Breast cancer is the leading cause of cancer deaths in women worldwide .October is celebrated every year as breast cancer awareness month worldwide. Its celebrated to create awareness about importance of early detection of breast cancer. The theme for this year is RISE (Rally In Screening Everyone)

 It is reported that 1 in 22 women in India is likely to suffer from breast cancer during her lifetime, while the figure is definitely more in US with 1 in 8 women have a chance of developing breast cancer in their life time

Worldwide the incidence of Breast cancer is 23,00,000 (11.7% of all cancer cases) in a year with 5,21,000 deaths per year. Its most common type of cancers in women.

In India we found 1,78,361 new breast cancer cases (13.5% of all cancer cases) with mortality of 90,000 per year. Over last 26 years breast cancer incidence have increased by 39.1% in India. In India breast cancer is more in urban population than rural. But more important is the alarming trends seen in India compared to the Western world is

1) Age Shift: more young females More common in 30-40 >50% patients in less than 50                        years of age

2) Increase Incidence

3) Late Presentation

4) Decrease Survival

5) Lack of Awareness

6) Lack of Screening

Why do people get breast cancer?

Breast cancer happens when normal cells in the breast change and grow out of control. Breast cancer is much more common in women than in men. But men can get the disease. Women with certain risk factors are more likely than others to develop breast cancer. A risk factor is something that may increase the chance of getting a disease.

Risk factors that cannot be changed

Age: The chance of getting breast cancer increases with age. Most women are over 60 years old when they are diagnosed.

Personal health history: Having breast cancer in one breast increases the risk of getting cancer in other breast. Also, having certain types of abnormal breast cells increases the risk of invasive breast cancer. 

Family health history: Breast cancer risk is higher among women whose close blood relatives have this disease.Having one first-degree relative (mother, sister or daughter) with breast cancer approximately doubles a woman’s risk. Having two first-degree relatives increases her risk about 3-fold. 

Genetic risk factors:About 5–10% of breast cancer cases are thought to be hereditary, resulting directly from gene defects (mutations) inherited from a parent.

Dense breast tissue: Women with denser breast tissue (as seen on a mammogram) have more glandular tissue and less fatty tissue, and have a higher risk of breast cancer. 

Previous chest radiation: Women (as children or young adults) who had radiation therapy to the chest area as treatment for another cancer (Hodgkin’s disease or non-Hodgkin’s lymphoma) have a significantly increased risk for breast cancer.

Risk factors that can be changed/lifestyle-related factors

Being overweight or obese after menopause:The chance of getting breast cancer after menopause is higher in women who are overweight or obese

Lack of physical activity:Women who are physically inactive throughout life may have an increased risk of breast cancer

Drinking alcohol:Studies suggest that the more alcohol a woman drinks, the greater her risk of breast cancer

Breast-feeding: Some studies suggest that breast-feeding may slightly lower breast cancer risk, especially if breast-feeding is continued for 1½ to 2 years

Breast cancer early detection

Early detection means using an approach that lets breast cancer get diagnosed earlier than otherwise might have occurred.

Screening

Screening refers to tests and exams used to find a disease, such as cancer, in people who do not have any symptoms.

The American Cancer Society recommends these screening guidelines for breast cancer

• Yearly mammograms starting at age 40 and continuing for as long as a woman is in good health
• Clinical breast exam (physical examination of the breast done by a doctor) every year for women 40 and over
• Clinical breast exam about every 3 years for women in their 20s and 30s 
• Women should know how their breasts normally look and feel and report any breast change promptly to doctor. Breast self-exam is an option for women starting in their 20s

Some women – because of their family history, a genetic tendency or certain other factors should be screened with MRI in addition to mammograms. 

Screening mammogram

A mammogram is an x-ray picture of tissues inside the breast. Mammograms can often show a breast lump before it can be felt. They also can show a cluster of tiny specks of calcium. Lumps or specks can be from cancer, precancerous cells or other conditions. 

Breast self-exam

It involves the woman herself looking at and feeling each breast for possible lumps, distortions or swelling.

Can breast cancer be prevented?

There is no sure way to prevent breast cancer. But, there are things all women can do that might reduce their risk (those risk factors that are under our control)of getting breast cancer.

• Adhere to regular physical activity
• Reduce your lifetime weight gain by eating fewer calories and getting regular exercise
• Avoid or limit alcohol intake

Women who choose to breast-feed for at least several months may also reduce their breast cancer risk. Avoiding hormone therapy after menopause can also help avoid raising the risk.