Breast Cancer: Risk Factors and Symptoms

How common is Breast Cancer? 

Breast Cancer is one of the leading causes of death and disability worldwide. Globally, over 1.5 million women are diagnosed with breast cancer every year. The GLOBACON 2012 report suggests that there is a steep rise in both morbidity and mortality related to breast cancer in India between 2008-2012. Breast cancer affects 25.8 per 100,000 Indians and accounts for 12.7 per 100,000 deaths among Indian women. When compared to the Western population, breast cancer occurs almost a decade earlier among the Indian women. Lack of early screening and the unavailability of appropriate medical care are the most common barriers of effective breast cancer management in India. 

What are the risk factors for Breast cancer?

The risk factors of breast cancer include:

Age- Increasing age increases the risk of developing breast cancer like most other cancers

Family history- The risk is related to the extent of involvement of family members. Higher the number of affected relatives and closer the relation, higher would be the risk

Radiation exposure- Radiation exposure in the region of the chest can increase the risk of breast cancer

Obesity- It is also one of the main reasons behind breast cancer

Hormonal imbalance- Women who have taken high doses of hormones as part of the treatment of infertility or postmenopausal symptoms also have a higher risk of developing breast cancer

Alcohol consumption- Regular intake of large quantities of alcohol is also one of the risk factors

Having the first child at an older age & inadequate or no breastfeeding - increases the risk for breast cancer

Early Menarche and late menopause– exposing a lady to longer duration of hormonal surge

What are the early symptoms of Breast cancer?

The most common symptom of breast cancer is the appearance of a new, painless, hard mass or lump. Some breast lumps may be soft or tender. However, almost 7 lumps out of 10 will prove to be non-cancerous. Other symptoms may include:

  • Nipple inversion, retraction, deviation or destruction

  • Skin dimpling or thickening, reddening of the skin

  • The heaviness of the breast/pain in the breast 

  • Nipple discharge

  • Intermittent breast itch

How do you prevent/decrease the risk of Breast cancer?

The breast cancer incidences are increasing rapidly due to increased life expectancy, urbanization and western lifestyle adoption.

Incorporation of certain lifestyle changes can play a major role in preventing these cancers as follows-

  • Exercising at least 30 minutes a day; five times per week including both cardio and strength training

  • Avoiding the consumption of alcohol and tobacco 

  • Keeping a check on your weight especially after menopause

  • Including a healthy, balanced diet rich in fruits and vegetables

  • Prevent exposure to ionizing radiation

  • Pregnancy and breastfeeding are thought to play a protective role against breast cancer. 

  • Avoid or limit the duration of hormone therapy, if it becomes necessary.

  • Women above 40 years are encouraged to undergo screening for early detection.

How is breast cancer diagnosed?

The diagnosis of breast cancer can be established by carrying out the following:

  • Breast examination: the doctor will check the breast for lumps and abnormalities

  • Mammogram: A mammogram is an X-ray of the breast and most commonly used to image the breasts

  • Breast ultrasonography: it helps to understand if the lump is solid or fluid-filled.

  • Breast MRI: It uses magnet and radio waves to create a picture of the breast

  • Biopsy: A small amount of tissue is removed from the breast with the help of a needle and studied under a microscope to understand the nature of breast cancer. A biopsy is the gold standard test for confirmation of cancer. 

What treatment options are available for Breast cancer?

In recent times, the survival rates of breast cancer have improved. The various treatment modalities include

Surgery- Depending on the type of tumour and stage of cancer, lumpectomy (removal of the lump only), or surgical removal of the entire breast (mastectomy) is performed.

Radiation therapy- High energy X- rays or gamma rays are targeted on tumour sites or post-surgery tumour sites. This helps in the effective killing of the remaining cells and is typically given for five weeks. Brachytherapy involves the placement of radioactive material near the tumour mass.

Chemotherapy- The use of anti-cancer drugs either after surgery or, to shrink the tumour and make breast-conserving surgery possible, it can even be used before surgery. Breast cancer may also be managed by hormone therapy, targeted drug therapy or immunotherapy depending upon the nature of breast cancer. 

 

Dr. Vedant Kabra

HOD And Consultant - Surgical Oncology, Oncology Sciences

Manipal Hospitals, Dwarka, Delhi

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