Breast Cancer Screening & Management
Breast cancer is the second most common cancer (after cervical cancer) in India with an estimated 115, 251 new diagnoses and the second most common cause of cancer-related death.
One in every 22 women is likely to suffer from breast cancer.
In India, almost 80% patient is in advanced stages when they come to hospitals.
Social taboos regarding breast cancer prevent women from talking to friends and families.
Breast cancer in urban areas of India is 3 times higher than in the rural part of the country.
Here screening of breast cancer plays a major role in early detection and better outcome by doing.
- Simple self-breast examination starts at the age of 20.
- Clinical breast examination, starts at the age of 20-39years, once in 1-3 years and once a year after 40 years.
- Screening by mammogram usually starts after 40 years of age.
Are you aware of risk factors for breast cancer?
- 100 times more frequent in women.
- Indian women are more likely to develop breast cancer at an earlier age.
- Fibroadenoma of the breast is itself is not a risk factor. The risk is increased in certain variants of fibroadenoma.
The risk is 80% increases if the first-degree relative diagnosed with post-menopausal breast cancer after the age of 50.
A history of ovarian cancer in mother’s (or) father’s family also increases the risk of breast cancer.
Screening of breast cancer plays a major role for these women.
Important information about BRCA1/BRCA2
About 5-10% of breast cancer cases are thought to be hereditary. Mutation of BRCA1/BRCA2 is associated with a 40-80% increased risk.
If girls mature early (<12years) and late menopause (after 55 years) have 20-50% increased risk.
Modifiable risk factors:
- No child or late childbirth double the risk of breast cancer
- Women who do not breastfeed or short period of breastfeeding are at a higher risk.
- Physical activity is protective against breast cancer.
If any women have got any of these risk factors, periodic clinical breast examinations, learning of self- breast examination and screening for breast cancer with mammogram are essential steps for early detection and better outcome.
Breast Cancer Screening:
It includes 3 methods for early detection
- Breast self-examination mostly starting in the 20’s
- Clinical breast examination (CBE) once in 1-3 years starting in the 20’s till 39 years and yearly after 40 years.
- Mammographic screening once a year starting at the age of 40 years.
- BSE pattern every woman should learn. Please report to the doctor if you find any recent and persistent changes in after BSE.
Clinical breast examination:
Performed by health professional starts from the age of 20-39 years every 1-3 years and age of 40 years and old once a year
The examination includes feeling for a
- Lump (or) swelling
- Skin dimpling
- Nipple pain (or) retraction(lump inwards)
- Redness (or) scan lines of the nipple (or) breast skin.
- Discharge from the nipple other than breast milk.
- CBE and increasing awareness of breast cancer are viable options for Indian women in age group less than 50 years.
- Studies of WHO (World Health Organization) of screening in Indian woman support men CBE is an effective way and survival can be improved by up to 16%.
It is an x-ray of the breast that uses very low level of radiation, so nothing scary about exposure to radiation.
- It is only a screening test, not a confirmatory test.
- In India breast cancer incidence peaks before the age of 50 years. So mammographic screening is beneficial if it starts at the age of 40 years once a year.
- MR screening with mammogram is targeted for high-risk patients.
The hereditary risk is more if the woman has a family member with a young age of onset.
- Has a family with more number of cases of breast cancer.
- If cancer affects both the breasts.
- The risk of ovarian cancer also increased in these women.
- The best way to protect one’s self in through early detection by screening.