It is 8th March, International Women's Day – a time to focus on issues that relate to women health, women empowerment, and a time to break the bias! Let us learn about breast cancer which is the most common cancer affecting women. It is also the commonest cause of death due to cancer in women. Breast cancer cases account for almost one fourth of all cancer cases in women in India. A higher proportion of our patients are younger than 40 years of age and a vast majority (almost 60%) present in stage 3 or 4 of disease.
All women (and even men) are at some risk of developing breast cancer in their lifetime. The risk varies as per hereditary factors and environmental factors. Factors that are associated with higher risk of developing breast cancer include family history of breast or related cancers, increasing age, obesity, alcohol, exposure to radiation, reproductive history (early menarche, late menopause, no children) etc. However, in about half of breast cancer cases no such risk factor may be apparent.
Breast cancer most commonly presents as a painless lump in the breast and or armpit. However, 9 out of 10 breast lumps are not due to cancer. Patients could also present with an alteration in size, shape or appearance of the breast, skin redness/ pitting/ dimpling, inverted nipple or abnormal nipple discharge. When spread to other body parts, the symptoms could include bone pains, jaundice, headache, loss of appetite and weight etc.
Breast cancer is curable if detected early. Though, it is treatable in all stages, even stage 4 when it is widespread to various body parts. Effective treatments are now available that can make patients live longer and better. Breast cancer is treated by a multidisciplinary team including medical & radiation oncologists, breast surgeon along with other support staff. In India, we have the expertise and the capability to offer the best recommended cancer treatment to our patients. We now have not only newer chemotherapy and hormone therapy to treat breast cancer, but also targeted treatments such as monoclonal antibodies, antibody-drug conjugates, CDK inhibitors, and immunotherapy. The surgeries are less mutilating now. Radiotherapy machines and techniques can deliver radiotherapy safely now.
There is also a lot that one can do as an individual to reduce the risk of developing breast cancer. Follow these simple suggestions to reduce your risk of getting breast cancer:
- Maintain healthy weight throughout life by adopting healthy diet and undertaking regular exercise.
- Avoid intake of alcohol.
- Breast feed you newborn for a year or longer.
- Avoid hormone replacement therapy. Take help of non hormonal alternatives to manage menopausal symptoms.
- Avoid unnecessary exposure to radiation
- Be aware about your breasts, so that you can pick up any changes quickly.
- Make cancer screening a part of your life.
If someone has positive family history of breast or ovarian or other related cancers, one could undertake the following measures towards cancer risk reduction-
- Genetic counseling and testing for finding the genetic mutation (such as BRCA 1 & 2, TP53, CHEK2, PTEN etc.)
- Medicines such as Tamoxifen or Raloxifene
- Preventive (prophylactic) surgery to remove breasts and or ovaries
Hence with advances in cancer treatment, there are more reasons to be hopeful now than to be fearful. Stay aware & informed, stay positive and never lose hope.
(Dr Jyoti Wadhwa, Director of Medical Oncology, Medanta The Medicity Hospital, Gurgaon)
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