Breast cancer is the most common cancer seen in India (14 per cent) and worldwide (11.8 per cent). The breast consists mainly of three different types of tissues – lobules (milk producing glands), ducts (drain the milk from lobules to nipple) and fat (tissue that make up the rest of the breast).
If the cancer arises from the lobules it is called lobular carcinoma, if it arises from the duct it is called ductal carcinoma and if from the fat or the blood vessels then it is called a sarcoma.
There are many risk factors that may contribute to the occurrence of breast cancer. Some of these risks we cannot change (unmodifiable) and some we can (modifiable). The unmodifiable risk factors that may increase the chances of developing breast cancer are sex (more common in females, but men can also get breast cancer) and age (older women are more likely to develop breast cancer). Other unmodifiable risk factors are early menarche and late menopause, consumption of certain hormonal drugs such as oral contraceptive pills and infertility.
Dr Vijay Agarwal, Lead and Senior Consultant, Medical Oncology, Aster RV Hospital, “There are certain genetic factors that may contribute to the development of breast cancer such as inheriting BRCA1 and BRCA2 mutated genes from your parents.
Modifiable risk factors include obesity, lack of regular exercise, sedentary lifestyle, having children late in life, not breast feeding and high alcohol consumption. The symptoms of breast cancer are usually painless lump in the breast or under the armpits. Other symptoms include change in the size or shape of breast, discolouration or puckering of skin over the breast, change in nipple size or colour, or discharge from the nipple area.”
If breast cancer is suspected then various investigations such as mammography (X-Ray of the breast), Ultrasound, biopsy, CT scan, PET CT scan, MRI of breast and molecular studies may be required. The main reasons for doing these tests are to confirm breast cancer, know the nature of the cancer and whether it has spread to any other organs in the body. The treatment is very varied and depends upon the type of cancer, its molecular characteristics and stage.
Breast cancer treatments now are very advanced and personalized to the individual, based on a multi-disciplinary approach.
The main stay of early breast cancer treatments are usually surgery, radiotherapy and chemotherapy. Other treatment option such as targeted therapy and hormone therapy may be advised based on molecular characteristics of the tumour. In advanced breast cancer, the main treatment options are chemotherapy, hormone therapy, targeted therapy or immunotherapy depending upon the nature of chancer, its molecular characteristics and patient’s wishes and expectations.
We know that if breast cancer, if identified early such as in stage 1 and 2, the cure rate from treatment is in excess of 90 per cent as opposed to stage 3 and 4 where it is significantly less. It is important that we try to identify them early through breast screening programmes such as self-breast examination, clinic breast examination and mammogram screening.
It is recommended that all women above the age of 40 years should undergo 2 yearly mammograms, which can be increased to yearly in high risk women. All women should be self-breast aware and know how their breast feel.
They should examine them regularly and if there is any change, they should report to their family doctor. This is likely to increase the pickup rate at early stages, thereby having the maximum impact in breast cancer survival and outcomes.