Breast Cancer is becoming more and more common in younger age group and 50 % cases are now seen in 35 to 60 years of age group especially in India.
Breast cancer has evolved into one of the most easily detectable cancer of the mankind. It is so far the most researched cancer and that is the reason that a significant success has been achieved towards its treatment. Breast Cancer may in times to come, become a lifestyle disease just like hypertension and diabetes. Even Stage IV patients are now having good survival benefits.
In India, there are approximately 1.5 lakh new cases of breast cancer that are diagnosed every year.
The primary risk factors for breast cancer are female sex and older age. Other potential risk factors include: genetics, lack of childbearing or lack of breastfeeding, higher levels of certain hormones, certain dietary patterns, and obesity.
Common Symptoms of Breast Cancer
- Lump in the breast.
- Change in Nipple shape or retraction.
- Thickening of the skin
- Lump in the armpit.
- Abnormal nipple discharge.
These are some of the common symptoms to determine breast cancer which need to be further investigated. But the best treated breast cancer is the one which is detected on screening, i.e before the symptoms could develop. This is because it is a very early stage and if treated properly, usually results in curing the disease.
What are the screening methods in breast cancer?
Screening is to detect a disease early. In breast cancer this can be done by:
- clinical and self breast exams
- genetic screening
- magnetic resonance imaging.
A clinical or self breast exam involves feeling the breast for lumps or other abnormalities. Clinical breast exams are performed by health care providers, while self breast exams are performed by the person themselves. Evidence does not support the effectiveness of either type of breast exam, as by the time a lump is large enough to be found it is likely to have been growing for several years and thus soon be large enough to be found without an exam. Mammographic screening for breast cancer uses X-rays to examine the breast for any uncharacteristic masses or lumps. During a screening, the breast is compressed and a technician takes photos from multiple angles. USG of the breast is a better modality for screening in younger (pre-menopausal) women.
For any cancer diagnosis, a BIOPSY is must. It is a myth that doing biopsy spreads the disease. Any needle or incision biopsy is the only definite diagnosis for cancer. Similarly in breast cancer needle biopsy in the form of FNAC or Tru-cut biopsy is required to arrive at the diagnosis.
Tru-cut biopsy is the preferred modality of biopsy for breast cancer because it also gives us information about the receptor status which is very important to plan the treatment of breast cancer patient.
Biopsy does not result in spread of disease.
The sequence of treatment modality is of outmost importance.
The management of breast cancer depends on various factors, including the stage of the cancer and the age of the patient and receptor status. Nowadays we have multiple treatment options in breast cancer with surgery, chemotherapy, radiation therapy, hormonal therapy, targeted therapy, etc.
We can preserve the breast nowadays with breast conservation surgeries and even more and more plastic reconstructions are employed nowadays to give a better cosmesis to the breast cancer patients.
A multidisciplinary approach is preferable. Hormone receptor-positive cancers are often treated with hormone-blocking therapy over courses of several years. Monoclonal antibodies, or other immune-modulating treatments, may be administered in certain cases of metastatic and other advanced stages of breast cancer.