BREAST CANCER IS THE MOST FREQUENT MALIGNANCY AFFECTING WOMEN WORLDWIDE!

Dr Maria Kapoor, Dr. Varun Dogra and Dr Uzma Padwal

The World Health Organization estimates that in the year 2022, more than 2.3 million women were diagnosed with breast cancer, with an estimated 6,66,103 deaths globally. According to the Global Cancer Observatory (GLOBOCAN) 2022 data, India reported over 1,92,020 new cases of breast cancer, with an estimated 98,337 deaths.
The theme for Breast Cancer Awareness Month in 2024 is “No-one Should Face Breast Cancer Alone.” The theme highlights the importance of community support for individuals battling breast cancer. The theme aligns with the WHO Global Breast Cancer Initiative’s aim to lower the annual death rates by 2.5% through targeted strategies for early detection and treatment.
INFORMATION WE REQUIRE TO UNDERSTAND BREAST CANCER!

1. What is breast cancer?
   Breast cancer occurs when uncurbed cell growth in breast tissues develop into a tumor that can also spread to nearby tissues and organs. It usually starts in the milk-producing ducts or lobules of the breast and may spread through the lymphatic system. The cancer can be invasive (spreading beyond the breast tissue) or non-invasive (contained within the ducts or lobules of the breast).
2. What are the early signs of breast cancer?
   Early signs include:
   Ø An enlargement or lump in the breast or underarm.
   Ø Alteration in breast size or form.
   Ø Skin that shows Dimpling or puckering.
   Ø Nipple discharge (other than breast milk), especially if bloody.
   Ø Pain in any part of the breast that does not go away
   Early detection through regular self-examination and screenings like mammograms is key for effective treatment.
   3.Who is at risk for breast cancer?
   Risk factors include:
   Ø Being female (though men can also develop breast cancer).
   Ø Age, especially after 50 years.
   Ø Genetic variations or Family history (e.g., BRCA1, BRCA2).
   Ø Hormonal influence (e.g., early menstruation or late menopause).
   Ø Lifestyle factors like obesity, smoking and alcohol consumption.
   While some risk factors can’t be changed, maintaining a healthy lifestyle can help reduce the risk.
3. How can breast cancer be detected early?
   Early detection methods include:
   Ø Self-examinations: Regular breast self-exams help in noticing unusual changes.
   Ø Clinical Breast Exams (CBE): Performed by a healthcare provider, CBEs are often recommended for women in their 20s and 30s.
   Ø Mammograms: X-ray screenings of the breast, usually recommended for women over 40, help detect cancer before symptoms appear.
   Ø Ultrasound and MRI: May be used in conjunction with mammograms, especially for women with dense breast tissue.
4. What stages do breast cancer patients go through?
   There are five stages as described:
   Ø Stage 0: Non-invasive, cancerous cells remain in the ducts (DCIS).
   Ø Stage I: Early-stage invasive cancer, small tumour, minimal spread.
   Ø Stages II & III: Larger tumour, possible lymph node involvement.
   Ø Stage IV: Metastatic cancer, which has progressed to the liver, lungs, bones, or brain.
5. Can breast cancer affect men?
   Yes, men can get breast cancer; however, it’s uncommon. Men with a family history of breast cancer or specific genetic variations (e.g., BRCA2) are more susceptible, and risks increase with age. Symptoms are comparable to those of women, including lumps, changes in breast size, or nipple discharge.
6. How is breast cancer treated?
   Treatment varies based on the stage and type of cancer:
   Ø Surgery: Options include lumpectomy (removal of the tumour) or mastectomy (removal of the breast).
   Ø Radiation Therapy: Often follows surgery to destroy residual tumour cells.
   Ø Chemotherapy: Drugs-based approach to either delay or destroy cancer cells.
   Ø Hormone Therapy: For cancers that are hormone receptor-positive, hormone-blocking treatments can be effective.
   Ø Targeted Therapy: Focuses on specific characteristics of cancer cells, such as HER2 protein, to block their growth.
7. Can breast cancer be prevented?
   While breast cancer cannot be completely prevented, but certain modifications to one’s lifestyle can lower the risk:
   Ø Preserving a healthy body weight.
   Ø Regular physical activity.
   Ø Reducing alcohol consumption.
   Ø Having a healthy,balanced fruit and vegetables-rich diet.
   Ø Breastfeeding is protective.
   Additionally, women with a high genetic risk (BRCA mutations) may consider preventive surgeries or medications.
8. What part does genetics plays in breast malignancy?
   Hereditary mutations in genes like BRCA1 and BRCA2 account for 5 to 10% of incidences of breast cancer. These mutations dramatically increase the risks of developing breast cancer in women. Genetic testing and counselling can help identify high-risk individuals.
9. Is breast cancer survivable?
   Yes, especially if detected and diagnosed promptly; 5 Year survival rate for patients with localised breast cancer is more than 90%. Advances in treatment and early detection have significantly improved survival rates. However, this percentage declines with late-stage diagnosis. Hence, it’s essential that the patient reports to a health care provider early. To do that, especially in developing countries like India, stigma and taboo attached with breast cancer should be removed so that patient seek medical advice early without any hesitation.
   (The writers are senior doctors in AIIMS ,Vijaypur, Jammu).