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Breast Cancer

Introduction

Breast cancer develops from cell in the breast that have grown abnormally and multiplied to form a lump or tumour. Breast cancer accounts for 14% of cancers in India.
Stages of breast cancer are stage 0 (Non-invasive breast cancer), which is contained within the ducts or lobules of the breast and has not spread into the healthy breast tissue. Cancer that spread beyond the ducts or lobules into healthy breast tissue, lymph nodes or distant organs is called as Invasive breast cancer (Stages I-IV). It is the most common cause of cancer-related deaths in women and occurs most frequently in postmenopausal women over the age of 50. Breast cancer is also seen in men but in very rare, making up around 1% of all breast cancers.
Breast cancer is treatable, and chances of survival increases if it is detected early. The best way of early diagnosis is awareness of signs and symptoms of breast cancer.
 

Signs and Symptoms

• A lump in a breast or armpit
• Change in breast shape, size and location
• Discharge from nipple
• Changes in nipple size, texture and location
• Changes in the breast skin

Diagnosis

Initial detection of breast cancer starts with a detailed history, physical examination, mammography and ultrasound scan. In selected cases, breast magnetic resonance imaging (MRI) is helpful. If a tumour is identified, a needle biopsy will be taken to assess the cancer before any treatment is planned. PET scan get done for metastatic workup.

Management

Treatment of breast cancer depends on stages (0-IV) that is how advance the cancer is and types of cancer. Breast cancer is ‘staged’ according to tumour size, involvement of lymph nodes and whether it has spread outside the breast and lymph nodes to other parts of the body or not. This information is used to help decide and plan the best treatment. The presence of biomarkers such as hormone receptors (ER and PR) and a receptor called HER2 also help to determine what type of therapy is given. Treatment of breast cancer includes Surgery (breast conservation surgery BCS, Sentinel lymph node biopsy SLNB, Modified radical mastectomy MRM, breast reconstruction in form of oncoplastic breast surgery and Flap reconstruction), chemotherapy, radiotherapy, hormonal therapy and targeted therapy.
Lifestyle modification plays a vital role in management of breast cancer by improving prognosis and optimizing overall health. Lifestyle modification includes weight management, physical activity (at least 150 minutes per week), diet (fruits and vegetables rich in antioxidants), avoiding alcohol and smoking, etc.

Follow-Up

It is recommended to visit your doctor every 3-4 months for the first two years after finishing treatment, every 6-8 months from years 3-5 and once a year thereafter. You will also have a regular mammography every year. You also need to monitor side effects associated with the therapy and if found talk to your doctor about it.