OCTOBER, the month of our favorite festival. October, when the leaves sheds, temperature cools down, considerably and the transition of summer to winter is marked but we know what else this month ushers in, right? Yes, BREAST CANCER!
October is the Breast Cancer Awareness Month, a great time to take stock of our knowledge of this disease, its risks and symptoms. It’s about staying informed and helping yourself take the right steps to fight breast cancer, including early detection and prevention. But first, let’s have a quick refresher on the basics of breast cancer.
Among women, breast cancer is the most common cancer and the second leading cause of cancer deaths after lung cancer. It affects 1 in 8 women all over the world. Men can get breast cancer, too, but they account for just one percent of all breast cancer cases. According to the latest WHO data published in 2017 Breast Cancer Deaths in Nepal reached 1,054, that is 0.65% of total deaths. The age adjusted Death Rate is 9.21 per 100,000 of population. This ranks Nepal at 163 in the world.
How does it start?
As in all forms of cancer, the abnormal tissue that makes breast cancer is the patient’s own cells that have multiplied uncontrollably. Those cells may also travel to locations in the body where they are not normally found. When that happens, the cancer is called metastatic.
Breast cancer develops in the breast tissue, primarily in the milk ducts (ductal carcinoma) or glands (lobular carcinoma). Breast cancer usually begins with the formation of a small, confined tumor (lump), or as calcium deposits (microcalcifications) and then spreads through channels within the breast to the lymph nodes or through the bloodstream to other organs. The tumor may grow and invade tissue around the breast, such as the skin or chest wall.
What causes it?
75% of women who develop breast cancer have no known risk factors. Among the most significant factors are advancing age and family history. Risk increases slightly for a woman who has certain benign breast lumps and increases significantly for a woman who has previously had breast cancer or endometrial, ovarian, or colon cancer.
The link between diet and breast cancer has been debated. Obesity is a noteworthy risk factor, predominately in postmenopausal women, because obesity alters a woman’s estrogen metabolism.
Drinking alcohol regularly — particularly more than one drink a day — also increases the risk of breast cancer.
What Are the Symptoms of Breast Cancer?
- Lump or thickening in or near the breast or in the underarm that persists through the menstrual cycle.
- A mass or lump, which may feel as small as a pea.
- A change in the size, shape, or contour of the breast.
- A blood-stained or clear fluid discharge from the nipple.
- A change in the feel or appearance of the skin on the breast or nipple (dimpled, puckered, scaly, or inflamed).
- Redness of the skin on the breast or nipple.
- A change in shape or position of the nipple
- An area that is distinctly different from any other area on either breast.
- A marble-like hardened area under the skin
How Is Breast Cancer Diagnosed?
Treatments for breast cancer work best when you find the disease early. So it’s important to get the right screening test at the right time.
Breast self-exams are a cancer screening option for women starting in their 20s.To do a self-exam, you’ll need to look at and feel your breasts.Stand in front of a mirror to look for dimpling or changes in shape or symmetry. The rest of the breast self-exam is easiest in the shower, using soap to smooth your skin. With light pressure, check for lumps near the surface. Use firm pressure to explore deeper tissues. Gently pinch all parts of your nipple and the colored area around it, called the areola. If there is any discharge from your nipple — especially if it is bloody — see your doctor.
Mammograms are the most effective way to detect breast cancer.They can find lumps up to 2 years before you or a doctor can feel them by hand. But medical experts don’t agree on how often women need them. The American cancer Society recommends that women age 45 – 54 have one every year and women age 55 and older have one every 1 – 2 years. Imaging tests such as digital mammography, 3-D mammography, and ultrasound can help you see if the lump has the physical features of a tumor.
What Are the Treatments for Breast Cancer?
The treatment options for breast cancer depend on the size of your tumor and how far it has spread in your body, your age, and how healthy you are.
For most people, the first step is to remove breast cancer with surgery, followed usually by some mix of radiation therapy, chemotherapy, or hormone therapy.The standard surgery for breast cancer used to be the removal of the entire breast and lymph nodes nearby, called a modified radical mastectomy. But today, many women who find breast cancer before it has spread can remove just the lump. This operation, called a lumpectomy, has proven to work just as well as a mastectomy, and the physical changes it causes are much less drastic.
How Can you Protect yourself From Breast Cancer?
Comprehensive cancer control involves prevention, early detection, diagnosis and treatment, rehabilitation and palliative care. Control of specific modifiable breast cancer risk factors as well as effective integrated prevention of non-communicable diseases which promotes healthy diet, physical activity and control of alcohol intake, overweight and obesity, could eventually have an impact in reducing the incidence of breast cancer in the long term.
Follow these three steps for early breast cancer detection:
- Consider starting annual screening mammography between the ages of 40 to 50. The American Cancer Society recommends mammograms start at age 45. Breast cancer experts don’t agree when women need to begin getting mammograms. Ask your doctor.
- Women in high risk categories should have screening mammograms every year and typically start at an earlier age. MRI or ultrasound screening can also be given in addition to mammograms. Discuss the best approach with your doctor.
- Have your breasts examined by a health care provider at least once every three years after age 20, and every year after age 40. Clinical breast exams can complement mammograms.
Raising general public awareness on the breast cancer problem and the mechanisms to control as well as advocating for appropriate policies and programs are key strategies of population-based breast cancer control. We should talk more and hide less of these burning issues and make sure everyone is safe.
Janata Clinic conducts regular breast cancer awareness and screening programs in different communities. Look out for us as we may be at your doorstep next!
Janata Clinic | Samartha Nepal
Intern – Research
Janata Clinic | Samartha Nepal