What you definitely need to know to combat breast cancer

The biggest problem in the battle against breast cancer is that it goes undiagnosed. If detected early, it is curable, says Namita Pandey

Though most of us know about breast cancer, we don’t take the necessary steps for early detection; somehow we tend to believe it can never happen to us. Though more common in females, breast cancer cases have also been found in males. The good news is that, if detected in the early stages, you have a great chance of beating it.

What do I look for?

Most often, the patient will notice a visible lump in the breast, which is usually painless. In the initial stages there are no symptoms; but as the disease progresses, there might be mild to severe pain in the breast or armpit, ulcers, blood-stained nipple discharge and dimpling of the skin among other things. In the later stages these symptoms may be accompanied by a loss of appetite, weight-loss, jaundice, backache, bone fracture and breathlessness.

In spite of the severity of breast cancer, most women refuse to undergo mammography with the excuse that “there’s no breast cancer history in my family, so why do I need to worry?” However it has been found that though genetics is a big risk factor, it contributes only between five and 10 per cent of all breast cancer cases; the remaining cases have no genetic traces.

So what can put me at risk for breast cancer?

The risk factors can be divided into three categories:

Genetics
If you have the BRCA1 and BRCA2 gene mutation, it can lead to breast cancer. Family history is one of the highest risk factors for developing the disease. It is important to consider both maternal and paternal sides. Also, hereditary breast cancer is doubled if:

  • There is someone in your family who has had breast cancer at a young age, either if she was pre-menopausal or younger than 50 years when diagnosed.
  • At least two close blood relatives [e.g. mother, sister, daughter] on the same side of your family [mother’s or father’s] have been affected by breast cancer.
  • You have any male relative with breast cancer.
  • A relative of yours has a history of breast and ovarian cancer.

Inherited gene mutations account for just a tiny portion of all cases of breast cancers diagnosed. There are special screening guidelines for women with a strong family history of breast cancer. Though hereditary genetic mutations could cause breast cancer, there are plenty of women with a strong family history who do not carry known gene mutations. Be wary of taking unnecessary measures, like opting for a mastectomy when no cancer has been detected, based on your family history.

Hormonal issues
Early menarche, late menopause, having your first child after you are 30, not breastfeeding your child, having no children, prolonged infertility treatment and HRT [Hormone replacement therapy] have all been found to increase breast cancer risk.

Be wary of taking unnecessary measures, like opting for a mastectomy when no cancer has been detected, based on your family history

Most studies carried out worldwide into oral contraceptives and the risk of breast cancer showed that women using the pill have a slight but statistically significant increase in getting breast cancer. On the flipside, evidence suggests that the risk decreases once you stop taking the pill. And 10 years after you stop, your chances of getting breast cancer go back to normal. If you are worried about using the pill, especially if you have a family history of cancer, you should consider other methods of contraception.

HRT involves taking female sex hormones to replace hormones that your ovaries no longer produce after menopause. HRT has been known to increase breast cancer risk even when used for only a short time, since it prolongs the affect of oestrogen on the breast tissues.

Lifestyle choices
Stress can cause many physical health problems, which can affect your chances of getting breast cancer risk. But the evidence that stress itself causes cancer is weak. If you are perpetually stressed, you might turn to certain behaviours—smoking, overeating or drinking alcohol—which, in turn, can up your risk of getting cancer.

Can it be prevented?

Yes, there are some measures that you can take to stave off breast cancer-

  1. Have an annual mammogram done along with sono-mammograms, especially if you are older than 40. In the event that several of your family members have had breast cancer, you are advised to undergo screening when you are five years younger than the age when the youngest patient in your family was diagnosed.
  2. Do regular monthly BSE [Breast self-examination].
  3. Exercise and a healthy diet are imperative to keep any disease/cancer at bay.

While you cannot control the age at which you reach menarche and menopause, there are some things within your power. Starting your family early and breastfeeding your children are some things you can do to decrease your risk.

Treatment

Today, there are plenty of options available to deal with breast cancer.

Once a lump has been detected, it is removed and a biopsy is done to assess the stage the cancer is at or if it is cancerous at all. If the cancer is local, but if it has gone beyond the breast region [metastasised] then chances of a cure are lower.

Treatment is divided into three categories:

Surgery: There are two types of surgery. A breast conservation surgery entails the removal of the lump and armpit nodes, while a MRM [Modified Radical mastectomy] is a complete breast removal. For many women, the idea of undergoing a mastectomy is scary, because they believe that not having a breast seems to make them less of a woman. However, they need not worry as there are procedures available to reconstruct the breast.

Chemotherapy: These are injections given to kill the circulating cancer cells. These drugs are now created to have minimum side-effects. Currently, patients are opting for Chemoport, a small device which is placed surgically under the skin, through which the chemotherapy drugs can be delivered painlessly.

Radiotherapy: A treatment in which the patient gets her breast [in case of conservation] or chest [in case of mastectomy] radiated. These machines are highly accurate and destroy microscopic tumour cells that may have not been removed during surgery.

If you or a loved one has been diagnosed with breast cancer, there is no reason to despair. There are ways to combat it. Breast cancer is a treatable disease if detected early.

Breaking some myths

Mammograms are painful
Mammograms are not painful if done properly, but yes, it may be uncomfortable for a few moments because the breasts, which are a delicate organ, are pressed in between the X-ray plates. It is advisable that you do a mammogram on the 7th to 10th day of your menstrual cycle so that the discomfort is minimal.

You cannot get breast cancer if no one in your family has it
As mentioned earlier, 90 to 95 per cent of breast cancers occur in the absence of any family history.

Mastectomy is the best surgical treatment
Multiple studies have confirmed that within certain parameters, breast conservative surgery and mastectomy have the same result. In most cases, your doctor will first see if a breast conservative surgery is possible.

I may spread cancer to other family members
Cancer is not contagious and will not spread to people in close contact with the patient.

October is Breast Cancer Awareness month

This was first published in the October 2014 issue of Complete Wellbeing.

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