast where the ducts
come together and turn into larger ducts so the milk can leave the
breast. The nipple is surrounded by slightly darker thicker skin called
the areola. A less common type of breast cancer called Paget
disease of the breast can start in the nipple.
 The fat and connective tissue (stroma) surround the ducts and
lobules and help keep them in place. A less common type of breast
cancer called phyllodes tumours can start in the stroma.
 Blood vessels and lymph vessels are also found in each breast.
Angiosarcoma is a less common type of breast cancer that can start
in the lining of these vessels. The lymph system is described below.
 A small number of cancers start in other tissues in the breast. These
cancers are called sarcomas and lymphomas and are not really
thought of as breast cancers.
 hoW BReast canceR spReads
Breast cancer can spread when the cancer cells get into the blood or
lymph system and then are carried to other parts of the body.

The lymph (or lymphatic) system is a part of your body's immune system. It
is a network of lymph nodes (small, bean-sized glands), ducts or vessels,
and organs that work together to collect and carry clear lymph fluid through
the body tissues to the blood. The clear lymph fluid inside the lymph
vessels contains tissue by-products and waste material, as well as immune
system cells.

The lymph vessels carry lymph fluid away from the breast. In the case of
breast cancer, cancer cells can enter those lymph vessels and start to
grow in lymph nodes. Most of the lymph vessels of the breast drain into:

 Lymph nodes under the arm (axillary lymph nodes)

 Lymph nodes inside the chest near the breastbone (internal
mammary lymph nodes)
 Lymph nodes around the collar bone (supraclavicular [above the
collar bone] and infraclavicular [below the collar bone] lymph nodes)
If cancer cells have spread to your lymph nodes, there is a higher chance
that the cells could have travelled through the lymph system and spread
(metastasized) to other parts of your body. Still, not all women with cancer
cells in their lymph nodes develop metastases, and some women with no
cancer cells in their lymph nodes might develop metastases later.
Nipple changes
Breast and nipple changes can be a sign of breast cancer.
Signs and symptoms of breast cancer may include:

 A breast lump or thickening that feels different from the

surrounding tissue
 Change in the size, shape or appearance of a breast
 Changes to the skin over the breast, such as dimpling
 A newly inverted nipple
 Peeling, scaling, crusting or flaking of the pigmented area of skin
surrounding the nipple (areola) or breast skin
 Redness or pitting of the skin over your breast, like the skin of an
orange
0
 classIfIcatIon
 BENIGN BREAST DISEASE :
I) Aberrations of normal development and involution(ANDI):
Mostly with clinical mastalgia
II) Primary Non-Cyclical Mastalgia: Musculoskeletal.
Cervical root pain.
BI) Breast Lumps:
1. Cysts
2. Galactocele
3. Sclerosing Adenosis
4. Fat necrosis
5. Cyclical Nodularity.
6. Chronic Abscess.
7. Lipoma
IV) Benign Neoplasm [2] :
1. Fibroadenoma
2. Phyllodes tumour
3. Duct papilloma
V) Disorders of the nipples and periariolar region :
1. Nipple discharge and inversion.
2. Mammary fistula.
3. Duct ectasia/periductal mastitis.
4. Retraction.
5. Sepsis.
NON-NEOPLASTICLESIONS
I) Abnormalities of growth and development:
1. Ectopia: a) Supernumerary breast tissue
b) Aberrant breast tissue.
2. Macromastia.
3. Amastia and hypoplasia.
AI)Inflammatory and reactive lesions:
1. Breast abcess.
2. Sub-areiolar abcess.
3. Non-specific chronic mastitis:
a) Granulomatous lobular mastitis.
c) Fat necrosis.
d) Diabetic mastopathy.
4. Specific Mastitis:
a) Tuberculous mastitis.
b) Actinomycosis
c) Fungal infections.
d) Parasitic infections.
e) Viral mastitis.
f) Foreign body granulomas.
g) Sarcoidosis.
BENIGN NEOPLASM
1. Fibroadenoma.
2. Phyllodes tumour
3. Duct papilloma.
MALIGNANT NEOPLASMS OF THE BREAST:
1. Carcinoma
2. Sarcoma.

