Wednesday, 14 November 2018

The Pink Facts of Breast Cancer

13 August 2018 | Features | By Dr Rajeev Kumar

Females at higher risk and after the age of 50 should undergo screening mammography and magnetic resonance mammography as per screening protocols.

Breast cancer is the most common cancer in Indian women, and is also the commonest cause of cancer deaths in women.

Here are 8 facts every woman should know:

  1. Younger women have a higher risk for developing breast cancer. The risk factors are
  • Inherited genetic mutations for breast cancer (BRCA 1 and 2)
  • Personal history of breast cancer before age 40
  • Family History: Two or more first-degree relatives (mother, sister, daughter) with breast cancer diagnosed at an early age
  • High-dose radiation to the chest
  • Early onset of menstrual periods (before age 12)
  • Late age (>30) at first childbirth
  • Nulliparous
  • Dense breasts
  • Heavy alcohol consumption
  • Obesity
  • Sedentary lifestyle
  • High intake of red meat and poor diet
  • Race matters (Caucasian women have a higher risk)
  • Personal history of uterine, ovary, or colon cancer
  • Recent oral contraceptive use

2. Majority of (80%) lumps are not cancer but cysts,benign tumors and a lumpy feel during menses. But its important not to ignore, speak up early  and get a consultation with the right doctor  to rule out cancer.

3. Prevention is better than cure  is the universal truth. Females at higher risk and after the age of 50 should undergo screening  mammography and magnetic resonance mammography as per screening protocols. Breast Self-Exams should be learnt by everyone and done once a month  to notice any subtle changes early. The changes are as follows

  • A lump in breast or underarms
  • Changes in the size or shape of breast
  • Dimpling, puckering, or thickening of skin
  • Recent retraction  or inversion of nipple
  • Skin redness, soreness, rash
  • Nipple discharge (could be a watery, milky, or yellow fluid, or blood)

4. Find the right Doctor, be proactive in disease management and find out best possible treatment alternatives.

5. Family history matters because 5-10% breast cancer cases are hereditary. Recent advances provide genetic counselling and testing especially BRCA1/2 testing.

6. The multidisciplinary and multimodality approaches and management have made treatment strategies of breast cancer simpler and with  lesser complications. The diagnostic, surgical and adjuvant therapies like chemotherapy and radiation techniques have come a long way through.

7. Breast cancer surgery no longer equates to a flat chest. With a plethora of oncoplastic surgical techniques its even impossible to find out whether one has undergone a mastectomy. Numerous options are available ranging from silicon implants to microvascular free flap reconstructions resulting in very good cosmetic outcomes.

8. The prognosis of breast cancer varies with histology, receptor status and age. Triple negative cancers (ER-,PR-and Her-2 neu -) are very aggressive and usually found in younger women with higher chances of recurrence.

 

Dr Rajeev Kumar, Sr. Consultant & Chief of Breast Services, Rajiv Gandhi Cancer Institute and Research Center, New Delhi

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