Dr Sushma Devi
Breast cancer, a disease that knows no boundaries, strikes women and even men from all walks of life, transcending age, race, and socioeconomic status. It is a silent predator, often lurking undetected until it reaches an advanced stage, making it crucial to raise awareness about this life-threatening condition.Breast cancer awareness is not just about wearing pink ribbons; it’s a call to action, a rallying cry for early detection, and a plea for better support and research funding.
October is designated as Breast Cancer Awareness Month, during this month, various activities such as awareness campaigns, community events, or simply sharing information on social media, and fundraising initiatives are organized to educate people about breast cancer and support breast cancer patientsThe theme for the year 2023 is “Keeping Her in the Picture,” which serves as a heartfelt appeal to all individuals to pay close attention to the well-being of the important women in their lives. It’s a call to action for people of all genders to actively participate in reminding and encouraging their cherished ones, including wives, mothers, sisters, and close friends, to regularly conduct monthly breast self-examinations and undergo routine mammographic screenings. These proactive measures are crucial for early detection and intervention in this potentially life-threatening condition.
The most common questions and concerns about breast cancer are as follows:
Q) What are the symptoms of breast cancer?
Recognizing the symptoms is crucial. These may include a lump in the breast or armpit, nipple discharge (especially if it’s bloody), skin changes like thickening, scaling, or redness, and the presence of skin ulcers.
Q) Who is at the high risk of developing Breast Cancer?
Breast cancer risk factors can be categorized as non-modifiable and modifiable.
Modifiable risk factors are those where the chances ofbreastcancer in the future can be avoided by adopting certain lifestyle practices. These factors are obesity with BMI> 30, nulliparous women/ first pregnancy after 35 years of age, age at first childbirth> 35 years, use of HRT (hormonal replacement therapy) for more than 10 years, smoking, alcohol consumption, and Radiation exposure. So, by adjusting the above-mentioned factorsand following a healthy lifestyle,you can decrease the riskof breast cancer in the future.
A non-modifiablefactoris age, as with increasing age incidence of breast cancer increases. Femalegender is another risk factor as breast cancer is also seen in males, but females have more chances of having this disease than males.Family history with first-degree (mother, sisters, or daughter) relative having breast cancer also increases risk. Also,5-10% of cancers are hereditary, with BRCA1 and BRCA 2 gene mutations increases the risk.Early menarche (first menstrual cycle), and late Menopause (last menstrual cycle) is also risk factor.
Q) How can we makean early diagnosis ofbreast cancer?
The adage “prevention is better than cure” holds exceptionally true in the case of breast cancer. Regular breast self-exams, clinical breast exams, and mammograms can detect breast cancer at an early, treatable stage
a) Self-Breast Examination: Women over 20 yearsold are encouraged to perform monthly self-breast examinations, preferably about a week after their menstrual period. This involves feeling your own breast tissue that can helpin identifying asymmetry or any other abnormalities.There are lots of videos demonstrating the procedure of breast self-examination on social media, from where you can learn this method and detect any abnormality as mentioned in the symptoms.
b) Clinical Breast Examination: Your doctorplays a vital role in spotting unusual changes in breast tissue. Women should schedule clinical breast exams with yours doctor every three years after turning thirty.
c) Screening Mammogram: This is an X-ray of the breast that utilizes very low levels of radiation to detect breast cancer. It can identifybreast cancer at very early stage even beforethe appearance of symptoms that can be detected by clinical examination. Women are recommended to undergo a screening mammogram annually starting at the age of 40 to detect any abnormalities in the breast tissue.
Thus, educating individuals, particularly women, about the importance of self-examinations and routine screenings is paramount. Knowledge empowers individuals to take control of their health and potentially catch breast cancer in its infancy when it is most treatable.
Q)What are the treatment options of breast cancer?
In the management of breast cancer, the first-line approach typically involves surgery, and there have been significant advancements in surgical techniques.
Breast conservation surgery is an option for early-stage breast cancer. During this procedure, the surgeon removes the breast lump along with a 1cm margin of surrounding breast tissue.
Another option is a modified radical mastectomy, where the entire affected breast is removed. However, it’s essential to understand that even in such cases, efforts are made to preserve the shape and contour of the breast. This can be achieved by using flaps, which are tissues from the patient’s own body, or with the assistance of implants. Therefore, patients should not fear the loss of their breasts entirely, as modern surgical techniques prioritize both cancer removal and aesthetic outcomes.After surgery, further treatment includeschemotherapy, radiotherapy, and hormonal therapy. The decision for this therapy depends on the histopathology report of the removed tumour tissue
Q)What are the ways to preventbreast cancer?
This includes adopting a healthy lifestyle with a balanced diet, regular exercise, maintaining an ideal body weight, and stress management. Such practices can contribute to a more robust immune system and a better quality of life.Quitting smoking and excessive alcohol intake also decreases future risk of breast cancer.Encouraging breastfeeding, which is protective against breast cancer.Some of the birth control pills and hormonal replacement therapy also increase the risk of breast cancer so you should always askyour doctors if there is any component in your therapy that may increase the risk of breast cancer.
In Conclusion, Breast cancer management is a comprehensive and ongoing process that aims to address all aspects of the disease, from diagnosis through treatment and beyond. We must foster an environment where individuals feel comfortable discussing their experiences, fears, and questions. This open dialogue can help break down the barriers that prevent people from seeking timely medical attention and support. It is time to unite in our efforts to promote breast cancer awareness, destigmatize the disease, and provide unwavering support to those impacted by it. Together, we can make a difference in the lives of countless individuals and strive for a world where breast cancer is not a dreaded diagnosis but a preventable and treatable condition.
(The author is Associate Professor, Department of General Surgery, AIIMS Jammu).