1.Carcinoma:
1) ductul carcinoma of breast
 ductul carcinoma in situ
 invasive ductul carcinoma
2) lobular carcinoma of the breast
2. sarcoma
3. mixed connective tissue and epithelial tumours
4.miscellaneous tumours
5.unclassified tumour
6.Tumours like lesion
 STAGES OF TUMOUR ] :
 Stage 1: Lump is 2 cm or smaller, no spread in
lymph nodes.
 Stage 2:

Stage 2 A: 1. Smaller than 2 cm, spread in lymph nodes or

Bigger than 2 cm and not spread to the lymph nodes.
Stage 2 B: 1. Lump is smaller than 5 cm,spread in lymph nodes.
Bigger than 5 cm, not spread to lymph
nodes
 Stage 3:
Stage 3 A: Lump can not be found in breast or less than 5 cm,
spread to lymph
nodes.
Stage 3 B: 1. Cancer has spread to tissue near breast.
2. Attached to skin or
muscles. Stage 3 C: 1.
Cancer spread to 10 cm
2. More lymph nodes are involved in armpit
3. Lymph nodes below or breast bone near neck.
 Stage 4:
1. Spread to the bones, liver, lungs.
3. Secondary or metastatic breast cancer.
 Tumour size
Tumours under 1 cm in diameter are unlikely to spread
systemically. Tumours are staged by size.0
0–5 mm T1a0
5–10 mm T1b0
10–20 mm T1c0
20-50mm T20
>50 mm T30
Tumours involves skin or chest wall T4
.
 Despite advancement in radiology or radiodiagnosis,
FANC holds its key important position. unlike excisional
biopsy. FANC is simple, fast, effective and widely used tool for
diagnosis in breast tumours.
A preoperative diagnosis offers several treatment
can be planned in advanced with the informed consent of the
patient. If cancer is conformed staging investigation (bone scan,
liver scan) can be done preoperatively.
Many benign conditions can be confidently diagnosed by
fine needle cytology combined with radiological imaging and
surgery can be avoided. hospital facilities can be more
economically used if the extent of surgery
is know beforehand.
The need for frozen section diagnosis is reduced. The
percentage of complete sensitivity of FNAC in the breast
cancer is 90-95% in most series. The aim should be a
sensitivity of number less than 95% and this can be achieved
with increasing experience. Sensitivity is lower for low grade
carcinoma (invasive and in situ), lobular carcinoma, and very
small and very large cancers.
The positive predictive value of a malignant diagnosis is
approximately 99%. But although rare occasional false positive
diagnosis of malignancy are recorded in most series. Skill and
experience are important in performing and in the preparation
and reading the smear.
Although the technique is simple, training and continuous
practice are essential to acquire and to maintain skill.
Significant accuracy occurs with experience. Soon breast
cancer will be the most prevalent malignancy in females, so
effectiveness and use of fine needle aspiration cytology of
breast will remain paramount in near future.
  Introduction
Arbuda is constituted of the root word“arbb” and the verb “udeti”. The meaning of
the “arbb” is to kill, to hurt, or to go towards and the meaning of the verb “udeti” is
to elevate, to rise, to through up

 DEFINITION OF ARBUDA
The definition of arbuda is that means at any part of the body when vitiated doshas
takes place by afflicting flesh it produce a swelling which is rounded, fixed, slightly
painful, big in size, broad based, slowly growing and not suppurate. It is deep
seated and takes place by mansa dushti and medodushti.

 SEAT OF ARBUDA:
The sixth fold or layer is called rohini, which is of equal thickness as a vrihi (grain),
and it is the seat of granthi, apachi, arbuda, slipada and galgand etc.

 Arbuda swarupa

अरुदोऽयंगााथद महगन भवथथ ।

The word Arbuda means an abnormal glandular growth within or of any bodily tissue
or organ. This word describes cells believed to have no natural function in the body.

The disease Arbuda was mentioned during the Vedic period.

