Breast Cancer

It was predicted that 155,800 Indian women would be diagnosed with breast cancer in 2015 alone. Cervical cancer was the most common cancer in India for almost last four decades or more. However, since the last 10 years breast cancer is steadily increasing and is now the most common cancer in women in India.

The age adjusted ratio for breast cancer is 1 in 28 in urban India and 1 in 60 in rural India.

India is experiencing a tremendous rise in breast cancer across all age groups but the incidence is more in age groups above 50 years. The exact cause of breast cancer is still not known. But there are various modifiable and non-modifiable risk factors which everyone should be aware of:

Non-modifiable risk factor (Not in our hand)

• Being a lady puts you at risk for having cancer does not mean that males are spared, but it’s rare (1%)
• Increasing age
• Hereditary/Familial - About 5% of breast cancers are hereditary i.e. through genes transmitted either from father or mother. If a woman has a mother/sister who has suffered from breast cancer her risk of having breast cancer increases 3 fold.
• Early age of onset of menstrual cycle/late age of menopause adds to the risk to some extent.

Modifiable Risk factors (in our hand)

• Late age at first child birth (more than 30 years of age)
• Less number of children
• Not breast feeding or breast feeding for shorter duration
• Obesity

The chances of cure in women with breast cancer are related to early detection. Breast cancer is absolutely curable if it is detected early.

There are three ways of detecting breast cancer:

• Early clinical examination by breast specialist
• Mammography
• Self-examination

It has been seen that if clinical examination by a skilled breast surgeon is done properly it may be as effective as mammography.

Many women have breast pain before the start of their menstrual cycle, which is usually due to hormonal imbalance and rarely related with cancer. This can be managed with analgesics.

Many young women have lumpy breast or mobile painless lumps usually called fibroadenosis and fibro adenoma. Again, these are not precursors for cancer.

What are the symptoms and signs of breast cancer?

• Painless hard lump in breast or under the arm
• Unilateral blood stained nipple discharge
• Unilateral nipple retraction or ulceration over the nipple.
• Skin over the breast is thickened, hardened

In case of any lump in the breast, you must visit the specialist doctor as early detection of cancer impacts the overall survival i.e. breast cancer is absolutely curable if detected early.

What you should know once cancer is diagnosed:

• Stage of the disease
• Treatment options available
• Tumour sensitivity

Breast cancer arises from the lining of the milk duct and slowly increases to form a lump in the breast. If detected early, the breast can be saved by excising the lump and armpit gland evaluation. This treatment is followed by radiotherapy to the breast. Radiotherapy gives radiation to the conserved breast as well as to tumour bed from where tumour has been excised. Radiotherapy is mandatory after breast saving surgery. Chemotherapy is usually given after surgery to kill tumour cells circulating into your blood stream.

In the few cases where the tumour is big and restricted to the breast and armpit but not feasible for surgery, chemotherapy can be given prior to surgery to reduce the size of tumour. If your tumour is sensitive to hormones then after completion of chemotherapy ant hormone therapy is given, which is in the form of tablets to be taken daily for 5 to 10 years.

Once breast cancer spreads to other organs, the disease is usually incurable and only palliative and supportive treatment is offered to the patient.