It’s that time of the year again when pink is in - the colour that symbolises breast cancer awareness; a clarion call for women to take advantage of October - ‘The Breast Cancer Awareness Month’, and get that screening done before it’s too late. Breast Cancer is the second most common cancer prevalent among women across the world, including India. The number of deaths caused by Breast Cancer is alarming – as many as 70,218 women died from this disease in 2012 in the country. Studies predict that this number is likely to skyrocket to 76,000 in 2020, primarily due to the lack of awareness regarding early signs and symptoms as well as self-examination. There are others who are bound by cultural and religious differences and hence, even shy away from discussing issues about their bodies with their partners or family members.
With increasing urbanisation in India and a shift towards the faster life, there is a greater incidence of this plague in women, and more so in younger ones. While its incidence was traditionally linked with age, today’s scenario seems to tell a different story. Irregular sleep patterns, unhealthy diets, sedentary lifestyles, and high stress levels are all coming together and making women more prone to this condition. In fact, statistics suggest that 1 in every 8 women will suffer from Breast Cancer during their lifetime.
But it’s never too late – take an educated leap towards awareness right away. Here’s a ready reckoner of all that you need to know regarding early detection, symptoms, and prevention of breast cancer:
Signs and Symptoms of Breast Cancer
It is important to know how your breasts look so that you can observe the slightest change, as part of good breast health. While screening tests like mammography are an absolute must, look out for certain visible symptoms such as the appearance of a new lump or mass. A lump associated with Breast Cancer is generally tender, soft, or well-rounded. It can sometimes be painful as well.
Even if there is no lump, observe if there is any swelling of all or part of the breast, skin irritation or dimpling, breast or nipple pain, nipple retraction (when the nipple turns inwards), redness, or scaling of the breast skin and nipple discharge (apart from milk by lactating mothers).
At times, the breast cancer can spread to the lymph nodes either under the arm or somewhere near the collar bone, which might cause a lump or some visible swelling. While these symptoms could also be an indicator of any other health challenge, it is advised to consult a healthcare professional if you observe either of these early symptoms.
Diagnosis of Breast Cancer
First of all, it is essential to conduct a self-examination every month to observe the noticeable changes in each breast. If you come across any of the above-mentioned symptoms or some other unusual change, your doctor will first perform a breast exam, where he/she will check for lumps or other abnormalities in your breast or lymph nodes.
Besides, you will be asked to go for a mammogram, which is usually a screening to detect Breast Cancer. In case there’s an abnormality revealed, your doctor may ask you to further go for a diagnostic mammogram to rule out any suspicion. Additionally, your doctor may advise a breast ultrasound to determine whether the lump is a solid mass or a fluid-filled cyst.
In case this doesn’t help, the only way to determine Breast Cancer is biopsy, which involves removing a sample of breast cells for examination. These samples are sent to the laboratory to check for cancerous cells, and to figure the grade of cancer as well as determine if the cancer cells have hormone receptors.
In some cases, a Magnetic Resonance Imaging (MRI) is also conducted to deeply examine the interiors of your breast.
Stages of Breast Cancer
If you’ve been diagnosed with Breast Cancer, your doctor will determine the aggressiveness or grade of this disease. This is to accordingly go with the best treatment possible. It is not possible to determine the cancer stage unless you go for a Breast Cancer Surgery.
Based on your diagnosis, there could be further blood tests, mammogram of the other breast, a bone scan, Computerized Tomography (CT) Scan as well as Positron Emission Tomography (PET) Scan.
The different stages are:
Stage 0: Early diagnosis of cancer, which means the cancerous cells showed up in the breast ducts and have stayed there.
Stage 1: This is when the cancer is called ‘invasive’, which means it has moved around to attack healthy tissue. If the cancer has spread into the fatty breast tissue, it is Stage 1A. This is when the tumour is not bigger than a peanut, or there could be no presence of tumour. If it’s Stage 1B, the cancer cells might be found in a few lymph nodes.
Stage 2: The cancer has grown or spread or maybe both. If it's Stage 2A, the tumour in the breast is likely to be small and there may be no cancer of the lymph nodes. In some cases, it may have spread. In Stage 2B, the tumour is bigger and could vary between the size of a walnut or even a lemon. It could be present in the lymph nodes.
Stage 3: While the cancer may have not spread to the bones or other organs, it is still considered advanced. In case of Stage 3A, the cancer can be found in up to nine lymph nodes and can be present from your underarm right up till the collar bone. It could have also affected the lymph nodes present deep in your breast. There may or may not be a large tumour in your breast. If it's Stage 3B, the tumour has made its way into the chest wall or skin around the breast. It could have spared the lymph nodes. In Stage 3C, cancer can be found in 10 or more lymph nodes and could have spread above or below the collarbone. Generally, fewer lymph nodes outside the breast are affected; the ones inside are generally cancerous.
Stage 4: This is when the cancer cells have spread further from the breast and lymph nodes. It can affect bones, lungs, liver, and brain. This stage is referred to as ‘metastatic’, which means it has spread beyond the region where it was first diagnosed.
Treatment of Breast Cancer
Based on the grade of your cancer, your doctor will prescribe the best treatment. In most cases, women go for Breast Cancer Surgery and receive additional care before or after it’s done. Most women are advised lumpectomy, which is basically a procedure to remove the tumour and a certain portion surrounding the healthy tissue. This is generally in the case of small tumours. For those with a large one, chemotherapy is suggested to shrink the tumour and then follow it up with lumpectomy.
Another option is mastectomy, wherein the entire breast tissue is removed, including the fatty tissue, ducts, lobules as well. In some cases, a few lymph nodes are also removed if the cancer cells have spread.
Some women who have been diagnosed with cancer in a single breast can also opt for removal of the healthy breast, if they are prone to this condition due to a strong family history.
Radiation therapy is often prescribed to breast cancer patients, which aims to kill cancer cells in your body through high-powered beams. This can last from three days to six weeks, depending upon your situation. Certain side-effects that are observed include fatigue, red rashes, swollen, or firm breasts.
Additionally, chemotherapy is an oft-heard treatment that uses drugs to destroy cancer cells that multiply rapidly. If you are at a high risk of a cancer relapse, your doctor may recommend chemotherapy after surgery to control its recurrence. It is also conducted on women whose cancer has spread to other organs. Some of the common side-effects include hair loss, nausea, an increased risk of infection, premature menopause, infertility as well as damage to heart and kidneys, in rare cases.
Some doctors also go for hormonal therapy that blocks cancer cells from receiving the hormones they need to grow.
While all the information about cancer may overwhelm you, it can be treated if there is timely detection. Don’t wait, take that step towards good health today!