In Atharvaveda, a reference to Arbuda and its management is mentioned. Acharya
Charaka, Sushruta, Vagbhata have clearly mentioned Hetu, Lakshana, and
Anekviddha Upkrama of Arbuda.
 According to Ayurveda, there are various disease entities that resemble new
growths. They are described under the headings of Shotha, Dushtavrana, Gulma
Kshudraroga. But for purpose of the malignant nature of the disease, the
description of Granthi and Arbuda come nearest to the cancer than any other
disease.
The derivation of the word arbuda generally means the disease which spreads
very abruptly The words Granthi, Arbuda, Gulma, and Ashtila etc.are the words
chosen for different abnormal growths "The Doshas being vitiated in any area of
the body and hurting the body tissues, cause a swelling which is round, fixed,
mildly uncomfortable, large in size, broad based, slowly developing, and does not
suppurate," says Aacharya Sushurta.” Although there is no precise definition of
cancer (Arbuda) in the Charaka Samhita, Acharya Charaka has classified it as a
Vata-Rakta complication. Acharya Vagbhata noted that Arbuda is relatively bigger
than Granthi.Shotha, Granthi, Arbuda, Apachi, Gulma, and Vidradhi have
comparable clinical manifestations of cancer.
 The ancient literature contains descriptions and identifications of malignant
disorders (tumours). There are various allusions to cancer in Ayurvedic writings.
Dwirarbuda refers to the spread of cancer from one portion of the body to another.
Arbuda is the most specific term for malignant cancer.
When it comes to tumour formation, Samprapti appears to be of Vata-Kapha
origin. Vata is responsible for incorrect cell division, whereas Kapha is responsible
for unregulated cell proliferation.
Kapha is most commonly associated with benign tumours. Pitta, on the other
hand, is vitiated in cancers, and the illness becomes Sannipatika in character as it
reaches the impacted Dhatus, Kapha plays a major role in Granthi. Medas, Mamsa,
and Rakta are the most commonly impacted Dhatus. Mamsa and Rakta may be
involved.
Arbuda's etiopathogenesis is based on Doshic hypothesis. Despite the fact that
vitiated "Doshas" are to blame for Arbuda's growth, practically all Ayurvedic books
place a premium on Kapha. Arbuda does not suppurate due to an excess of Kapha,
according to Sushruta, this is a common and crucial factor in any type of bodily
growth.
Various surgical conditions like cysts, lipoma, benign tumourss which are
characterized by swelling can be considered under the umbrella of Granthi. Based
on lakshana and chikitsa all cysts can be considered under Granthi but all Granthis
cannot be considered under Cysts.

Cancer originates due to metabolic changes.

Vata dosha is responsible for cell division. Aggravation of vata dosha and
suppression of kapha doshas or both the doshas
interacting with one another may result in proliferation of cells. However, the
Ekadesavriddhi (growth at a specific part) is a part of abnormal cell division
resulting in benign or malignant tumours.
According to our Samhita grantha vitiated dosa goes in raktadi and then obstruct
the way. Due to this obstruction and extra large growth called arbuda develops.
The term Nidan relates to both Etiology and diagnosis of the disease. The etiology
helps in ascertain the causative factors of a disease whereas , diagnosis helps in
the determination of the nature of the disease. But the former is of prime
importance since it deals with causative factors. As per the description avaible with
the texts, hetu or causes of arbuda can be classified into :
1. samanya hetu 2. visheshhetu.

 Samanya Hetu:
 Charak Samhita
Charakacharya has also mentioned the etiological factors, site, shape, dosha
and dushya of arbuda are the same as granthi. So that samanya hetu of
mansapradoshaj vikara and shoth can be considered as samanya hetu of
arbuda. Charakacharya has mentioned arbuda as mansapradoshaj vyadhi and
also a type of shoth according to following references.This means the disease
like arbuda, adhimans etc. which are similar where the characteristics of
growth is concerned and have got some other different signs, symptoms and
names, can be taken under the chapter of shoth. Acharya charak and vagbhat
included this disease under the heading of shopharog. Both these authors are
unanimous in their opinion that the etiological factors ,which are responsible
for shopha,are also responsible for arbuda.
 Sushrut samhita
Acharya sushruta while dealing with arbuda says that causative factors
andclinical features are same as granthi. Acharyas of laghutrai followed the
statement. In harit samhita it is mentioned that abhighataj (trauma) vrana, and
vayu are responsible for origin of arbuda as per references.

 Vishesh Hetu

The etiological factors mentioned for specific type of disease is called as

vishesh hetu. Acharya sushruta, vagbhat, madhav, bhavmishra etc. had
explained following vishesh hetu for mansaj arbua that ,when the body part is
inficted with blow of flesh etc,the vitiation of muscle takes place, and it gives
rise to growth which is swollen. As well as the characteristics he given, that the
growth is painless, glossy of the same colour, non-supputrating, stonelike
and immovable. This can be curable and found in those peoples whose
muscle is vitiated and who indulge in meat-eating.
Acharya sushruta, vagbhat, madhav, bhavprakash, yogratnakara, all acharyas
has mentioned very similar samanya samprapti means common pathogenesis
of arbuda. They states that, when aggravated doshas vitiate muscle and thus
produce found,firm,large,deep rooted,slowly developing ,non-suppurating and
swollen fleshy mass and this is known as arbuda.
 SAMPRAPTI GHATAK :
 Dosha : Predominance of kapha and vata with tridosha.
 Dushya : Mansa,meda,rakta.
 Strotas : Mansa,meda,rakta.
 Stroto-dushti : Siragranthi
 Agni : Agnimandya.
 Rog-marga : Bahya.
 Udabhav-sthana: Anywhere in the body.
 Adhisthana : Sixth layer of the skin means rohini.
 Pratyatmalinga: Mansopchaya and shoth.

