The term breast cancer refers to a malignant tumour that has arisen from cells in the breast. Breast cancer is the commonest cancer to affect Sri Lankan females, with an incidence of 7.7 per 100,000.
This number may be increasing and thus it is of paramount importance that women in Sri Lanka are educated regarding the dangers of breast cancer as early detection and diagnosis may save your life. Therefore breast awareness is essential.
Breast cancer is caused by the uncontrolled growth of cells in the breast. This uncontrolled growth may give rise to benign (not dangerous to health) or malignant (dangerous to health) tumours. Malignant tumours are considered to be cancerous.
Risk factors
- Age: More than 80% of women diagnosed with breast cancer are over the age of 50 years. It is rarer in the younger population.
- Gender: Being a woman increases the chances significantly, but don't forget that men have breasts too and can also get breast cancer. The incidence in women is about a 100 times greater.
- Family history: If you have a family history the risk is increased, especially if cancer was present in first degree female relatives
- Genes: 5% of patients with breast cancer are thought to develop it due to inherent abnormal gene defects (BRCA1 and BRCA2).
- Start of menstruation early and stopping of menstruation late has also been associated with an increase in risk
- Having children before the age of 30 years and breast feeding has been shown to decrease the risk of breast cancer
- Being active and within a normal body weight decreases the risk.
- Drinking on average one unit of alcohol per day increases a woman's risk of breast cancer by about 6%.
Diagnosis
Normally patients will see their family doctor when they are aware of a lump in their breast which wasn't there before. Not all lumps are breast cancer, but it is better to seek advice if you feel there is a change in size, shape and consistency of your breast, and especially if you feel an abnormality which hasn't been there before.
If your doctor suspects breast cancer he will then refer you for investigations and specialist treatment.
Investigations
When the specialist sees you he will examine you and may arrange for a small biopsy to be taken from the breast. You may be asked to do a special scan called a mammogram which will give further information regarding the lump. Both breasts will be looked at in detail. Further scans maybe carried out to ascertain the extent of spread, such as CT, MRI and PET scans.
Treatment
This depends on the type of cancer, but will be a combination of surgery, radiotherapy and chemotherapy. The type of surgery will depend on the extent of the lump and its spread. A mastectomy is when the whole breast affected is removed. If there is concern regarding spread of the cancer to the lymph nodes, these will be cleared on the same side as well.
Surgery is usually followed by radiotherapy to the area and the oncologist will then decide whether it would be beneficial to add drug therapy as well. This will be in the form of drug treatment through a vein directly into your blood stream. After initial treatment you may also be commenced on a drug called Tamoxifen if it is indicated.
Follow-up
After you have been treated for your breast cancer your specialist doctor (oncologist) will decide with you as to what the follow-up plan will be. This is on an individual basis.
Breast awareness
Knowing your breasts well is vital. You must be aware of how they look and feel so that you are able to pick up quickly if there is anything abnormal.
Changes to look out for:
- Size and shape: Is one breast larger or lower than the other?
- Texture: dimpling of the skin
- Nipple: Turning in of the nipple
- Discharge: Unusual discharge, it may be blood stained
- Lumps in the armpit
- Pain in the breast which is unusual for you
Most lumps are benign but being aware of them enables rapid diagnosis and treatment. Breast cancer is a treatable condition if caught early. Be aware, be breast aware.
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