With October being observed as Breast Cancer Awareness Month, much awareness is being dawned through education and research by thousands of organizations worldwide to fight this disease that claims many lives every year.
Facts and Figures:
Breast cancer is most dreadful, accounting for 30 percent of female cancers and 14 percent of deaths due to cancer. Breast cancer has been known since ages. But women in the past,hesitated to accept the probability of having the disease and more importantly lacked knowledge about the course of illness. This led to the late disclosure of initial alarming symptoms. However, morbidity and mortality have declined in the recent years owing to increasing awareness about the importance of early detection through screening techniques and availability of advanced treatment options.
Clinical features:
- 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.
Morphology and spread:
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 that carry milk to the nipple. The connective tissue ( fibrous and fatty tissue) serves to hold everything together.
Most breast cancers begin in the ducts or lobules, where the cells of the breast proliferate beyond control. When cancer cells from the breast spread elsewhere in the body through blood/lymphatics, it is said to have metastasized/widespread.
Also Read: Stop Breast Cancer before it starts!!!
Risk factors involved are classified as follows:
Risk factors involved are classified as follows:
1. 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: The 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. Even usage of hormonal pills increases 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 devoloping cancer.
2. 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 breastfeed are more prone.
- Physical inactivity.
- Obesity
- Alcohol intake
Tips to reduce the risk:
- Maintain healthy weight.
- Excercise regularly
- Avoid/Limit alcohol intake
- Breastfeed your children
- Seek early medical help to lower the risk in case of family history of breast cancer or inherited BRCA1 and BRCA2 gene mutations..
Screening guidelines and tests:
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 atleast once in 3 years from 20 years of age and annually from 40 years.
- Imaging techniques such as Mammogram(X-Ray breast) and MRI should be done regularly as suggested by the doctor.
Eventhough screening techniques cannot prevent , they serve to identify cancer in the initial stages , when it is easier to treat.
Diagnostic modalities:
Abnormal findings detected through screening techniques doesn’t necessarily point to the diagnosis of breast cancer but need further evaluation by the following methods as advised.
Breast ultrasound : To look at internal breast structure as part of detailed evaluation of the abnormalities detected through screening.
Elaborate Mammogram/MRI
Biopsy: Removal of tissue or fluid from the suspected area and sent for pathological examination and interpretation.
So, Beware and Be Aware!!!
