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WHAT IS BREAST CANCER?

Breast is made up of three main parts namely lobules, ducts, and connective tissue. The lobules are the milk producing glands. The ducts are tubes, which carry milk to the nipple. The connective tissue that includes fibrous and fatty tissue, holds everything together.

Breast cancer occurs when the cells of the breast proliferate beyond control. It can be localized in the ducts or lobules or metastasize/spread elsewhere in the body through blood/lymphatics.

WHAT CAUSES BREAST CANCER?

Non-Modifiable (Factors that cannot be changed):

  • Age: The risk for breast cancer increases with age > 50
  • Genetic mutations: Women who have inherited certain genetic mutations such as BRCA1 and BRCA2. (Not everyone who has a BRCA1 or BRCA2 gene mutation will get affected but having a gene mutation increases the risk).
  • Prolonged Estrogen Exposure: As with cases of early menarche (menstrual periods before age 12) and late menopause (Cessation of menses after around 55 years of age) leading to prolonged duration of hormone exposure or usage of hormonal pills, increase the risk.
  • Dense Breast Tissue: Breasts with increased connective tissue constitution are more likely to develop breast cancer.
  • Family History: Women with either an affected mother, sister, daughter or multiple family members are definitely at an increased risk of developing cancer.

Modifiable (Factors that can be changed):

  • Obstetric History: Women with no children or having a first child after age 30 and those who do not breast feed are more prone.
  • Physical Inactivity
  • Obesity
  • Alcohol intake

WHAT ARE THE SYMPTOMS OF BREAST CANCER?

  • Any noticeable change in the shape or size of the breast.
  • New lump/swelling/area of thickening in the breast or underarm.
  • Pain over the breast.
  • Nipple discharge.
  • Puckering/irritation/dimpling of the skin over the breast.

**Disease can progress in some without any of the aforementioned symptoms.

Imaging techniques such as Mammogram (X-Ray breast) and MRI are to be done regularly as suggested by the doctor. Should you notice any abnormal changes or experience pain during self-examination of your breast, do consult a doctor at the earliest.

WHAT ARE THE TREATMENTS FOR BREAST CANCER?

Staging the cancer based on the tumor size and the extent of its spread, is an important first step because as it highly influences the treatment and prognosis. Modalities commonly employed in treatment are:

  • Surgery.
  • Radiotherapy, which uses high-energy radiation to kill cancer cells.
  • Chemotherapy involves the usage of drugs to shrink tumors and stop them from growing.
  • Hormone therapy.

Screening guidelines and tests:

Even though screening techniques cannot prevent, they serve to identify cancer in the initial stages, when it is easier to treat.

Current recommendations are to screen women annually between ages 45 to 54. From then on, screening every two years is suggested. Women at high risk of developing breast cancer such as those with a positive family history and with gene mutations, should be screened earlier starting at age 30.

  • Self-breast Examination: It is an important part of breast cancer screening strategy. Monthly breast examination (preferably after the end of periods) done by a woman starting from 20 years of age, serves to pick up abnormalities such as lumps, pain, or changes in size, that may be of concern.
  • Clinical Breast Exam: This is a comprehensive method of early breast cancer detection done by a health care provider and advised to be done at least once in 3 years from 20 years of age and annually from 40 years.
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