 As per Haritsamhita:
Prakupit dosha enters in raktanadi and obstruct the way,due to this
obstruction an extra large growth called Arbuda develops. Stages of
samprapti with modern concept:

 SANCHAY: (LOCALISATION)
 PRAKOPA : (ACCELERATION)
 PRASARA : (SPREAD)
 STHANSANSHRYA : (EMOBILISATION)
 VYAKTI: (REACTION)
 BHEDA: (CHRONICITY)

Acharya Susruta has explained about six stages in the pathogenesis

of all diseases. They are
 Sanchaya, the early stages of localized neoplastic changes;
 Prakopa it transformation of primary growths into metastatic
tumours;
 Prasara is metastasis;
 Sthana samsraya is complete metastasis and secondary growth
 Vyakti is the clinical signs and symptoms observed.
 Bheda is the stage where differentiation of growth is
understood on the basis of histopatholog
The close study of ayurvedic literature reveals that all the acharyas were in
agreement to the fact that the disease arbuda is very much similar to granthi,
and shotha. so, this should be differentiated on the basis of clinical features.
some of them tabulated as :
 According to Dosha
1.Vataja 2. Pittaja 3. Kaphaja 4. Tridoshaja

 Dhatu According

 Pitta prevalence in Raktaja Arbuda

 Mamsaja Arbuda- sarcoma is classified as Mamsaja Arbuda due to
Vatika predominance.
 Medoja Arbuda (Fatty tissue) - However, there is a detailed
description available in which Asthi (Bone) is linked in creating
swelling in the same way that Arbuda is.

 SPECIAL VARIETIES OF ARBUDA:

 DWIR-ARBUDA:
 ADHYARBUDA
 SHARKARA-ARBUDA:
 As per chronicity of Arbuda:
Navyarbuda and Jeernarbuda:
Sushruta mentions the symptoms Vrittam, Sthiram, Mandrujam, Mahantama,
Unalpa-moolam, Chiravruddhi, and Apakam. These symptoms can be seen in
both benign and malignant stages of

cancer in the current day. The symptoms of a benign tumour grow slowly and do
not invade or spread. These are the well distinguishable. The classic symptoms
of benign growth are Vrittam (round), Sthiram (immovable), Manda ruja (slightly
uncomfortable), Mahant (large size), Unalpa-moolam(deep seated), Chirvruddhi
(slowly expanding), and Apakam (non-suppurating). Benign tumours have a low
proclivity for invading surrounding tissues. It's almost as though it's distinct from
the surrounding tissues. Sushruta mentioned Adhyarbuda and Dwirarbuda, two
types of Arbudas that can be linked to cancer's aggressive stage or metastasis.
Gatrapredeshe kvachit: Anywhere in the body or any tissue may be
damaged.
 Mansam-abhi-pradushyam : Predominantly it is the disease of
 mansa,that is damage of the muscular connective and
epithelialtissues.
 Vrittam-Sthiram: The growth is round and stony hard.
 Manda-rujam: Pain is not present except final stage.
 Mahantam: It is spread with deep route and so it is compared with
a sign of crab.
 Chir-vriddhi: It is chronic in nature and gradual in development.
 Apakam: Non-suppurative.
 Analp-mulam: The root is big in size, deep rooted.
  UPADRAVA
Sushruta mentioned pandu as Upadrava for Raktarbuda due to Raktasrava.
Adhyarbuda and Dwirarbuda also can be taken under Upadrava. This can be
correlated to the secondaries.

A secondary may develop at any site of the body after the primary has been
caused.Lakshana, Samprapti of Arbuda, and Granthi are similar; hence, the
treatment prescribed for Granthi should be followed here. As Arbuda is Included
among the vitiation of Mamsa and Medas,0 hence treatment is prescribed for
diseases due to vitiation of Mamsa (Shodhana, Shastra, Anushatra procedures)
and for the disease of Medas (Medohara/Atisthou lyahara)
should also be used. The treatment of Arbuda should be avarnagna, Amapachana,
dhatuposhana, Vyadhibalavirodhirasayana, arbudagna, panduhara. To date, three
major conventional therapies for cancer surgery, radiation therapy, and
chemotherapy Ayurvedic treatment

