Breast cancer is a global disease. Breast cancer is the most common cancer diagnosed in women worldwide . India is undergoing a period of dramatic social and economic change.Cancer is now the second leading cause of death in Indians after cardiovascular disease.Amongst women cervical cancer is still the most frequently diagnosed cancer but breast cancer is now the most commonly diagnosed cancer in urban Indian women. Data from National Cancer Registry Programme shows that in all urban areas of India breast cancer has now surpassed cervical cancer as the most frequently diagnosed cancer in women .This implies, practically, one fourth (or even approaching one thirds) of all female cancer cases are breast cancers.

The term “breast cancer” refers to a malignant tumor that has developed from cells in the breast. Usually breast cancer either begins in the cells of the lobules, which are the milk-producing glands, or the ducts, the passages that drain milk from the lobules to the nipple. Less commonly, breast cancer can begin in the stromal tissues, which include the fatty and fibrous connective tissues of the breast.

Risk Factors – late child bearing, fewer pregnancies, reduced duration of breast feeding, use of hormone replacement therapy ,Women who started having periods earlier or entered menopause later than usual are at a higher risk of developing breast cancer. This is because their bodies have been exposed to oestrogen for longer duration. Women who have certain gene mutations, such as a BRCA1 or BRCA2 mutation, have an increased risk of breast cancer. These women also have an increased risk of ovarian cancer, and may have an increased risk of other cancers. Men who have a mutated gene related to breast cancer also have an increased risk of breast cancer.Hereditary breast cancer makes up about 5% to 10% of all breast cancer

Symptoms and Signs of breast cancer include A lump or thickening in or near the breast or in the underarm area, A change in the size or shape of the breast, A dimple or puckering in the skin of the breast, A nipple turned inward into the breast, Fluid, other than breast milk, from the nipple, especially if it’s bloody, Scaly, red, or swollen skin on the breast, nipple or areola (the dark area of skin around the nipple), Dimples in the breast that look like the skin of an orange, called peau d’orange.

In its early stages, breast cancer usually has no symptoms. As a tumor develops, the above mentioned signs may develop. A lump in the breast or underarm that persists after your menstrual cycle is often the first apparent symptom of breast cancer . Lumps associated with breast cancer areusually painless, although some may cause a prickly sensation. Lumps are usually visible on a mammogram long before they can be seen or felt.

Breast cancer detection:

“Early detection is the key to prevention.”NEED OF THE HOUR is awareness about breast examination, beginning from 20 years of age, and regular screening from a qualified doctor, so that it can be detected early and treated successfully.It is important to self examine your breasts. Women should be aware as to how their breast normally look and feel. It may better to wait 3 to 5 days after your period ends to do your self-exam. That’s because hormonal changes before your period can cause a temporary thickening in your breast that goes away after your period.First look for dimpling or changes in shape or symmetry of your breasts. It might be best to do that by looking in a mirror. The rest of the self-exam is easiest to do in the shower, using soap to smooth your skin. Use light pressure to check for lumps near the surface, and firm pressure to explore deeper tissue. Any time you find a new or unusual lump in your breast, have your doctor check it. Most lumps aren’t cancer.Squeeze each nipple gently — if there’s any discharge, see your doctor. Also let her know if you notice a change in the position or shape of a nipple. If you feel any change, then consult the doctor. It is advisable for women who are around 40 to get their mammography done. Mammography is a simple radiographic technique which helps in detecting irregularities in the breast tissue. Women with high risk  should have screening mammograms every year and typically start at an earlier age. Ultrasound screening can also be given in addition to mammograms. Mammograms don’t prevent breast cancer, but they can save lives by finding breast cancer as early as possible.

AUTHOR :
Dr. Precella T Thomas
MBBS, DGO, DNB, FMAS, Fellowship in ART
Consultant Obstetrician & Gynaecologist
Laparoscopic Surgeon & Infertility Specialist.