Kerala Kaumudi Online
Monday, 06 July 2020 12.00 PM IST

Pinktober – know your breast, knock out breast cancer


Breast cancer is the most common cancer in women, affecting more than 10 million women worldwide. The month of October is observed as Breast cancer Awareness Month, an annual campaign conducted all over the world to increase awareness of the disease.

Know Your Breast: Breast Awareness

Breast is composed of glands called lobes that produce milk during lactation. The milk is carried to the nipple by thin tubes called ducts. Breast cancer originates from the lobes or the ducts of the breast. Normally, changes in breast can occur during pubertal development, reproductive age during pregnancy and that occuring at menopausal state.

Everyone’s breast looks and feel different. Even for a woman the right breast is different from the left. Breast awareness means being familiar with the normal look, feel of your breast and understanding the normal changes your breasts undergo with time and advancing age. There is no right or wrong way to self-examine your breast. You can see your breast by standing in front of mirror. You can feel the breast in lying down position or while taking bath. Always make sure you not only examine the breasts, but also the arm pits and upto the collar bone.

Warning Signs of Breast Cancer

The changes that you need to watch for in your breasts are - a new lump in your breast or armpit, any new change in size or shape of breast, dimpling of skin over breast, redness or flaking of skin in and around nipples, inverted or sunken nipple, discharge from nipples.

If you are aware of your breasts, these new changes can be picked up early. All these findings need not necessarily be cancer but always meet your doctor without delay.

Screen your breasts for cancer –how and when?

Screening of breast cancer is most effectively done using mammogram. Mammogram is a low dose X-ray examination of breast cancer. It helps in early detection of breast cancer even before any signs or symptoms cancer manifest.

All females more than 40 years of age should undergo screening mammogram once in two years. Along with this they should visit the doctor for clinical breast examination once in a year. Studies have shown that regular screening has reduced the the number of women who die from this disease by 30%.

However certain females are at higher risk of breast cancer as compared to normal population especially those with their first-degree relatives (first degree relatives include mother, sister or daughter) diagnosed with breast or ovarian cancer. They should meet the oncologists to undergo counselling and get enrolled in more frequent screening programs.

Why should breast cancer be diagnosed early?

Prognosis of breast cancer is highly dependent on stage of diagnosis. Treatment of breast cancer is highly successful when diagnosed in the early stages. The five-year survival rate ranges from 84% for early disease to just 18% for advanced cancers. This highlights the importance of early identification of the disease that assures effective treatment, longer survival and better quality of life.

Being diagnosed with breast cancer – is it the end of the life`s journey?

Being diagnosed with breast cancer today is an entirely different experience as compared to what it was about 3 decades ago.

Prior to 1970s, the only option for a woman diagnosed with breast cancer was to undergo a radical mastectomy where the whole breast along with nipple, lymph nodes in arm pit and chest wall muscles were removed. This was a destructive and disfiguring operation that led to a psycho social disaster for women then. Over the last 20 years the surgery of breast cancer has become more and more conservative. Moreover, breast reshaping and reconstruction are increasingly done to rebuild the breast.

Hand in hand there has been a lot excitement in the systemic treatment of breast cancer. The most important therapies being hormonal therapy, chemotherapy and targeted therapy. Targeted therapy selectively inhibits the mechanisms by which tumour cells grow, invade and metastasise. Radiotherapy has a crucial role in local control and survival.

Now we realise one size fits all approach doesn’t apply to management of breast cancer. Each patient will have a variety of concerns specific to them. The field of oncology has entered the era of personalised medicine where treatment of each patient is tailored such that maximum benefit is offered at minimal toxicity.

Last but not Least - Big salute to the She-Ro

With the advent of better screening and treatment modalities, women diagnosed with breast cancer are living long. They are the SHE-RO who have courageously and passionately fought and conquered breast cancer. Breast cancer survivors face a number of physical and psychological challenges while returning to normal life and attaining a new balance. Supporting them and giving them the optimal care is a major challenge the medical community is facing today.

Does the story end here?

Today the women diagnosed with breast cancer have a much brighter future. Though breast cancer still affects a lot of women it kills few. While much has been achieved, much more needs to be learned. Many women still develop recurrence and ultimately succumb to the disease. Ultimately the story of breast cancer remains incomplete. We look forward to the news somewhere in future that breast cancer has become a preventable disease. Hopefully that will be the best ending to this enduring story.

Dr Rajitha L MD, DM (Medical Oncology)

Consultant Medical Oncologist

KIMS Cancer Center, Trivandrum

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