 Shodhana Chikitsa (strong purifying modalities)

which eliminates vitiated doshas, has been primarily used for medical management
of cancer. Botinternal and external purifications aregiven by five techniques known
colletivelyas Panchakarma Chikitsa

 Shamana Chikitsa (palliative treatment)

pacifies doshas and gradually relieves the disease. However, this treatment is
prescribed only to weaker patients, for whom shodhana chikitsa is contraindicated.
Because it is important to maintain the strength of the patient during the treatment
 Chemotherapic drugs can be considered asvisha dravya (toxins) as they are
cytotoxic and produce symptoms same as Garavisha. Theyare Ushna in virya ,
Tikshana, Laghu, Ruksha,Vishad, Vyavayi, Vikashi guna.
Most of the properties are opposite to Rasa, Rakta,Shukra dhatu, Ojus and
Prakrit Kapha.Ayurveda is exploring the treatment of malignancies by clinical
evidence through various research works.
Management of complication of chemotherapy can be wemanaged by the
principles & line of treatmentmentioned in Ayurveda. In Ayurveda these set of
medicines (chemotherapeutic Drugs) can be understood as Tikhsna Aushadhas
and their properties are almost similar to properties of visha (poison).
The drug which cures the disease and at the same time will not produce any
other disease or discomfort is uthamabheshaja (best medicine). So this review
illustrates the same concepts.Though from the lateral half of management of cancer,
one should escalate our self to the former half of the management of cancer.
Modern medicine also uses cytotoxic,chemotherapy, radiotherapy, and
surgicalremoval of tumourss, which are mainly shodhana (Purificatory) measures
and mainly kapha reducing Ayurvedic treatment of cancer is a holistic approach
and is currently preferred.
The new wave of ‘‘system biology’’ and ‘‘genome revolution’’ is expected to
provide a holistic approach to the treatment of cancer. In spite of it, this approach
tends to ignore the relationship between mind, body, and spirit.It is our hope that
Ayurveda can help fill this gap.
Shaman therapy involves Rasayana (Rejuvenative therapies), Poly herbal
formulations, Herbo-mineral/ herbo-metallictherapeutics, diet etc. Rasayana means
the way for attainin excellent rasa and other dhatus i.e. one attains longevity,
memory, intelligence, freedom from disorder, that are strengthening or restorative in
nature are used to balance and remove any debility in the patient caused by the
purification or cleansing.With the introduction of rasa shastra (the science of
Mineral/Metal processing [bhasmas]) many cancers were considered curable,
especially if they were treated in the earlystages.[ Rasoushadhis
[Herbometallic/herbo-mineral preparations] is one of the most promising area of
treating Cancer and occupied superior status among the Ayurvedic Chikitsa due to
their high therapeutic potency in eliminating dreadful diseases and also for
rejuvenation purpose.

Mamshajanam tu samshuddhi: shastra kshara agni karma cha ||

Surgical management in Ayurveda includes fomentation by means of external
application,cleansing by internal medication, opening the tumour surgically for
evacuation of its contents, cauterisation to avoid recurrence and post-operative care
for healing the wound Arbuda is excised completely from its deep root seat by
cauterisation to destroy any of the remaining cell particles by using herbal and
mineral medicines. Even agni karma, kshara sutra and jalukacharana have a great
role in managing a disease like cancer. In the unripe stage of granthi, a treatment
recommendes assame as that of shopha.

Different kinds of sweda (fomentation), upanaha (poultice), and lepa (pastes) were
recommended. Once the granhi got ripens it should be cut open and drained of
pus and the ulcer washed with the herbal decoctions and purified, followed by
kshara agni karma by heat or alkalis and medicated oil application.

There are seven Ashay in male, whereas in female there are another three
ashaya more than male. Out of these three ashay Stana are two of them.
According to the reference of Acharya Sharangdhara, this ashaya named
Stanyashaya is present in female.According to Sushrutacharya, there are
three another strotasa in female than in male.
Two stana that is breasts are from these strotasa. These are two in number.
There are ten number of peshi means, two strotas, two ashayas,
and two dhamnyas present as stana. Development of stana takes
place at adolescent age.
Shape of Stana: Kalashakruti.
Two parts of Stana: 1.Stanachuchuk
2.Krishna mandal.

 Stanasampat Lakshanas:
1. not much more to upper side (natiurdhvam)
2. not much elongated( natilambam )
3. not very much thin.(anatikrusha)
4.not very much big(anatipinau)
5. easy to suck for the baby (yukta-pippalakausukhprapanau)
The special references about “Stanarbuda” were not mentioned in ayurved
samhita literature. But references about arbuda were mentioned in bruhtrai as well
as in laghutrai.

