Breast cancer- let's talk about it!

BY: Dr. Arundhati Marathe Lote - 10 Nov-2021

October is breast cancer awareness month; A month to spread awareness about the disease. With so much development in medical science today, we now know that breast cancer is curable if detected early. We just need to have a sound knowledge of the disease and be aware of what exactly is cancer.

Cancer is abnormal growth and proliferation of cells in the body. Breast cancer occurs when some breast cells begin to grow abnormally and divide more rapidly than healthy cells and continue to accumulate, forming a lump. Cells may spread through the breast to lymph nodes or other parts of the body.

Breast cancer is the most common cancer in Indian women. Around 14% of cancers in women is due to breast cancer and the percentage is higher in urban cities than in rural parts of India. As per International Agency for Research on Cancer, a total of 1.78 lakh new cases of breast cancer were diagnosed in India in 2020 which was 26.3% of all cancer cases diagnosed in women in the country making it the most commonly diagnosed cancer in India. Men can also get breast cancer and account for approximately 1% to 2% of all breast cancer cases.

Breast cancer can present in many ways, from a painless lump in the breast to abnormal nipple discharge. Few warning signs of breast cancer are painless lump, blood-stained/ dark brown nipple discharge, lump in axilla, breast skin changes such as redness, dimpling, puckering or orange-peel appearance of the skin. Many patients also present with nipple abnormalities alone such as retraction, deviation, excoriation or ulceration of the nipple.

The key to cure of breast cancer is early detection. The Sooner the cancer detection, better is the treatment course and cure rate. For this to happen, one must always perform self-breast examination from the age of 20 years. It should be done once a month, 4-5 days after menstrual cycle. Clinical breast examination should be done annually by a doctor. Advanced screening methods such as mammography with sono-mammography should be performed in women from age 40 onwards to detect breast cancer in time.
 
Certain risk factors associated with breast cancer are smoking, frequent alcohol consumption, obesity, long term hormone therapy. Prolonged exposure to menstruation, that is early menses (before 12 years of age) and late menopause (after 50 years of age), not bearing a child, avoiding lactation are also certain risk factors for breast cancer. 2-3% of breast cancer cases can be familial and have a genetic cause.

As all other cancers, breast cancer also has four stages. Stage 1 being the earliest stage and stage 4 being late stage wherein cancer spreads to other organs of the body like lungs, liver, bones, brain etc. Patients with Stage 1 to 3 are offered curative treatment comprising of combination of surgery, chemotherapy, radiotherapy, hormonal therapy and targeted therapy depending on stage and receptor status. Stage 4 patients are treated with palliative intent to prolong survival and provide best quality of life to patients.

Surgical trend has now shifted to conservation of breast. Removal of tumor alone is possible (depending on stage of cancer and size of tumor) and the remaining breast can be saved, thus avoiding the psychological and social trauma which most women face. Chemotherapy and radiation therapy have also improved and become more customized over the years. Chemotherapy can be taken as a daycare procedure. Previously administered month-long radiation therapy protocols have also changed to a much better and shorter one- week protocols.

Early detection and treatment of breast cancer can provide 5-year survival rate in excess of 80 to 90 percent, hence all efforts should be made to detect breast cancer in stage 1 and 2. Medical science is now advanced and still progressing on a fast pace. What we need is better awareness of the disease. One size fits all is now obsolete and a customized treatment plan can be made for every patient for better outcomes and survival. So don’t be shy, speak up and spread awareness about breast cancer, because its curable.

This article is published by VOH Team

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