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Breast cancer

What is breast cancer?

It is a malignant tumor of the breast. It is one of the most common cancers in the world and in India. Most cases develop in women over the age of 50 but younger women are sometimes affected. Breast cancer can rarely occur in men.

Breasts are made up of fat, connective tissue and glandular tissue made up of lobes. A network of ducts connects the lobes to the nipple. Breast cancer can develop from the cells that line the breasts, the lobules and draining ducts.

A woman's breasts goes through many changes in the course of her monthly cycle and even through various stages of her life. Most changes are benign, but it is important to be breast aware, which means knowing what is normal for you and what changes to look out for.

Changes to be aware of:

• Size and shape - if one breast becomes larger, or lower; a change from the normal
• Nipples - if a nipple becomes inverted (pulled in) or changes position or shape
• Rashes - on or around the nipple
• Discharge - from nipples
• Skin changes - puckering, dimpling or thickening of the skin on a part of the breast
• Swelling - under the armpit or around the collarbone
• Pain - breast or armpit
• Lump or thickening - different to the rest of the breast tissue

Any different or unusual change in the breast should always be examined by a doctor. If cancer, the earlier the treatment is given, the more likely it is to be successful.

Risk factors

May develop for no apparent reason but there are certain 'risk factors' which increase the chance that breast cancer will occur. These include:

• Age: Risk of breast cancer increases with age.
• Geography: Incidence varies between countries. May reflect genetic or environmental factors.
• Family history: Increased risk if close relatives have or have had breast cancer.
• Previous history: Benign breast diseases or breast cancer.
• Being childless, or if you had your first child after the age of 30.
• Early age of starting periods.
• Having a menopause over the age of 55.
• Taking HRT (hormone replacement therapy).
• Lifestyle factors: High fat intake, lack of exercise, obesity after menopause, and excess alcohol.

Family history and genetic testing

About 1 in 20 breast cancers are caused by a 'faulty gene' which can be inherited. If you have a strong family history of breast cancer you may wish to discuss this with your doctor. Genetic testing to see if you have inherited certain 'faulty genes' is possible.

How is breast cancer diagnosed?

Initial assessment: A doctor will normally carry out a physical exam of the breasts and armpits to look for lumps or any other changes. Additional tests such as a mammography (x-ray of the breast) or an ultrasound scan of the breast may be recommended.

Biopsy: A biopsy is when a small sample of tissue is removed from a part of the body. Assessing extent and spread: Further blood tests, ultrasound scan of the liver, chest x-ray, bone scan and other tests may be carried out.

Treatment

Surgery, radiotherapy, chemotherapy and other newer therapies are the various modalities of treatment used to manage breast cancer depending on the stage of the disease.

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