Until a decade back, breast cancer was largely considered to be a disease of the developed world. Not anymore! Not only is the incidence of this disease rising in India, doctors are also reporting the manifestation of more aggressive cancers in relatively younger women today.
Roughly 144,937 women in India were detected with breast cancer in 2012 and 70,218 died of it...
Breast cancer is today the leading cause of cancer-related deaths in women. According to estimates of the World Health Organization, roughly 144,937 women in India were detected with breast cancer in 2012 and 70,218 died of it, making it one death for every two new diagnoses. With the incidence of the disease rising by more than 20% since 2008, India is expected to have a whopping 200,000 new cases of breast cancer per year by 2030.
These growing numbers can be partly attributed to an increase in recorded numbers due to more women being diagnosed. At the same time, a number of lifestyle factors such as increasing urbanization, rise in obesity, sedentary ways of living and changing reproductive behaviours such as delayed childbirths are also believed to be propelling the incidence.
It is important to note here that breast cancer can also strike men. But more on it, later.
Does early detection matter?
Do you know that in North America, Sweden and Japan, survival rates of breast cancer patients are as high as 80%? In Western countries, regular screening programs have succeeded in early identification and treatment of a large number of women. However, the absence of a community-based screening program in India puts the onus on individuals. No wonder, survival rates here are among the lowest in the world.
Sabhyata was only 40 years old when she was diagnosed with breast cancer. In the absence of regular screening or clinical examination, her disease was detected only in stage III. She underwent a surgical treatment, followed by radiation therapy but her cancer returned within 6 months. More than 60% of breast cancers in India are diagnosed in stage III or stage IV. By this time, it is too late to cure the patient or significantly prolong her life. Early detection not only presents a good chance of cure and long-term survival but also allows for breast conservation.
Breast cancer can be detected early only if a combination of self and clinical breast examination, coupled with a mammography, is conducted regularly by women. It is extremely important for women to keep a close track of any changes occurring in their bodies. Any lump in the breast or underarm area, any unusual discharge from the nipple, any change in the shape or size of the breast should be taken note of and immediately reported to a doctor for further examination.
Modifiable risk factors
You would be surprised to know that obesity can be directly linked to increased risk of 13 types of cancers. Breast cancer is one of them. Apart from excessive weight, there are other modifiable and preventable risk factors such as physical inactivity, smoking, unhealthy eating habits, and reproductive behaviours like late pregnancy and reduced duration of breast feeding. In fact, a study cited by WHO concluded that, 21% of all breast cancer deaths worldwide were attributable to alcohol use, excess weight and obesity, and physical inactivity.
21% of all breast cancer deaths worldwide were attributable to alcohol use, excess weight and obesity, and physical inactivity.
While you cannot eliminate the risk of breast cancer, reducing it is certainly in your hands. Having the right Body Mass Index, making sure to have 30 minutes of exercise daily, avoiding smoking and alcohol and trying not to delay childbirth are active ways of curtailing your risk.
Can genetic testing help?
While you can modify your lifestyle to beneficial effect, the most significant risk factor lies in your genes. In normal cells, the BRCA1 and BRCA2 genes help prevent cancer by making proteins that keep the cells from growing abnormally. However, in case there is a genetic mutation in these genes, the risk of breast and ovarian cancers is high. To better illustrate this point: in people with normal genes, the risk of breast cancer is 12%. The same risk is as high as 50-80 in a person with BRCA2 gene mutation. The BRCA1/2 mutations run in families. There is a 50% chance that a child born to a parent who carries a mutation in one of these genes shall inherit the mutation.
While the genetic test to determine gene mutation cannot predict "if" or "when" a woman will develop breast cancer, it can certainly determine if she is at risk because of faulty gene(s). If the test puts you in the latter category, you can be better prepared and adopt screening strategies to ensure early diagnosis and a good prognosis. You can also make radical informed choices. Angelina Jolie, for example, underwent preventive mastectomy (surgical removal of breast) after discovering in a genetic test that she had mutated BRCA1/BRCA2 genes.
Here I'd like to reiterate: breast cancer might be a deadly disease but it is not undefeatable. By adopting a healthy lifestyle and staying alert to your body's needs, you can fight off the disease.
Not just a woman's disease
While most of the focus around breast cancer is on women, men too can develop it, though the disease is rarer in them. Breast cancer manifests in men in the same way as it does in women—in the form of a lump or a discharge from the nipple. Unfortunately, lack of awareness about their susceptibility makes many affected men ignore the signs of the disease. It is as much important for men as women to stay alert to any abrupt changes in their bodies and report it to a doctor immediately.
By adopting a healthy lifestyle and staying alert to your body's needs, you can fight off the disease.
The risk factors for men include a strong family history and high levels of the hormone estrogen, which stimulates breast cell growth. Men can have high estrogen levels if they have consumed hormonal medicines or have a high alcohol intake which impedes liver's ability to regulate estrogen levels in the blood. Being overweight can also increase estrogen production in the body.
Steps you should take
· Perform regular self-examination every month after 25 years of age.
· Undergo an annual clinical breast examination after the age of 35.
· Undergo annual mammography screening after the age of 40.
· Those with a family history of breast cancer must get their genetic testing done for BRCA1/BRCA2 gene mutations.