With over 1,62,000 cases reported each year (according to GLOBOCAN 2018), breast cancer is the most common cancer affecting women in our country. “A person dies every 10 minutes due to breast cancer. The actual numbers can be much more than this. While we cannot pinpoint a reason for developing the disease, it can be controlled to a great extent by being breast aware,” says Dr P Raghu Ram, director of KIMS – Ushalakshmi Centre for Breast Diseases, Hyderabad and president of The Association of Surgeons of India.
Being breast aware V/S Breast self examination?
Though the term is often used interchangeably, they are not the same. “Being breast aware is to become familiar with one’s breast and the changes that happen to it throughout a person’s life,” Dr Ram explains. Women of all ages should be encouraged to touch and feel their breasts with their hands every day. This can be done anywhere and it helps to make us aware of what is normal and what is not. The point is to start as young as possible, to normalise and destigmatise it, and to make it a part of the daily routine. Breast self examination (BSE) is the regular checking of breasts at a particular time every month. “This is now replaced by breast awareness as a standard practice.”
Changes to look out for
During the examination, we must look out for changes including:
Painless lump or thickening
A noticeable change in size
Recent retraction of the nipple
Swelling under the armpit or around the collarbone
Rash on or around the nipple
Bloodstained spontaneous (without pressing) discharge from one or both nipples
Dimpling of the skin
Constant pain in any portion of the breast or armpit
What if there is a change?
The changes do not always mean that it is cancerous. “Nine out of 10 breast health issues are benign. But this should not stop women from consulting a doctor,” says Dr Ram. To know if the lump is benign or cancerous, a woman will have to go through a triple assessment. “It comprises clinical breast examination by a doctor, breast imaging (a combination of mammogram and ultrasound), and core needle biopsy (ideally guided by ultrasound),” he explains. Along with being breast aware, a woman over 40 should also ideally undergo a screening mammogram once a year or at least once in two years.
Who is more prone to breast cancer?
Studies prove that prolonged exposure to the estrogen hormone is a contributing factor: “People who had their menarche at a very early age (before 11 years), those who have late menopause (after 55).” Post-menopausal obesity is also a factor as fat cells are capable of producing estrogen. Childbirth below 30 years of age and breastfeeding for two years has proven to decrease this risk. Another factor is hereditary. It is caused by an abnormality in BRCA1 and BRCA2 genes. However, only 5% to 10% of breast cancers are caused by this anomaly.
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