Importance of early detection and treatment in breast cancer
Dr Ajit Lukram
Breast cancer has emerged as the most common type of cancer in women worldwide as well as in our country. Breast cancer accounts for 14% of all cancers in Indian women. In major cities, 25 to 32% of all female cancers is accounted by breast cancer, that is about one- fourth of all female cancers.
Breast cancer is on the rise in both rural and urban areas. One in twenty-eight women in India carries the risk of developing breast cancer during her lifetime. While in urban areas the risk is one in twenty women, the risk in rural areas is one in sixty women.
Every 4 minutes an Indian woman is diagnosed with breast cancer. More than 50% of Indian women who present with the disease present in the advanced stage of the disease and post cancer survival becomes low compared to developed countries. To quote, the post cancer survival rate in Indian women with breast cancer is about 60% while in the US it is 80%. A 2018 data gives the number of new cases of breast cancer in India as 1,62,468 while the number of deaths due to the disease as 87,090. While the disease is detected in developed countries in the early stage and prognosis following treatment is good, in our country due to presentation in the late stage, the outcome after treatment is poor despite the best treatment. This is due to lack of awareness and poor screening and diagnosis rate. Only way to change is by increasing awareness about the disease.
Breast cancer is a treatable disease and chances of survival are higher if it is detected in time and treated early. The simplest way is by encouraging self breast examination, to be aware of signs, symptoms and risk factors and also screening at regular intervals.
The signs and symptoms for breast cancer diagnosis are to be aware of:-
(1) A new lump/thickened area
(2) Change in shape or size
(3) Discharge from nipples
(4) Swelling in armpit
(5) Skin changes/dimpling
(6) Change in nipple position/retraction
The risk factors are:-
(1) Overweight after menopause
(2) Hormone pills
(3) No children
(4) Sedentary lifestyle
(5) Alcohol use
(6) Tobacco use
(7) Family history
(8) Radiation exposure
(9) Chemicals present in paint, metallic industry, fertilizers, environmental pollution etc.
The most important screening test for breast cancer is the X-ray mammogram. It can detect breast cancers up to 2 years before the tumour can be felt by the patient or the doctor. It is advised to start screening at 40 years of age till 75 years at 3 yearly interval. Higher risk groups can start screening in the early thirties.
Early detection of breast cancer is important as it is associated with an (1) increased number of available treatment options (2) increased survival (3) improved quality of life.
While there is no definitive method of preventing breast cancer, early detection provides the best chance of effective treatment.
The writer is DNB (Gen Surgery), Fellow Breast & Endocrine, Colorectal (North Cumbria University, United Kingdom), and a Consultant Surgeon at Shija Breast & Thyroid Clinic