Worldwide OCTOBER month has been dedicated for “Breast cancer Awareness” & 3 rd week is specially dedicated for Male breast cancer awareness. Pink ribbon symbolises the Breast cancer awareness & was created by Evelyn Lauder of Cosmetic Conglomerate Group, USA.
In this year 2014, as an awareness campaign-Empire State Building in Newyork, Eiffel tower in Paris, The Colosseum in Rome, The Bandra -Worli Sea link in Mumbai, The Burj Al Arab in Dubai & Peninsula in Hongkong are likely to be lit up in pink this month.
Why Breast cancer awareness is required? OR What are the Facts about Breast cancer
- Incidence of Breast cancer is increasing. Breast cancer is the leading type of cancer in women worldwide so also in Indian urban population. It is the second leading cause of cancer deaths in women.
- Overall one in every 10 women can develop breast cancer in their lifetime. In US for every 5-6 newly diagnosed cases of breast cancer one dies of breast cancer, it has been reported that one woman dies of breast cancer every 12 minutes in US.
- In India breast cancer has beaten cervical cancer in the past decade as the leading cancer & for every 2women newly diagnosed as breast cancer one lady dies of breast cancer(WHO 2012) which is attributed to phobia, lack of awareness & screening.
- Identifying people with risk factors, regular screening,early diagnosis & treatment can definitely increases the cure rate & survival rate.
It is a disease wherein cancer develops in the breast tissue – May be in the cells lining the milk ducts called “Ductal carcinoma” which is more common or May be in cells lining the milk duct lobules called “lobular carcinoma”.
Interaction between environmental factors & genetically susceptible host can trigger cancer
- Average age is 43-46 yrs in India
- Average age is between 53-57 yrs in USA
- However younger & older age than mentioned are not exempted. Infact 25% of the
- total breast cancer cases are seen in less than 50 years of age.
- Obesity &dense breast tissue
- Sedentary life style, lack of exercises
- Diet rich in fat, red meat & poor in fruits, vegetables, greens, omega 3 fatty acids
- Smoking, Alcohol
- Early age of menarche, no children or children after 30 yrs, not breast feeding
- Prolonged use of birth control pills, Hormone replacement therapy(HRT)
- Exposure to radiation
- Hereditary factors ( 5-10%of the cases)
- Certain chemical exposure like Biophenyles, pesticides, polycyclic hydrocarbons etc
- Include mainly
- Breast lump, although less than 20% of the lumps are cancerous
- Change in breast size, colour, shape, position
- Change in shape of nipple or any discharge from nipple.
- Ied scaly patches on skin, puckering of skin
- Those with cancer spread may have jaundice, breathing difficulty, above pain, enlarged lymph node.
- Once Biopsy confirms breast cancer, other tests are done to know the spread & staging is done ( stage 0-4 depending on the severity). Treatments includes combination of surgery, Radiation, Chemotherapy depending on disease condition of the patient.
- Breast reconstructive surgery can be done.
- Following surgery regular follow up is must & overall – healthy diet &lifestyle, exercise, positive thinking, regular screening – reduces the risk of recurrence
- Men can get breast cancer altho it accounts to less than 1%
- Median age group of diagnosis 67-70 yrs
- Incidence is rising consistently
- Risk factors include obesity, diet, smoking, alcohol, genetic factor
- More than 40% of male patients are diagnosed with stage 3/4 due to late approach
- 3rd week of October is dedicated for male breast cancer awareness
- In the recent years survival rate is increasing due to awareness, regular screening, early diagnosis & treatment.Survival chance decreases with advanced stage or disease & is as below as per National cancer Institute SEER database(American cancer society).
- Stage 1 -99-100%
- Stage 2 – 93%
- Stage 3 – 72%
- Stage 4 – 22%
- If breast cancer is caught early results are excellent
Prevention starts with
- Eat Right – say no to junk food, include 5 portions of fruits & vegetables, greens, omega 3 fatty acids in daily diet
- Weight management – excercise at least 30 minutes 5 days a week
- Healthy Habits – no smoking, alcohol
- Breast Feeding
- Regular screening for Breast cancer
- Undergoing genetic test & counselling for prophylactic mastectomy in genetically susceptible individuals
- Screening is recommended for all women because -in more than 70% of breast cancer patients no risk factor is found.Screening tests are those which can detect the tumour in a precancerous stage or in the very early stage so that immediate treatment would result in almost 100% cureScreening tests Include
- A. Self examination of breasts-which can be carried out by herself every month after the periods or on any particular day of month in post menopausal lady. Drawback here is very small tumour may be missed
- B. clinical examination of the breast by a medical person is recommended every year after the age of 40 & every 3 years between 20-40 years
- C. Ultrasound examination is recommended in any suspicious lump. In India sonomammogram can be started from the age of 40 considering ealry age occurrence of breast cancer
- D. Mammogram-is recommended 2yearly between 50-74 yrs or if any lump is suspected
- E. MRI is most sensitive test with high accuracy & is recommended when Mammogram is not conclusive
Always gold standard for diagnosis is lump biopsy & histopathologic study (microscopic study)
There are many ongoing myths unfortunately….. like
- Breast cancer occur only in older age group
- Touching breasts repeatedly causes breast cancer
- Mammogram is very painful & mammogram itself causes breast cancer
- Underwire bra causes breast cancer
- Deodorants &antiperspirants causes breast cancer
- Drinking coffee &plastic water bottle left in hot car causes breast cancer
- Normal mammogram means no cancer
- Breast cancer in pregnancy is very rare, but is the commonest of all the cancers seen in pregnancy.
- Incidence is increasing.
- Normal Breast changes in pregnancy like enlarged breasts with lumpy feeling & tenderness overlap with cancer symptoms making diagnosis difficult & late.
- Symptoms include-lump, skin changes, blood stained discharge from nipple
- Evaluation is done with the help of ultrasonography, MRI &biopsy
- Treatment is challenging in the interest of both mother & baby
- Surgery is the gold standard treatment in pregnancy with or without chemotherapy
- In general pregnancy after breast cancer treatment should be planned in discussion with doctor & usually deferred for 2-5 years