1) Varna: In varna examination,the colour of skin over arbuda is considered.

1. In vataj arbuda the skin colour over arbuda becomes blackish
2. In pittaj arbuda the skin colour over arbuda becomes yellowish or inflamed.
3. In kaphaj arbuda and in mansaj arbuda there is no change in colur.
4. In medoj arbuda the skin over the arbuda becomes glossy or there is no change in
colour.

2) Sparsh: In sparsh examination palpation of stanarbuda is done and recorded.

1. In vataj stanarbuda, the feel of arbuda is like stretched bladder, but it is hard on
palpation.
2. In pittaj stanarbuda,the skin over arbuda is hot and inflamed.
3. In kaphaj stanarbuda, the feel is hard and cold.
4. In medoj stanarbuda,it is soft and diffuse.
5. In mansaj stanarbuda,it is hard like stone and fixed to skin.
6.In raktaj stanarbuda,it is having fleshy sprouts and hard but galloping.

3) Akruti: In Akruti examination, the size of tumours is considered.

1. Size of 0-1 cm is charted as ‘very small’.
2. Size of 1-4 cm is charted as ‘small to big’.
3. Size of 4- 10 cm is charted as ‘big’.
4. Size of above 10 cm is charted as very big.
5. In Vataj Stanarbud size of arbud is from ‘small to big’ to big.
6. In Pittaj Stanarbud rather than size of stanarbud, it’s inflammation and supparation
are cardinal signs.
7. In Kaphaj Stanarbud size is small to big.
8. In Medoj stanarbud size is big to very big , but there is cyclical variation in size.
9. In Mansaj Stanarbud size is small to big , but edges of stanarbud are irregular like
stone.
10.In Raktaj Stanarbud size is small to big but with irregular edges

4) Ruja:
1. In Vataj stanarbud, pain is intermittent, gives rise to various types of pain.
2. In Pittaj Stanarbud, pain is like burning type or pain as in inflammation.
3. In Kaphaj Stanarbud there is no pain or Alpa-Ruja.
4. In Medoj Stanarbud, there is little pain. It may increase or decrease with size.
5. In Mansaj Stanarbud there is no pain.
6. In Raktaj Stanarbud there are episodes of pain or pulsating pain.
5) Strav:
1. In vataj stanarbuda it may secrete acha-rakta means fresh blood when it
brusts.
2. In pittaj stanarbuda , when it supputares it discharges hot and vitiated blood.
3. In Kaphaj stanarbud it discharges pus like substance when it burst. In medoj
stanarbuda when it bursts it discharges ghee like substance. In mansaj
stanarbuda there is no discharge
4. In raktaj stanarbuda,when it bursts it discharges vitiated blood.

6) Vruddhi: Rate of growth is clearly mentioned about kaphaj, medoj, and raktaj
stanarbuda.
1. In kaphaj stanarbuda, the growth is slow.
2. In medoj stanarbuda, growth is also slow, but it increases and decreases.
3. In raktaj stanarbuda, it is mentioned is shighra or acute.By considering other
manifestations
4. it can be said that the pittaj stanarbuda, growth can be acute.
5. In mansaj stanarbuda growth is slow by taking account its other signs and
symptoms.
6. In vataj stanarbuda, its growth can be acute or chronic.

7) Shoph:
1. In vataj stanarbuda there is swelling.
2. In kaphaj and medoj stanarbuda there is little swelling.
3. In pittaj stanarbuda there is little swelling.
4. In mansaj stanarbuda there is no swelling.
5. In raktaj stanarbuda there is less swelling.

