What You Should Know About Breast Cancer
Across the world, breast cancer impacts millions of women every year. One of the most prominent women's health issues, it is also the most common cancer in women and accounts for atleast 1 death in every 2 diagnosed cases. As per the Globocan 2018 report, India had around 2 lakh new case and 87, 090 breast cancer related deaths in 2018.
What Is Breast Cancer?
A malignant tumor (potential to affect other tissues or spread to other parts of the body) that starts in the breast cells. Breast cancer can occur in any of the 3 parts of the breast (lobules,ducts, connecting tissues) but usually most cancers begin in the lobules or ducts.
What Are The Symptoms?
1. Lump in or near the breast or under the arm
2. Changes in the size or shape of breast
3. Dimpling, puckering, or bulging of skin
4. Nipple change - change in position or an inverted nipple (pushed inward instead of sticking
5. Skin redness, soreness, rash
7. Nipple discharge (watery, milky, or yellow fluid, or blood)
What Are The Stages?
According to the TNM system (one of the most widely used cancer staging systems),
1. T connotes the size of the cancer and the extent or the areas to which it has spread. The numbers 1,2,3,4 are used to refer to the size of the tumor with 1 being small and 4 being large.
2. N connotes the number of lymph nodes to which the cancer may have spread. It can be anywhere between 0 (indicating no lymph node has cancer cells) and 3 (indicating large number of lymph nodes have been affected by the cancer).
3. M connotes metastasis - meaning the cancer has spread from the primary tumor to other body parts. It is either 0 (meaning the cancer has not spread) or 1 (meaning the cancer has spread to other body parts)
- The exact specificities are denoted by numbers along with the letters TNM. For instance, T4N3MI means an advanced cancer that has spread while T2N1M0 means a small cancer that spread to the lymph nodes but not to any other part of the body.
- Additional references are sometimes made such as the use of letters along with 'TNM' to further categorize breast cancer. For instance, the letters p and c are used before the letters TNM to indicate whether it's a pathological or clinical stage cancer.
- The letter X means the tumor cannot be measured and the number 0 means either the tumor cannot be found or it has not spread
Sometimes doctors use an alternative staging system that categorizes breast cancer
1. Stage O | In Situ Breast Cancer Presence of abnormal cells in the breast duct (DCIS OR Ductal Carcinoma In Situ) or in the breast lobules (LCIS or Lobular Carcinoma In Situ) that has the potential to become cancerous. It is non-invasive meaning it has not yet spread to any surrounding tissue.
2. Early Stage Breast Cancer:The tumor is small (less than 5cm) and has not spread beyond 3 lymph nodes.
3. Locally Advanced Breast Cancer: The tumor is larger than 5cm and have spread to certain parts like the skin, muscles of chest walls or more than 3 lymph nodes.
4. Metastatic Cancer: This is stage 4 cancer meaning it has spread to other body parts.
Under the numbering system, breast cancer stages are denoted as,
Stage 1 (1A and 1B) | Stage 2 (2A and 2B) |Stage 3 (3A, 3B and 3C) |Stage 4
Risk Factors Of Breast Cancer
The most common and significant risk factors include the following:
Gender: Women are more at risk
Obesity: Being overweight, especially after menopause increases the risk.
Dense Breasts:Breasts that have more of fibrous or glandular tissues and not enough fat.
Radiation: Exposure to ionizing radiation for medical treatment at an early age
Family History: The risk increases if there is a previous record of one or more first-degree family member (mother/sister) having had breast cancer.
Genetic: Certain types of inherited genetic mutation such as in the genesBRCA1 or BRCA2 is also a risk factor. In normal cells, they help make proteins that repair damaged DNA, however, mutated versions of the same can lead to abnormal cell growth, thus leading to cancer.
Lifestyle: Sedentary lifestyle, poor diet, smoking, heavy consumption of alcohol and red meat.
Pregnancy Post 30 Years or No Full-Term Pregnancy: Pregnancy before the age of 30 reduces a woman's risk of post-menopausal cancer. On the contrary, the older a woman is in having her first pregnancy or if a woman has never had a pregnancy, the risk increases as there is more exposure to estrogen over the years. The hormone estrogen advances breast cancer.
Hormone Replacement Therapy and Recent Oral Contraceptive Use: Recent use of either of these or long term use of oral contraceptives slightly increasesthe risk of breast cancer.
Reduced Risk And Improved Scope Of Recovery
Women should be more sensitive to their own well-being and rather than being dismissive, should be taught from a young age to understand their body and not be ashamed of it or to speak out.
An often ignored condition, breast cancer awareness is especially significant in a country like India where the number of cases, particularly in younger women as well as in rural areas is significantly higher. While certain factors are not controllable, knowing the right approach to tackling the issue is a necessity.
Lifestyle monitoring and precautionary measures
Regular screening, especially at post-menopause stage
Check your breasts on a regular basis and watch out for any change. Even if you're young, there may be a potential chance of you getting it, so be persistent and consult a doctor.
Avoid any dismissive attitude and seek a second consultation. Ask question about everything that is related: medical terms, treatment choices, side-effects, preventive measures, and even the outcome.
Awareness and early detection can be highly empowering and significantly impact breast cancer treatment. While India has noted a shift in terms of numbers, the good news is that there has been much improvement in diagnosis and treatment of breast cancer over the years. Advanced medical facilities are now available that has not only enhanced treatment and the quality of life for patients but also lowered breast cancer related mortality.