Early detection of breast cancer has a lot of benefits. Firstly, it simplifies surgical and other treatment modalities. The fifteen minutes you spend periodically to examine your own breasts is one of the three valuable means of early detection of breast cancer. Cancer of the breast is by far the most common cancer in women in urban India. For this reason it deserves your attention and periodic investment of fifteen minutes.
Management of early breast cancer
There have been two recent surgical advances that have passed on the benefits of early detection to the patient herself. At Indraprastha Apollo Hospital, the practice of these advances has reduced the duration of hospital stay, and done away with mutilating effects of total breast removal and removal of glands from the armpit without compromising on the cure rate.
- Breast Conservation Surgery (BCS): In this, the tumour is removed with a safe margin of normal breast tissue (lumpectomy). This preserves most of the breast and leaves minimal or no deformity. Any tumour of the breast upto 4 cm in size is amenable to BCS. The smaller excisions do not require breast reconstruction by plastic surgery. Lumpectomy with breast conservation is a precise procedure and requires an expert surgeon to perform it.
- Sentinel Lymph Node Dissection (SLND): This requires a precise location, identification, dissection and examination of the first node (sentinel node) in the chain of armpit lymph nodes, to which the breast cancer spreads. If no tumour is detected in the sentinel node, it dispenses with the need of dissection of the entire chain of lymph nodes in the armpit, a procedure that causes some disability of the shoulder and swelling of the arm.
The benefits of early detection extend beyond minimising surgery. If the biological markers of your tumour are favourable, you can avoid chemotherapy. Chemotherapy has side effects like nausea, vomiting and unavoidable hair loss, and is also expensive.
Measures for early detection
Improved screening techniques have been one of the major causes of the high cure rates achieved. There are three screening techniques that are crucial to the detection of breast cancer at an early stage. These are:
- Periodic Breast Self-Examination (BSE) over the age of 20 years: The international guidelines vary, and we in India consider breast self-examination as a vital tool in the early detection of breast cancer. The most common presentation of breast cancer is a lump in the breast. Breast Self-Examination (BSE), as the name suggests, is examination of one’s own breasts. This involves detecting lumps, changes in skin or nipple, and the presence of nipple discharge.
- This is easy to learn and should be regularly practised once a month, a week after the menstrual cycle ends. It is recommended that you seek medical advice if any changes are detected. BSE can be carried out in the calm ambience of one’s home at one’s convenience.
- Annual mammography after the age of 50 years (start earlier if there are major risk factors): Mammography is a specialized X-ray of the breast, which can differentiate between normal tissue, cancerous tissue and other non-cancerous growth. Young women less than 40 years have dense breasts because of functioning ovaries and hence mammography can miss cancerous growth. Yearly mammography has been shown to reduce breast cancer mortality by 30 per cent. The current recommendation is for women over 50 years to undergo a yearly screening mammogram. Women between 40 and 50 years with risk factors should consult a doctor. Low dose mammography carried out under supervision of your doctor carries no risk of radiation hazard.
- Annual Clinical Breast Examination (CBE): Clinical breast examination is a breast examination performed by an experienced breast specialist. This should be done annually after the age of 30 years. Sometimes, clinical breast examination can pick up cancers missed by mammography or by breast selfexamination.
Warning signs of breast cancer
The appearance of any of the following sings requires that you consult a breast specialist immediately.
- Any new lump or change in texture of the breast.
- If nipple discharge is from both the breasts and is clear in colour (serous), then it is not likely to indicate cancer. Bloody discharge, especially if unilateral, from a single duct and spontaneous (i.e. appears without pressure) needs to be further evaluated.
- A sore or a wound confined to the nipple/ breast which is not healing for a number of days or weeks should be evaluated for Paget’s disease (a form of breast cancer). To summarise, women themselves play an important role in the early diagnosis of this disease by periodically examining their breasts. BSE, annual mammography, and CBE by a breast specialist should be a part of every adult woman’s routine, just like other healthy lifestyle choices.
Remember an investment of fifteen minutes every month on BSE can
- Prevent late detection
- Make breast cancer treatment easier for you and your family
- Avoid the physical and emotional trauma of losing your breast
- Save you from expensive treatment of late-stage breast cancer
- Save your LIFE
These are worthwhile dividends!
To know more visit https://www.apollohospitals.com/departments/cancer/organ-cancer/breast-cancer