Breast cancer is the most common cancer in women in India and accounts for about a quarter of all cancers in women in Indian cities.
The average age for breast cancer in India is almost a decade lower than that in the west.
Cancers of breast and Cervix uteri are the most common cancers seen among Indian women: incidence of breast cancer is on the rise while cervical cancer is on the decline. The highest burden of breast cancer was observed in metropolitan cities such as Hyderabad, Chennai, Bengaluru and Delhi. (ICMR 2020)
For every two women newly diagnosed with breast cancer, one woman dies of it in the country, accordingly to the National Institute of Cancer Prevention Research (NICPR).
With such shocking trends it is time we took notice of this often ignored but common disease.
Could you be at risk?
Age: As you grow older, your chances of suffering from the cancer also increases – Most breast cancers are found in women who are 50 years or older.
Reproductive history: If you have attained puberty before the age of 12 or have hit menopause after 55, you are exposed to hormones longer, raising the risk of breast cancer.
Dense breasts: Dense breasts have more connective tissue than fatty tissue. This makes it harder for a doctor to identify tumors on a mammogram. Women with dense breasts are also at a greater risk of suffering from breast cancer.
Family history of breast cancer: If you have a first degree relative (blood relative) who suffers from or has suffered from breast or ovarian cancer then you are also at a higher risk of suffering from breast cancer.
Also, if a male member in your family (blood relative) has suffered from breast cancer, you are also at increased risk.
Although, men are also at risk of suffering from this type of cancer, they make up less than 1% of the population suffering from breast cancer.
Personal history of other cancerous or non-cancerous breast related disease: If you have suffered from breast cancer in the past, it is possible that the cancer may recur. What also puts you at risk is having conditions like atypical hyperplasia or lobular carcinoma in situ.
Past treatment with radiation therapy: If you’ve had radiation therapy to the chest region before the age of 30, your risk of suffering from breast cancer increases.
Not being physically active: Women who are not physically active have a higher risk of suffering from breast cancer.
Being overweight or obese after menopause: Being overweight after the onset of menopause puts you at greater risk of suffering from breast cancer.
Hormone therapy: Some forms of hormone replacement therapy, taken during menopause for more than five years, raise your risk of suffering from breast cancer. Apart from that certain contraceptive pills have also been known to increase your risk of breast cancer.
Reproductive history: If you’ve had a baby after the age of 30, not breastfed or never had a full-term pregnancy, you’re at a higher risk of suffering from breast cancer.
Drinking alcohol: Studies have shown that your risk of suffering from breast cancer increases with the amount of alcohol you drink.
Genetic mutation: If you have certain mutated or inherited genes named BRCA1 and BRCA2, your risk of suffering from breast and ovarian cancer increase.
Other factors: Research has also shown that working in the night shift, smoking and/or being exposed to chemicals can increase your risk of suffering from breast cancer.
What symptoms should you look out for?
Dr Ashay Karpe, Medical oncologist and hematologist, says the symptoms of breast cancer are
“a lump in the breast that is painless, increases in size or causes any wounds on the surface, if your nipples retract or get pulled in, blood-tinged discharge from the nipples, and redness of the skin.”
“The symptoms of breast cancer can vary from person to person so getting regular mammograms between the ages of 35-40 can help a lot,” adds Dr Ashay.
How is breast cancer diagnosed?
If you feel a lump in your breast during a breast self-exam, or your doctor sees one in a mammogram, he/she will do the following things to diagnose you.
Your doctor will first take your personal health history and family history. You may then be asked to get an imaging test such as an ultrasound, MRI or mammogram. He/she may then do a biopsy to further study the cells within the tumor. A biopsy is also useful in understanding the stage and type of cancer.
You may also be required to take some blood tests to better understand your overall health.
What are the stages of breast cancer?
Breast cancer can be staged from 0 to stage 4.
Stage 0: Also known as a noninvasive tumor, this is where the cancer has not spread to the lymph nodes.
Stage 1: This is where the cancer is less than one centimeter big and hasn’t spread.
Stage 2A: When the cancer is smaller than two centimeters across with underarm lymph node involvement. Or when it is between two to five centimeters across without lymph node involvement.
Stage 2B: Is when the tumor is larger than five centimeters across without underarm lymph node involvement or when it is between two to five centimeters across with lymph node involvement.
Stage 3: This is also known as a locally advanced breast cancer and is divided into stages 3A, 3B and 3C.
Stage 3A: Is a tumor that’s larger than five centimeters that has spread to the underarm lymph nodes or near the breast bone. Or any tumor with cancerous lymph nodes that stick to nearby tissue and one another.
Stage 3B: Is where the tumor has spread to the skin and chest wall.
Stage 3C: Where a tumor of any size spreads and involves more lymph nodes.
Stage 4: Also known as a metastatic breast cancer, this is where the tumor regardless of its size spreads to other organs, tissues, lymph nodes and bones.
How is breast cancer treated?
Based on the type and stage of the cancer, you may get treated with multiple treatment modalities like surgery, chemotherapy, immunotherapy, targeted therapy, hormonal therapy, biological therapy and radiation therapy.
If Diagnosed early and taken proper treatment, breast cancer can ne completely cured.
How can you prevent breast cancer?
Dr Ashay Karpe says, “If detected at an early stage, breast cancer can be completely cured with newer modalities and therefore self-breast examinations are important. All women above the age of 20, should do a self-breast examination at least once a month. Apart from that a physical examination should be done, at least once a year by an expert nurse or doctor. And, between the ages of 35 to 40, you should get at least one mammography done annually or once in two years till the age of 65.”
Other factors include staying active, reducing alcohol intake, losing weight, breastfeeding for as long as possible and limiting hormone replacement therapy after menopause.
Intake of more saturated fats and obesity have been linked to breast cancer.
The nutrition guidelines and the World Cancer Research Fund recommendations advocate that having a diet with a liberal amount of vegetables and fruits, less of saturated fats decreases the risk of breast cancer.
References
- WHO Summary report on HPV & cervical cancer statistics in India (18/03/2008)
- http://cancerindia.org.in/cancer-statistics/
- http://www.breastcancer.org/symptoms/understand_bc/what_is_bc
- Rangarajan B, Shet T, Wadasadawala T, et al. Breast cancer: An overview of published Indian data. South Asian J Cancer. 2016;5(3):86-92. doi:10.4103/2278-330X.187561
- Agarwal G, Ramakant P. Breast Cancer Care in India: The Current Scenario and the Challenges for the Future. Breast Care (Basel). 2008;3:21-27
- https://www.cancer.gov/types/breast/research#:~:text=HR%2DPositive%20Breast%20Cancer%20Treatment&text=Approved%20drugs%20include%3A,advanced%20or%20metastatic%20breast%20cancer.
