Breast Cancer

Breast cancer is the most common type of cancer in women. Breast cancer is one of the most curable cancers if detected early.

The incidence of breast cancer rises after age 40. The highest incidence (approximately 80% of invasive cases) occurs in women over age 50.

Symptoms:

Majority cases it is painless lump, swelling in the armpit, skin changes over breast, nipple discharge.

Like any other cancer, treatment outcomes can be significantly better if the cancer is detected at an early stage. ‘Self-exam’ is the best step that every woman should take.

How Should A Breast Self-Exam Be Performed?

In the Shower:

Using the pads of your fingers, move around your entire breast in a circular pattern moving from the outside to the center, checking the entire breast and armpit area. Check both breasts each month feeling for any lump, thickening, or hardened knot. If you notice any change, immediately consult your doctor.

In Front of a Mirror:

Visually inspect your breasts with your arms at your sides and by arms raised.

Look for any changes in the shape, any swelling, or dimpling of the skin, or changes in the nipples. Next, rest your palms on your hips and press firmly to flex your chest muscles. Left and right breasts may or may not exactly match, depending on the individual – but you should look for any changes. If you notice any change, immediately consult your doctor.

Lying Down:

When lying down, the breast tissue spreads out evenly along the chest wall. Place a pillow under your right shoulder and your right arm behind your head. Using your left hand, move the pads of your fingers around your right breast gently in small circular motions covering the entire breast area and armpit.

Use light, medium, and firm pressure. Squeeze the nipple, check for discharge and lumps. Repeat these steps for your left breast. If you notice any change, immediately consult your doctor.

You should be aware of few terms that are frequently used with respect to Breast Cancer diagnosis and treatment:

Mammography:

It is basically an X-ray with low dose radiation; it takes two X-rays, one of each breast. Mammography procedure is not painful but gives some discomfort to the breast. Mammography should be done after 40 years of age; younger females
require sonography of breast to detect any kind of breast lump of breast cancer.

Micro calcification:

Microcalcifications are small calcium deposits that look like white specks on a mammogram. This is an extremely common finding on mammograms. In majority of the cases these are non-cancerous (Benign).

Microcalcifications though are usually not a result of cancer, but if they appear in certain patterns and are clustered together, they may be a sign of precancerous cells or early breast cancer.

DCIS:

DCIS stands for ductal carcinoma in-situ, which means cancerous cells have started to grow within one of the milk-ducts of the breast. If the cells were still confined to the milk duct, it is classified as having a Stage 0 breast cancer.

Invasive breast cancer:

Majority of Breast cancers are of the Invasive variety. Invasive breast cancer occurs when cancer cells from inside the milk ducts or lobules break out into nearby breast tissue. Cancer cells can travel from the breast to other parts of the body through the bloodstream or the lymphatic system. After investigation, the patient’s cancer stage is decided, and accordingly treatment is given.

Breast Conservative Surgery (BCS)/ Oncoplastic Breast Surgery

Not all breast cancer patients require removal of breast. Breast can be saved in the majority of breast cancer patients.

In BCS, only the tumor and a small margin of surrounding normal tissue are removed, along with a few lymph nodes for testing.

Oncoplastic Breast Surgery:

Oncoplastic Breast surgery is an approach for breast cancer patients that improve cosmetic outcomes. To do this, surgeons will combine breast cancer tumor removal (a lumpectomy or partial mastectomy) and plastic surgery techniques (reconstructive surgery) at the same time of breast conservation surgery

Mastectomy:

A mastectomy involves the surgical removal of the entire breast and all the lymph nodes in the armpit.

Chemotherapy:

Chemotherapy is a drug treatment to kill fast-growing cancer cells in the body. Many different chemotherapy drugs are available. Oncologists (specialist doctor for treating cancer) decides which drug is best for the patient.

Can you avoid chemotherapy?

Early stage breast cancer with hormone receptor positive, requires few special tests, if it is low risk tumor, chemotherapy may not be required, instead the Oncologist may decide to give hormonal treatment.

Is chemotherapy dangerous?

Majority of side effects of chemotherapy are reversible. Patients with good nutritional intake, family support and specialized medicine can treat these side effects very well.

Hair loss is one side effect that everyone is concerned about, but hair growth starts almost a few months after completion of chemotherapy.

Hormonal Therapy:

Hormonal therapy is a treatment that adds, blocks, or removes hormones to slow or stop the growth of cancer cells that need hormones to grow.

Breast cancer is fuelled by hormones, such as estrogen circulating in the body. After the initial surgery, tumor samples are examined in the lab for the presence of estrogen receptors, progesterone receptor and Her 2 neu receptor.

The results of these tests will determine if a woman would be a good candidate for a drug, which binds to the hormone receptors – and prevents the real estrogen from acting on the tumor. Such drugs can slow or stop the growth of cancer cells and are considered highly effective in lowering the risk of breast cancer recurrence.

Targeted Therapy:

Targeted therapy is a cancer treatment that uses drugs to target specific genes and proteins that are involved in the growth and survival of cancer cells.

Remember, there can be life after breast cancer, the only prerequisite is early detection.