Breast Cancer – All you need to know

Interview with Dr. Shefali Karve, Consultant Pathologist, Vikram Hospital, Bangalore

October is breast cancer awareness month, an annual campaign to raise awareness and reduce stigma around the disease. Breast cancer accounts for an alarming 25% to 31% of all cancers in India and is one of the most prevalent forms. While no one knows how, when and who will be afflicted with this illness, an understanding of the risk factors can help you take the required preventive measures and make certain lifestyle changes to reduce the likelihood of developing the disease.

We connected with Dr. Shefali Karve, consultant pathologist at the Vikram hospital, Bangalore, and asked her a few questions about breast cancer, it’s symptoms, treatments and some preventive measures.

What is breast cancer? Why is it prevalent now more than ever?

Breast cancer is a disease in which cells in the breast grow out of control. It is a compilation of distinct malignancies that manifests in the mammary glands. But thanks to the rapidly progressing molecular biology and genomic sciences, our understanding of the disease has drastically improved. It is seen to be more prevalent now and in developing countries mainly due to lifestyle changes like – lack of physical activity leading to obesity, excessive consumption of alcohol, avoiding breast feeding and ingestion of excessive hormones.

What are the early signs of breast cancer?

Prediction models stratify a woman’s risk of developing cancer and can help with screening recommendations based on the presence of known and quantifiable hormonal, environmental, personal or genetic risk factors.

Early signs would be noticing a lump in your breast while having a bath, or sometimes a retracted nipple or even some bloody discharge from the nipple can be a symptom.

Can I check for these signs myself?

Recent guidelines by NCCN advocate Breast self-examination (BSE) as an important tool to check for the signs. It has to be done by all women at least once a month. If you find anything suspicious, visit a doctor/surgeon at the earliest.

Are there any preventive measures?

One of the major preventive measures would be “lifestyle modifications”. Another important one is a prophylactic mastectomy, done in case you carry a gene prone to developing breast cancer (popularized by the likes of Angelina Jolie). But sometimes its just unavoidable. Bad luck I would say!

A lot of women don’t take the annual health check-ups seriously. How important are the regular health check-ups with respect to detecting and curing breast cancer?

Regular health checkups are extremely important, as an early detection can completely cure you of cancer and will avoid spreading of cancer to the other parts of the body.

If I am young, am I at a lower risk level?

Age does play an important role with respect to this disease. If you are younger, you are definitely less prone to developing breast cancer. But having said that, if it’s in your genes or if there is a family history of breast cancer, there is a good chance of developing the disease at a young age. I have in fact, seen patients as young as 21 years of age!

Who gets breast cancer? Is it only women?

Men have breast tissue and that they can develop breast cancer too. Cells in any part of the body can become cancerous and can spread to other areas.  Though breast cancer is less common in men, it can get quite aggressive if it isn’t diagnosed at the right time.

When should I visit a doctor?

You must visit the doctor when you notice any abnormality or lumps in your breast – no matter how small. Pain and nipple discharge or retraction are a few other things you should never neglect.

What are some of the tests for breast cancer?

There is a train of tests available starting from Mammogram, USG (scan), MRI, Fine needle Aspiration cytology, Biopsy etc., done depending on the severity of the case.

Can all stages of breast cancer be treated?

Though a variety of treatments are available at every stage of cancer, early stages are always more treatable. Once the disease spreads to other organs of the body, it becomes difficult to contain it. Therefore, for any cancer treatment, early detection is always the best.

What is the treatment for breast cancer?

There are protocols followed for treatment of breast cancer depending on the stage of the disease. If the tumor is small and is found in a relatively young woman, Chemotherapy is given to reduce the size of the tumor and then it is surgically removed. Sometimes breast conservative surgery can also be done in the younger age group. In the elderly, a complete mastectomy is preferred; post which, the tumor is tested for whether it is hormone sensitive or not – and then a hormone therapy is prescribed.

Will I lose my breast if I get breast cancer?

Newer techniques like breast conservative surgeries that can save the affected breast, are now available. But, it all boils down to what stage of the disease you have.

We hear that losing the breast is like losing womanhood for many. How do women cope with it psychologically?

Though losing a breast can seem like losing your womanhood or identity, it is important to understand that being a woman is much more than just the physical appearance (counselling during times like this can play an important role). That said, there are cosmetic solutions/options available post the surgery. Also, there are psychologists who specialize in Oncotherapy who can help guide the patient.

Is there anything else that you would like to add?

Breast cancer treatment has progressed by leaps and bounds. Many new drugs and target molecules are now easily available facilitating “personalized medicine”. Though you can’t change the fact that you have cancer, you can definitely change the way you live the rest of your life – make healthy choices and stay well.

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