coRRelatIon of canceR acc. modeRn and

ayuRveda
 Kaphaj stanarbuda
patients found to be of fibroadenoma (fibroadenoma without any inflammatory signs)
were found to be of Benign Hyperplastic epithelial lesion. So we can correlate kaphaj
stanarbud with fibroadenoma (i.e. fibroadenoma without any inflammatory signs)
 Vataj stanarbuda :
Vataj arbuda were found to be of fibroadenoma with inflammatory signs and
symptoms. Based on this we can say that we can correlate Vataj Satanarbud with
fibroadenoma with inflammatory features.
 Mansaj and Raktaj Stanarbud :
Mansaj Stanarbud were found to be of Intraductal Carcinoma with Metastasis.
 Due to this disease, there is severe swelling in the breasts. Along with this, pale
blue veins emerge on the breast. The skin there becomes hard and black. There is
burning and stinging pain in the breast all the time. The pain of pain increases
excessively during the night. The folds of the breast turn outward.
Since this disease occurs gradually, therefore different symptoms keep on arising in
it according to time. To understand this disease from the point of view of
convenience, its 3 stages have been considered-
1. First stage - Mostly stanyaarbuda starts from the left breast. First, a part of the
stana becomes rakta varna with soth, in which there is pain. It is also observed
that sometimes the front of the stana is vikruta. At the same time it sinks
inwards. Gradually, the whole breast gets compressed and enters inside. At
the same time, it becomes like a body by being pulled from all sides.
Sometimes the front of the breast becomes red and swollen. And the whole
breast swells fiercely and becomes hard like a brick. Sometimes both the
breasts get affected simultaneously and the disease spreads everywhere like a
source This disease progresses slowly in child widows. In women with children
between the age of 40 to 50, both their breasts get strongly attacked
simultaneously. They become hard like a brick within 3 months. In older
widows, breast cancer grows slowly and is usually not fatal.
2. Second stage - If proper treatment is not done in the first stage, the patient's
pain increases due to hardening of the mammary gland. There is unbearable
pain in the breast once in 24 hours. At the time of pain, the affected breast
become red and it appears as if they are about to burst.
3. Tertiary stage In this stage, breast cancer erupts. After bursting, blood-mixed
pus keeps coming out of it. The secretion is more at night than during the day.
After some time all the flesh of the breast gets destroyed and a foul-smelling
wound is formed there. This wound soon spreads inside. Due to the decay of
the flesh inside the breast, the skin above the breast gets compressed and
starts entering inside. In such a condition, the patient becomes very weak. He
gets jvara from the third prahar, which remains till morning. The patient cannot
sleep at night. He becomes disinterested in food. Sometimes the patient starts
having foul-smelling loose stools. The patient has unbearable pain for 3-4
hours during the day. The side where there is cancer in the breast, there is
also swelling in the hands and feet of the same side
Medicine- The treatment of this disease is done by Radium. Breast cancer
surgery is done if there is no relief from this therapy. In this, the distorted cells of
the entire organ are cut and removed.

Along with this, blood purifying medicines are also used. Inject the powder of
Nitromin 5mg ampoule into the flesh by speaking. Or take 5 mg tablet 2-3 times
a day.
Ayurvedic Medicine - Swarnapanti is used in this disease.
120-240 mg twice a day with Trikuta and honey.

Gradually the quantity is increased up to 240 mg. Along with this, blood purifier
and laxative should be given to the patient.

Need For this, mix 120 mg of Arogyavardhini Vati, 120 mg of Rasmanikya, 120
mg of Pravalpanchamrit with honey
.
In the evening, give 5 grams Panchattikta Ghrita Guggul with warm milk.
 Use of the following yoga is very beneficial in breast cancer.

Sarveshwar Parpati 6gm

purified hartal 6gm
Swarna bhasma 6gm
Abhrak Bhasma Sahasraputi 6gm
Muktapishti 6gm
diamond ash (superior) 25mg
Pannapishti 3gm
Amrita satva 60gm
Note- This treatment is expensive but cancer located at any place of the body can
be cured by continuous use of this yoga. The following yoga is used in the first and
second stage of breast cancer

Hira bhasma 120mg

Swarna bhasma 1 1/2 gm
Rasa sindur(shadguna gandhak jarita) 3 gm
Rasakapur shodita 3 Gm
Tamra bhasma 12 gm
Safed mircha 18 gm
Launga 9 Gm
Abhrak bhasma(shastra puti) 48 mg
Pannapishti 18 mg

It is also called Kaisargajakesari Vati

Make a fine powder by grinding rasasindoor and rasakapur in kharal. After

that grind cloves and white pepper and filter. then 1-1 all drugs mix together
and triturate 1 day. After that give the bhavna of sheep's milk for 3 days.
Them make the tablet of 60 mg

Dosage and method of consumption

1-2 tablets 2-3 times a day.

By taking a pill Eat a lot of ghee in the mouth before eating. or filling the pill into
a capsule Swallow and drink the milk from above.
By consuming diet and milk, it can also be used in the third stage of cancer.
Experimentation is beneficial.
 vedna sthapak chIkItsa
Analgesic therapy Breast cancer patient has excruciating pain once in 24 hours for
at least 2-3 hours due to which she remains restless. For this make the following
arrangements-Tamraparpati - Take 120 to 360 mg with castor oil in the morning
and evening. If there is no benefit from this, then use the following vati-

Shuddha 200 gm
kuchla 50 gm
Saunth
50 gm
mitha visha
50 gm
Launga
50 gm
pipar Mula
50 gm
Rasaparpati
50 gm
Kalimircha
Ajwain 50 gm
pipel choti 50 gm

Grind all of them finely and triurate them in a mortar, after that dissolve 20 grams
of opium in water and make tablets of one gram.

