WHAT IS CANCER?
Generally, normal cells multiply leading to an increase in the number of cells. To counter that, cells die naturally, thus maintaining a cycle of cell multiplication and cell death. Sometimes, under the influence of certain agents (carcinogenic agents), certain cells start multiplying beyond the normal rate. Such aggressive, uncontrolled growth of cells in the breast is known as breast cancer. When this growth is confined within the breast duct or breast lobule it is called a breast tumour. When the growth breaks through the boundaries, and invades into adjacent tissues or spreads to other parts of the body, it is termed as breast cancer.
TYPES OF BREAST CANCER
- Ductal – It is the cancer that begins in the cells that line the breast duct. When it is confined within the ducts, it is called as ductal carcinoma in-situ (DCIS). In this stage, cancers can be detected by mammogram and can be cured successfully. If the tumour breaks/ crosses the ductal lining, it may spread to other parts of the body.
- Lobular – It is the cancer that begins in the lobule of the breast. [When it is confined within the lobules, it is called as lobular carcinoma in-situ (LCIS).]
EARLY DIAGNOSIS AND PREVENTION
Diagnosis is important to detect or diagnose breast cancer and to decide upon further treatment. There are various techniques and tests that can be used to diagnose breast cancer. These include Clinical Breast Examination (CBE), Mammography, Ultrasound, Automated Breast Volume Scanner (ABVS), Biopsy and several diagnostic laboratory tests.
Dr. C.B. Koppiker talks about Breast Cancer risk factors
Breast Self- Examination (BSE)
Breast Self-examination is the best method for Early detection of breast cancer. Breast Self- Examination (BSE) is how you check yourself for suspicious lumps or thickening. BSE should be conducted every month, 4 or 5 days after your periods. If you have achieved menopause, you should choose one day of the month to maintain regular breast examination.
This is one of the key methods of breast cancer detection. In the 2003 National Health Interview Survey (NHIS), about 57% of the 361 breast cancer female survivors (diagnosed between 1980 and 2003) reported a self-detection method of breast cancer (either by purposeful examination or by accident).
Diagnosis
CBE should be done every year for women over 30 years of age and once every three years for women in their 20’s.
Mammography should be done every year for women over 40 years of age. It is a technique that uses X-rays to produce images of the breasts for examination and diagnosis. This procedure can detect early, pre-cancerous lesions.
Ultrasound is an imaging technique that produces images of the breasts on a viewing screen and is used to determine the type of abnormality detected by mammography or CBE.
ABVS is a technique that produces a 3D image of the breast and is used to detect tumours in women with dense breasts (as is the case with Indian women). Biopsy involves removing a tissue sample from the affected breast for further analysis using a needle. There are different types of biopsies such as FNAC, Trucut biopsy, Vacuum Assisted Biopsy (VAB) and robotic stereotactic biopsy. Biopsy is considered only when suspicious lesions are detected by mammography or ultrasound, and is a scarless and painless procedure. Laboratory tests such as hormone receptor status, ER/PR/HER2 status, FISH are conducted to detect the type of tumour and to determine the extent to which it has spread.
Dr. C. B. Koppiker talks about Diagnosis Of Breast Cancer
Prevention of Breast Cancer
However, high the risk of breast cancer must not scare you; it does not necessarily mean you will develop breast cancer. You can just follow these simple steps to reduce the risk caused by modifiable risk factors:
- Adapt your lifestyle to include exercising in your daily routine. A stretch in time saves lives!
- Avoid fast food and follow a healthy diet, rich in fruits and vegetables. An apple a day, keeps the doctor away!
- Give up on harmful habits such as consuming alcohol and smoking cigarettes. Bad habits die hard, but it’s better to lose them than hurting your breasts.
- Go for annual health check-ups, including screening of common cancers by your doctor.
Remember that old saying? Health is Wealth! Although genetic predisposition is a non-modifiable risk factor and nothing much can be done to prevent its risk, it is very important that you get counselled about it Genetic counselling will allow you to understand the risks of this disease, its diagnosis by various genetic tests, the further procedure as advised by the doctor, and your management and family planning options. It is very crucial for you to be genetically counselled because this can help you and your family make informed decisions about genetic testing for mutations (like BRCA1 and BRCA2), and can assess the risk of you having the disease. It can also help you in planning your pregnancy. There is no need to shy away from genetic counselling. It’s better to do it now than regret later. At Orchids, we have a dedicated Risk Reduction Clinic to identify, counsel and manage women at high risk by providing closer surveillance for better prognosis and outcomes.