Early detection key to fight breast cancer

  • Jan 18 , 2017

With rising incidence, the focus needs to shift from treatment to prevention strategies which include early detection, shares, Zoya Brar, Founder and MD, CORE Diagnostics.

Breast cancer is one of the leading causes of deaths in India. According to an estimation by the World Health Organisation, roughly 144,937 women in India were detected with breast cancer in 2012 and 70,218 died because of it, making it one death for every two new diagnoses. With the incidence of the disease rising by more than 20 per cent since 2008, India is expected to have a whopping 200,000 new cases of breast cancer per year by 2030.

The rise in incidence can partly be 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 urbanisation, adoption of western lifestyles, a rise in obesity, sedentary ways of living and changing reproductive behaviours like delayed childbirths are also believed to be propelling the incidence.

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 per cent? 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 and her cancer was detected only in stage III. She underwent a surgical treatment, followed by radiation therapy but her cancer relapsed within six months.

Breast cancer can be detected early only if a combination of self and clinical breast examination coupled with 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 and 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 breastfeeding. In fact, a study cited by WHO concluded that 21 per cent of all breast cancer deaths worldwide is attributed to alcohol, overweight, 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, indulging in 30 minutes of exercise daily, avoid cigarette, alcohol and try not to delay childbirth are ways of cut down the risks.

Photo Courtesy: Lee Health

Can genetic testing help?

While you can modify some risk factors of breast cancer, 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 per cent. The same risk is as high as 50-80 per cent in a person with BRCA1 gene mutation and 40-70 per cent in a person with BRCA2 gene mutation. The BRCA1/2 mutations run in families. There is a 50 per cent 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 be predicted ‘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 good prognosis. You can also make radically informed choices. Angelina Jolie, for example, underwent preventive mastectomy (surgical removal of the breast) after discovering in a genetic test that she had mutated BRCA1/BRCA2 genes.

Not just a woman’s disease

While most of the focus on breast cancer is on women, it should not be mistaken as just a woman’s disease. Men too can develop breast cancer, though it is rare. 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 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 the same to a doctor immediately.

The risk factors for men include a strong family history and high levels of estrogen hormone 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. Having excessive weight can also increase estrogen production in the body.

Recommendations:

  • To go for self-examination every month after 25 years of age.
  • To undergo annual clinical breast examination after the age of 35.
  • To 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.