Breast cancer is a leading form of cancer and a growing cause of alarm, especially in urban areas. It is also targeting younger women, with an age shift that sees Asian women getting the disease around the age of 40. “The incidence of breast cancer has increased by 20 to 30% since the last decade. The present incidence of 1.5 lakh new cases per year is projected to reach 1.9 lakh by 2020,” says Dr Sanjay Dudhat, surgical oncologist, Nanavati Super Speciality Hospital, Mumbai.
Technically, any abnormal growth of cell mass in the breast is considered to be cancerous. “These cells divide at speeds greater than those seen in healthy cells. When they accumulate to form a perceptible mass, they show up as a lump or tumour in the breast. Eventually, the tumour will spread to other areas of the body, such as the lymph nodes,” says Dr Alka Gupta, senior consultant-Obstetrics and Gynecology, Fortis La Femme, Delhi.
What puts you at risk?
Cells in the milk-producing ducts get affected the most. Studies have shown that factors like exposure to radiation, a lack of exercise, alcoholism, smoking and hormonal changes could induce the onset of breast cancer. “Risk factors for breast cancer include having children after the age of 30 or never having been pregnant, beginning periods at a young age (before 12) or having menopause at a late age (after 50), advancing age, and just being female. The disease can also be inherited, and certain ethnic communities may be more prone to it, including Asians,” says Dr Gupta.
Obesity can also increase after menopause, which can increase risk of breast cancer because of the production extra estrogen, says Dr Dudhat. And while breast cancer can run in families, only 10-15% of cancers are hereditary, and result from genetic mutations (e.g. BRCA1 and BRCA 2 genes).” The other risk factors are undergoing hormone replacement therapy (HRT) and eating a high-fat diet,” says Dr Dudhat.
How can you protect yourself
A periodic screening for breast cancer, including clinical examination, mammograms and ultrasound (for women younger than 35), can help to detect the disease. “Learn to recognise the shape and contours of your breast and perform a self-examination. Unusual lumps or changes could be suspicious,” says Dr Gupta, adding that certain estrogen-blocking medications could reduce the risk of this disease in women at high risk of it.
Dr Dudhat advises that a self-breast examination be done by all women from the age of 20, while a screening mammography with sono-mammography can be done yearly from the age of 40.
It also helps to limit the amount of alcohol you consume, avoid smoking, keep your weight in check, eat a low-fat diet and lead a stress-free lifestyle. Exercising for at least four days of the week could also eliminate some of the risk factors. “Postmenopausal hormone therapy has been known to cause breast cancer and hence, should either be avoided or be used in the lowest dosages possible,” says Dr Gupta.
If there is a family history of breast cancer, high risk individuals can undergo frequent screening with the help of genetic counselling,” says Dr Dudhat.
Symptoms and treatments of breast cancer
The most common symptom of breast cancer is a painless lump in the breast. Other signs include a change in breast shape, a thickening lump in the breast or arm pit, dimpling in the skin, redness or flaking of the breast skin, abnormal nipple discharge and nipple retraction.
The main treatments for breast cancer include surgery to remove the cancerous lumps or even the entire range of breast tissues, chemotherapy, radiation and hormonal therapy. A landmark study recently said that most women with early-stage breast cancer can now safely skip chemotherapy without hurting their chances of beating the disease.
Genetic counselling is also helpful in patients who have a family history of breast cancer. “These genetic tests (BRAC1 & BRCA2) detect high-risk individuals and we can screen them frequently,” says Dr Dudhat.
Immunotherapy or harnessing the power of the immune system can also be used to treat breast cancer, according to latest research. “This seems to work when there are a large number of mutations in cancer cells, so that the immune system can recognise at least some of them,” says Dr Gupta, adding, “Cancer cells need to be destroyed during treatment, but different women may have different mutations. So, a personalised approach for targeted therapies may be called for.”