By Dr. Madhuri Sudhakar – Consultant – Surgical Oncology at Iswarya Hospital, OMR Chennai
Early detection, timely comprehensive treatment and breast health awareness can save lives. Breast cancer is one of the most common cancers affecting women worldwide and is a growing public health concern in India. 1 in 28 women are at a lifetime risk of developing breast cancer in India (incidence slightly higher in the urban areas). The incidence rate is 31.8 per one lac, mortality rate is 13.7 per one lac. But the reassuring fact is that awareness and access to appropriate treatment are the keys to good outcomes.
Who is at risk?
Breast cancer can affect women more than 40-50 years. Having a family history of breast cancer and having some genetic mutations can increase the risk. Post menopausal weight gain , alcohol and reproductive factors like early menarche, late menopause , not having children , not having breast fed are risk factors for breast cancer .
Recognise the warning signs
Knowing what is normal for your breasts can help you recognise changes that need attention. Important warning signs include:
● A new lump or thickening in the breast or armpit.
● A change in the size, shape or appearance of the breast and redness on the skin of the breast / dimpling
● A persistent sore, rash or skin change around the nipple/ nipple turning inward/ nipple discharge.
80% breast lumps are not cancerous. Nevertheless, a new or persistent change should never be ignored. Breast cancer mostly occur without pain, so waiting for pain to develop before seeking medical attention can delay diagnosis.
Early detection makes a difference
Breast awareness means becoming familiar with the usual appearance and feel of your breasts and noticing any unusual changes. Breast self-awareness is useful, but it does not replace medical examination or screening.
Women should approach a doctor when they have these changes and according to the age and clinical examination, they are recommended an ultrasound or a full field digital mammogram of the breasts with or without biopsy .
Mammography is the screening tool that can detect breast cancers even before they can be felt by the patient or the doctor. Screening is intended for people without symptoms. Every woman more than 40 years needs to have an annual screening mammogram. Women with a strong family history or a known inherited genetic mutation may need earlier than usual recommended screening.
Can breast cancer be prevented?
Not all breast cancers can be prevented, but certain lifestyle choices like maintaining a healthy body weight, regular physical activity, eating a balanced diet, avoiding tobacco and alcohol are steps towards better overall health and risk reduction.
Breast cancer treatment has advanced
A diagnosis of breast cancer can be frightening, but it is not a reason to lose hope. Once the diagnosis of breast cancer has been made, whole body PET CT scan is done to rule out spread elsewhere. Treatment decisions should be made after appropriate evaluation and discussion with a multidisciplinary team (depending on stage and hormone receptor status).
Treatment may include surgery, radiotherapy, chemotherapy, hormone therapy, targeted therapy and, in selected cases, immunotherapy. Not every patient requires every treatment.
Surgical options include Breast-conserving surgery, which removes the cancer while preserving much of the normal breast in suitable candidates. Mastectomy, the removal of the entire breast. Breast reconstruction may be an option for women undergoing mastectomy.
. Equally important are emotional support, rehabilitation, management of treatment-related effects and follow-up care. This Breast Cancer Awareness Month, let us replace silence with conversation, fear with knowledge, and delay with action. Every woman deserves the opportunity for early diagnosis, appropriate treatment and a life beyond cancer.
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