According to the World Health Organisation, breast cancer occurs in every country of the world and in women at any age after puberty but with increasing rates in later life while health professionals point out that breast cancer is the commonest cancer in urban Indian women and the second commonest in the rural females. Experts have revealed that in India, breast cancer has been a silent killer that kills 75,000 patients every year and it has become an epidemic with its cases rising each year now.
Since no woman is immune to breast cancer, we all must be vigilant and create awareness against the disease. Ahead of World Cancer Day 2022, we got doctors on board to know more about the warning signs to watch out for or the range of symptoms which indicate the occurrence of breast cancer, how to prevent them and all about pregnancy and breastfeeding after chemotherapy.
What is breast cancer?
Dr (COL) R. Ranga Rao, Chairman of Paras Cancer Centre, Paras Hospitals in Gurugram explains, “Breast cancers usually occur when some breast cells begin to grow abnormally. These cells divide faster than healthy cells and continue to accumulate, thereby forming a lump or mass. The cells can metastasize through the breast to one’s lymph nodes and then to other parts of the body.”
Highlighting how breast cancer usually begins in the milk producing ducts of the breasts and is initially called invasive ductal carcinoma, Dr Ranga Rao pointed out another common region where breast cancer can begin – the glandular tissue called lobules which is diagnosed as invasive lobular carcinoma.
Studies claim that 5 to 10 percent of breast cancers are linked to gene mutations passed through one generation to another within a family with the most well known breast cancer genes being BRCA1 and BRCA2. However, a study by American Cancer Society shares that most breast lumps are benign and not cancer (malignant) and that these non-cancer breast tumours are abnormal growths but they do not spread outside of the breast nor are they life threatening yet can increase a woman’s risk of getting breast cancer.
Causes of breast cancer:
As per Dr Ranga Rao, the factors that are associated with an increased risk of breast cancer include:
1. Age: The older you are the more prone you are to developing breast cancer.
2. Family and personal history: If someone in your family had breast cancer or if you have had a breast biopsy that detected lobular carcinoma or atypical hyperplasia, you have an increased risk of having breast cancer.
3. Radiation exposure: If you have received radiation treatment to your chest as a child then you are at a higher risk of breast cancer.
4. Hormone therapy: Women who take hormone therapy medications which combine estrogen and progesterone to treat the signs and symptoms of menopause have an increased risk of breast cancer.
5. Obesity: People who are overweight are at a greater risk of breast cancer.
6. Period: Girls who get period before the age of 12 are at greater risk of breast cancer.
7. Menopause: Women who get menopause at an older age are at a greater risk of breast cancer.
8. Childbirth: The women who give birth to their child after the age of 30 have an increased risk of cancer.
9. No pregnancy: Women who have never been pregnant are at a greater risk of developing cancer than the ones who have been pregnant.
10. Alcohol consumption: Drinking alcohol increases the risk of breast cancer.
Warning signs of breast cancer:
Dr Ranga Rao listed a range of symptoms which indicate the occurrence of breast cancer. These include:
1. Change in the size, shape and appearance of the breast.
2. Formation of dimple or changes in the skin around the breast.
3. A breast lump or thickening which feels different from the surrounding tissue
4. Redness or pitting like the skin of an orange over your breast
5. Crusting, peeling, scaling or flaking of the pigmented area surrounding the nipple (areola) or breast skin.
6. A newly inverted nipple.
Pregnancy and breastfeeding after breast cancer treatment:
Some cancer treatments make it difficult to conceive since chemotherapy, in addition to killing cancerous tissues, can also harm healthy cells, including oocytes. For the uninitiated, breast cancer patients undergoing chemotherapy are more likely to experience early ovarian failure or menopause, which can lead to infertility and young women diagnosed with breast cancer may be concerned about how it will affect their ability to conceive children in the future.
According to Dr Kshitiz Murdia, CEO and Co-founder of Indira IVF, “Such fertility concerns should never limit women’s breast cancer treatment. A well-known fertility preservation treatment is ovarian stimulation followed by in vitro fertilisation (IVF) and embryo cryopreservation, which is especially effective in breast cancer patients who are still in their reproductive years. Patients with breast cancer who do not have a spouse might opt to cryopreserve their ova, commonly known as egg freezing, to plan their family after overcoming the disease. Embryos and eggs are kept in liquid nitrogen for up to ten years in both processes and can be utilised later to conceive.”
Asserting that after completing breast cancer treatment, women should wait at least two years before trying to conceive, Dr Kshitiz Murdia revealed, “This is because the risk of cancer returning diminishes with time and the first two years after diagnosis may be the most vulnerable. Getting in touch with a fertility specialist and an oncologist can help one in making an informed decision.”
He added, “After breast cancer treatment, many mothers are able to breastfeed their infants. If they have undergone breast surgery or radiation, they can have trouble feeding from the impacted breast. In some studies, decreased milk production as well as structural abnormalities in the afflicted breast have been documented, which may make breastfeeding painful or difficult for the new-born to latch onto.”
However, he informed that breastfeeding is harmless for the mother and the baby if they are not undergoing chemotherapy at the time or using a few specific long-term medications. Hence, he advised that before attempting to breastfeed their infant, one should properly speak with their doctor and get their queries answered if they are still taking any medication.
Preventive tips to avoid breast cancer risk:
Staying aware and paying attention to your own health will hold you in good stead when it comes to breast cancer prevention. Dr Ranga Rao shared a list of things that you can do to prevent breast cancer. They include:
1. Breast cancer screenings – A session with your doctor will help you understand whether or not to go for clinical breast exams and mammograms as you will be able to weigh down the pros and cons of the screening.
2. Self breast exam – A self breast exam can be done by inspecting your breasts for any potential lumps or other unusual signs.
3. Limit alcohol – Limit the use of alcohol to not more than one drink a day, if at all.
4. Regular exercise – Exercising regularly will reduce your risk of breast cancer so aim for at least 30 minutes of exercising each day.
5. Healthy diet – A healthy diet with fruits, vegetables, nuts, virgin olive oil, whole grains and legumes as well fish instead of red meat will reduce the risk of breast cancer. It will also help you maintain your weight and not consume more calories than you should.
6. Preventive surgery – Women with a high risk of breast cancer can take the decision of removing their breasts with a surgical procedure called prophylactic mastectomy.
“Breast cancers are treatable if it is diagnosed at its early stage. The best part of early diagnosis is that one does not have to lose the breast,” Dr Ranga Rao shared. He added, “Nowadays, breast conservative surgery is a very much a part of it. Then, self-breast examination and screening have become imperative for the early diagnosis of breast cancer and rule out the myths surrounding the breast cancer. The earlier the cancer is detected, the better the chances for treatment and survival.”