Quantity- 1-2 tablets should be consumed daily. This relieves pain and leads to
sleep.

Use of ice is also good for pain relief. If ice is not available, a bandage of very cold
water should be applied. Keep changing the bandage when it gets hot.
Along with the above mentioned medical arrangements, the following
modak should also be consumed. It is also called Abhyadi Modak-
 50 grams of small harde
 50 grams of pure bhilava,
 50 grams of white sesame and
 50 grams of jaggery,
Except jaggery, first grind them all, then make 6-6 grams of modak by adding
jaggery. Consume 1-2 modaks after licking Yodha drink, after that lick Goghrit
again from above.

Swarna bhasma
Rajat bhasma rasayan (immuno modulator)
Loha bhasma
Bhallataka rashayan
Kanchnar guggul
Sankhia(white arsenic)-arbuda sotha
Sankh bhasma
Navsadar
Vanga bhasma soth,vrana
Mandur bhasma
Sphatika bhasma

Homeopathic medicine - Keep taking calcarea floor long before the eruption of
breast-vulva. This cures breast cancer without operation.

Naturopathy - Naturopathy has proved to be quite beneficial in the treatment of this

disease. In this, along with the use of gold foil, naturopathy, such as enema of
boiled neem leaves water, abdominal wrap, steam bath for 3-6 minutes before
bath and after that friction bath, etc. are used. For this a naturopathy cancer
specialist should be consulted.
 conclusIon

Cancer is a disease that difficult to adjudicate because of its usual

symptoms whereby people ignore and treat them normally. Most of
the time patients come to known when only they reach to 3rd or
final stages.
Breast cancer is the highest type of cancer in the world women
suffers in the current times. With precautions, healthy diet,
exercises and proper diagnosis time to time helps them to fight or
prevent with the diseases.
Ayurved not only plays the major role in terms of preventing arbud
but following its concepts including pathya – apathya, yoga, and
proper “Upachar” along with allopathy medicines the chances of
treating the breast cancer is impeccable.
 RefeRences: -
1. Kaviraj kunjlal Bhishgratna, 2002, Sushrutsamhita Nidansthana, 2nd
edition,11, publication Chaukhmba Sanskrit series office, page no.84-
90.
2. Kaviraj kunjlai bhishgratna, 2002, 2nd edition, Sushrutsamhita
sharirsthana,3/3,pub.chaukhmba series office,Varanasi,page.no.166-
169.
3. Shri Prayagdatta Sharma, 1988, Sharangdhar Samhita, Pratham
khand, 68-69,Arbuda Prakara Adhyaya, page no.86.
4. . Vaidya Laxmipati Shastri, 1983, Yogratnakara, 3rd edition, 12/1-4,
Adhyaya Galgand-gandmala-apachi-granthi-arbuda-nidan,page
no.146-156.
5. Shri Madhvkara with the Madhukosh Sanskrit commentary by
Vijayrakshita Madhavnidan, 2000, 13th edition,38/19.
6. . Pt. Shri Brahma Shankar mishra, Bhavprakash,by ShriBhavmishra
with Hindi commentary, 2005,9th edition,Chapter Galgand-
gandmala-granthi-arbuadhikar,44/8,Publication Chaukhamba
Bharati academy,Varanasi,page no.446-448.
7. Kaviraj kunjlal Bhishgratna, 2002, Sushrutsamhita Nidansthana, 2nd
edition,13, publication Chaukhmba Sanskrit series office, page no.84-
90.
8. Kaviraj Arridev, Gupta, Vidyalankar, Ashtang Hriday, Uttartantra,
29/16-17
9. Yadavji trikamji acharya, charaksamhita of agnivesha with ayurved
deepika, commentary by chakrapanidutta, 2007, pub.chaukhamba
Sanskrit sansthan, Varanasi
10. .ashtang Hriday Uttartantra,29/16-17, 4th edition Pub.
chaukhamba Sanskrit series office, varansi page no.556.
11. www.reserchgate.com
12. book of diagnosis and management of cancer
13. book of stree rog and prasruti vigyan
14. book of stree rog chikitsa
15. book of gay’s anatomy