There can be no doubt whatsoever that incidents of cancer are on the rise. Can the risk of cancer in an individual be zero? Unfortunately the answer is ‘no’. Irrespective of one’s education, nutritional and socio-economic status, everyone faces a risk of developing cancer. This is called the population risk of developing cancer.
Cancer has always been considered a disease of the aged. Though that is true to a certain extent, the age at which women develop breast cancer has undergone a change in the last two decades. An increasing number of breast cancers are detected in the 25-40 years age group. Almost 45 per cent of breast cancers are detected in women below 50 years. This is a worrying trend indeed because it hits women in the peak of their lives — mothers, wives, daughters, career women who juggle so many different roles. But, unfortunately, they also put their health needs last on their list of things to do. “Where is the time?” they ask.
In India, more young women are developing breast cancer. The one intervention that has led to improved survival rates is regular screening. Many of us have a misconception that visiting a doctor is required only if we have symptoms that do not go away. It is important to understand that screening is for healthy women without any symptoms. It is when we screen healthy women that early detection of breast cancers happens and this translates into better long-time survival. ‘Symptomatic’ women with breast cancer may be at least stage 2B or more with a corresponding reduction in survival rates.
So what do women need to do? We need to be breast aware! Women must be familiar with structure of their breasts and do regular examinations. Women who continue to have their monthly periods can examine their breast about a week after their periods. For those who have gone through menopause, a breast exam should be done on the first day of each month. The breast self-exam can be done in privacy when having a shower. If you note any changes, see a doctor for a clinical exam and investigations, if required.
Things to look for during the breast exam:
A lump in the breast, even if painless; blood-stained discharge from the nipple; a recent indrawing of the nipple; any skin changes of the breast or nipple; any swelling in the armpit needs further evaluation.
There is a short video on self-breast examination in Tamil on YouTube
The standard recommendation for healthy women is to start having a screening mammogram — or an x-ray of the breasts — at 40 years. This helps pick up small abnormalities, which may not be felt during a self-examination. Screening mammograms help early detection of breast cancer. If there is a history of breast or ovarian cancer in the family, a visit to a cancer genetics clinic will help ascertain the risk of breast/ovarian cancer to the individual and offer information on the necessary preventive steps or early screening. Men can develop breast cancer too but the rate is quite low and may denote a genetic predisposition. So, what role do men play in breast cancer screening? Fathers, brothers and husbands should speak to their daughters, sisters and wives and make them understand the importance of regular breast and cervical cancer screening. More importantly, ensure they make time for it.
The writer is a Gynaecological Oncologist in Valavadi Narayanaswamy Cancer Center (VNCC) in GKNM Hospital and trustee of the Coimbatore Cancer Foundation (CCF).