Pink Ribbon Month, awareness is key


October is observed all over the world as Pink Ribbon Month or Breast Cancer Awareness Month. Breast cancer is the number one cancer in terms of incidence and mortality among women across the world, in both urban and rural areas of India. According to doctors, like most other diseases, breast cancer also attacks younger women, and those in their 30s and 40s fall prey to it. More than half of these cases are only diagnosed at an advanced stage due to a lack of awareness of timely screening.

Scary statistics

According to the World Health Organization, breast cancer kills about 6.85 lakh of women per year.

Globocan (a branch of the International Agency for Research on Cancer or IARC) cites the latest statistics available for 2018 in India to show that breast cancer has overtaken cervical cancer to become the most common cancer in women. women. About 1.62 lakh of new cases are diagnosed every year in India. Each year, around 87,000 die from the disease, and those numbers are expected to exceed 1 lakh of deaths per year by 2030, while new cases are likely to exceed two lakh.

Challenges of early diagnosis

Dr G Abhilash, Radiation Oncologist at Apollo Hospitals, says: “In India, issues of lack of awareness and late presentation continue to hamper our results. High-income countries detect breast cancer early and have a 70-80% chance of a cure, while in low- to middle-income countries like India, it is diagnosed late with a lower chance of survival. The proportion of young patients (under 35) ranges from 10% in developed countries to 25% in developing Asian countries, says Dr Abhilash. About one in ten women have inherited and associated a family history of breast cancer. Mutations in two genes – BRCA1 and BRCA2 – have a higher cumulative risk of causing breast cancer.

The diagnosis of breast cancer in younger women (under 40) is more difficult because their breast tissue is generally denser than that of older women, and routine screening is not recommended, says the doctor. Breast cancer in younger women can be more aggressive. Women who are diagnosed with breast cancer at an early age are more likely to have genetic mutations that predispose them to this cancer and others, he adds.

Providing more statistics, Dr Abhilash says that it has been estimated that 20% of breast cancers worldwide can be attributed to modifiable risk factors, including obesity, physical inactivity and alcohol consumption, with the potential to reduce the burden of disease by promoting a healthy lifestyle.

According to medical statistics, one percent of all breast cancers occur in men, although they are relatively low risk, he says. The lifetime risk of breast cancer in men is one in 833, compared to one in 10 for women. Besides genetic predisposition, age, obesity, smoking, cirrhosis of the liver and prostate cancer can be other risk factors.

“If members of your family have had breast or ovarian cancer, or if a member of your family is known to have a BRCA1 or BRCA2 mutation, you may be referred for genetic counseling,” notes Dr Abhilash.

Processing methods

“A variety of advanced and recent treatment modalities improve both survival and quality of life. The surgeries include mastectomy and axillary dissection, or removal of the entire breast, which has massive cosmetic and psychosocial implications for women, ”the doctor explains.

“There’s also breast conservation surgery and reconstruction and sentinel lymph node biopsy or dissection. It maintains the shape and contour of the breast. Radiation therapy is another mode of treatment. Systemic therapy includes chemotherapy, targeted therapy and hormone therapy, ”he adds.

A date with breast cancer

In May 2020, Delhi-based Shalini Nayar felt an unusual heaviness in her chest and felt a lump. Within 48 hours, she flew to Hyderabad amid the raging Covid pandemic to see a doctor. A physical exam, mammogram, ultrasound, and biopsy revealed the lump to be cancerous. “I felt my world was broken and I asked God, ‘Why me?’ Shalini says. “Being a workaholic, I didn’t have time for fitness activities. Dr Raghuram and his team advised me and treatment, including chemotherapy, lump removal, oncoplastic surgery, and radiation therapy, was given for the next few months. Finally, I beat the cancer, ”she says. Medical follow-ups are ongoing, Shalini has taken a sabbatical and is now following a healthier diet and lifestyle.

Shalini advises women to be alert for any changes in the breasts, to seek immediate medical attention if they detect any changes, and to have an annual mammogram after age 40. Staying strong and positive, trusting and applying the advice of the medical team is also very important, ”she says.

Take these symptoms seriously

l A painless lump or thickening that feels different from the rest of the breast
l Change in size, with the breast becoming noticeably larger or lower
l Recent nipple retraction
l Rash on or around the nipple
l Blood-stained discharge from one or both nipples
l Wrinkling or padding of the skin covering the chest
l Swelling under the armpit or around the collarbone (where the lymph nodes are)
l Constant pain in part of the breast or armpit

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