Breast Cancer

Dr. Nirja Chawla (Senior Consultant Gynaecologist and Endoscopic Surgeon)

Breast cancer is the second leading cause of cancer-related deaths in women, making it a significant health concern. Any woman can get breast cancer but there are some women who are more likely to develop it than others. Age is a major identifiable risk factor and more than 80% of breast cancers occur in women more than 50 years of age. It does occur in younger age groups but is rare in women less than 30 years. The chances of developing breast cancer at age 40 are one in 217, at age 50 they are one in fifty and at age 85 they are one in eight. The other risk factors in your check list should be: any family member with breast or ovarian cancer, male family member with breast cancer, no full term pregnancy, or having first child after 30 years of age and menopause after 55 years.

Irrespective of your risk status, however, remember that all women, low and high risk, should be screened for early detection of breast cancer and the best way to do this is to perform Mammography (a special X-ray of the breast) every 1-2 years from age 50, according to the latest recommendations of the American College of Physicians(2007). Mammography between ages 40-50 years will depend upon an individual woman’s concerns and risks. In cases where there is a strong family history of breast cancer, screening should begin at least 10 years before the age breast cancer appeared in the family member.

Scientific evidence-based-medicine suggests that breast self-examination (BSE) and clinical breast examination by your doctor (CBE) have not shown to decrease the death rate from breast cancer, sometimes cause undue alarm, anxiety and unnecessary investigations. Mammography alone or combined with ultrasound/MRI have shown to be extremely effective for early pick-up of breast cancer and thus improving cure rates.

Most often the first clues to breast cancer is a lump in the breast. But do remain alert to changes in the size, shape of the breast, dimpling or puckering of the overlying skin, discharge from the nipple or inverted nipple. Not all lumps in the breast are cancer. But if a lump or nipple discharge does not seem to go away it should be checked. Cancerous lumps are usually painless. Painful breasts, on the other hand, are very common and should not cause alarm unless they last more than a few days.

Breast cancer can be prevented by use of certain medicines in high risk cases. Based on scientific evidence, the risks can be lowered by moderate exercise, limiting alcohol intake and by avoiding obesity after menopause. Certain foodstuffs have also shown beneficial effects: those containing Isothiocyanates like broccoli, cabbage, cauliflower, mustard greens and turnips, Polyphenol containg foods like apples, onions, green tea, Lycopene found in tomatoes, Folic Acid rich foods like avocado, bananas, orange juice, asparagus, green leafy vegetables, dried peas and beans, Vitamin C rich foods like citrus fruits, guava, and Vitamin D obtained from sunlight and fortified milk.