The incidence of breast cancer is on the rise in India. It is the most common cancer in women in India today. Early marriage, early pregnancy, adequate lactation are low-risk factors for breast cancer. However, due to the urban lifestyle, many women choose not to get married or have children or lactate the child. Lack of exercise, eating fatty food, smoking, drinking alcohol regularly, and obesity are risk factors for breast cancer. Thus, in India, we are seeing breast cancer, presenting nearly a decade earlier than before. Dr Satish Rao, Senior Surgical Oncologist, Jaslok Hospital and Research Centre, Mumbai shares his inputs on how fatal can breast cancer be in times when technology is top notch.
Is Breast Cancer Fatal?
Breast cancer is diagnosed early is curable. However, people are ignorant, both urban and rural, about the symptoms of breast cancer. Breast cancer usually presents as a painless lump in the breast above the age of 35 years. It may also present as a blood-tinged nipple discharge. Painful and heavy breasts before periods is a sign of mastalgia of the breast, which is a non-cancerous condition. It is therefore important to understand that a painless lump in the breast in a lady above 35 years should be investigated to rule out breast cancer.
What Are The Stages Of Breast Cancer?
Early stage of breast cancer (stage zero breast cancer) is when the lump in the breast is small, mobile with or without any nodes, i.e. glands in the axilla(armpit). Locally advanced breast cancer (stage 3), i.e. when the lump in the breast is large in size or fungating without any spread of Cancer elsewhere in the body. Stage 4 breast cancer is the one where the Cancer has spread beyond the breast elsewhere in the body. The survival figures reduce as the stage increases. Stage 1 breast cancer is associated with a 90% 5-year survival while stage 4 breast cancer is associated with 22% 5-year survival. In India, about 50% of cases are diagnosed in an advanced stage.
How To Diagnose Breast Cancer?
We often come across queries like how is breast cancer diagnosed? Breast cancer is diagnosed by breast self-examination, an examination by the oncologist, mammography and biopsy. Breast self-examination is when the woman examines her breasts thoroughly for any lump after her periods with the flat of her hand. Mammography is an imaging modality which is very sensitive and can detect a lump in the breast which cannot be felt with the hand. A pet CT scan is done to see whether cancer has spread beyond the breast, elsewhere in the body.
How To Treat Breast Cancer?
In early breast cancer, i.e. stage 1 and stage 2 the treatment is breast conservation surgery, i.e. removing the lump in the breast with little margin of normal tissue around it and removing the nodes in the axilla. The patient, however, needs to compulsorily take radiation after breast conservation surgery in addition to chemotherapy and/ or hormonal treatment if required. It is also possible to do oncoplastic breast reconstruction in breast conservation surgery. In stage 3 breast cancer, chemotherapy is given to shrink the disease to make it operable, and this is followed by adjuvant treatment. In stage 4, the aim of the treatment is usually palliation, i.e. to improve the quality of life of the patient and this can be achieved by chemotherapy and/ or hormonal treatment and /or radiation.
The Right Time To Diagnose Breast Cancer?
It is very important to understand that if we can diagnose breast cancer early, that is stage 1, which has a 90% 5-year survival, then we can offer curative results to the patient. Proper education regarding the symptoms and risk factors of breast cancer, correct breast self-examination technique, timely diagnosis can help to diagnose breast cancer early. If diagnosed early, i.e. in stage 1 or stage 2 the fatality rate can be reduced in today’s day and age.
With inputs from Dr Satish Rao, Senior Surgical Oncologist, Jaslok Hospital and Research Centre, Mumbai
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