By Dr.Vikas Roashan
MBBS, MD (Radiation Oncology) American Oncology Institute
Breast cancer is the most common cancer in women in India, after cervical cancer. It is
an uncontrolled growth of tumor cells in the breast tissue. Breast cancer is primarily seen in women, but it can also occur in men (specific type) in rare cases.
Symptoms of Breast Cancer
- A lump or mass in the breast that looks distinct from the surrounding tissue.
- Change is the shape, size, or appearance of the breast.
- Changes in the skin over the breast, for example, dimpling.
- Breast pain
- Inverted or pulling-in of the nipple
- Scaling, peeling, or flaking skin over the breast, particularly in the dark area around the nipple
- Discharge from the nipple
- Bleeding from the nipple
- Redness or pitting of the skin of the breast, resembling the skin of the orange.
When to consult a Doctor?
If you experience a swelling or shift in the breast, see a doctor immediately.
It is recommended that women who have no symptoms of breast cancer should also undergo regular screening. The goal of breast screening is to detect breast cancer at the earliest when the treatment is known to show the best results. Mammograms are commonly recommended for imaging of patients over 40 years of age.
In younger patients, MRI breast is advised as breast tissue is thick and mammography is difficult to find cancer.
Ignoring breast cancer can lead to metastatic disease, which leads to serious life-threatening conditions. One of the biggest reasons for high breast cancer death is late diagnosis and treatment.
Who is at risk?
Factors that increase the risk of breast cancer include:
- Family history of breast and ovarian cancer
- Inherited genes that increase risk- BRCA1 and BRCA2 gene mutations
- In those females where periods starts at a younger age
- Beginning menopause at an older age
- Late or no pregnancy
- History of benign breast disease
- Postmenopausal hormone therapy
- History of Oral birth control pills intake
- Being overweight or obese
- Alcohol & tobacco consumption
Breast Cancer Screening
Tests are used to screen various kinds of cancer when a person has no symptoms. Mammography is the most common screening procedure for breast cancer. Magnetic resonance imaging (MRI) can be used to screen people at high risk of breast cancer and young patients.
Apart from these Breast Inspection, Thermography, Tissue Sampling, etc are also used for screening.
Breast Cancer Treatment Options
- Breast Cancer Surgery: Operations used to treat breast cancer include:
- Breast lumpectomy: During a lumpectomy, the surgeon removes the tumor and a small margin of surrounding healthy tissue.
- Mastectomy: Mastectomy is a procedure performed to remove all your breast tissue. Mastectomy can be followed by breast reconstruction surgery to restore the appearance of the breast.
- Modified radical mastectomy: In this procedure, the entire breast is removed – including the skin, breast tissue, areola, and nipple – along with most of your underarm lymph nodes. However, the chest muscles are left intact.
- Breast conservation surgery: This is a procedure to remove cancer while leaving as much normal breast tissue as possible. In many cases, some surrounding healthy tissue and lymph nodes are also removed.
Radiation Therapy: It uses high-powered beams of energy, such as X-rays and protons, to kill cancer cells.
- It’s given to destroy any cancer cells that may have been left in the breast and surrounding area after surgery. You may hear this called adjuvant radiotherapy.
- Radiotherapy is given using Linear Accelerator
External beam radiotherapy
- This is the most common type of radiotherapy used to treat primary breast cancer.
- X-rays are delivered by a machine which directs a beam of radiation at the breast.
- The x-rays do not make you radioactive, so when you leave the treatment room you can safely mix with other people, including children.
Intensity modulated radiotherapy (IMRT)
- IMRT is another way of giving external beam radiotherapy.
- The intensity of radiotherapy can be varied, allowing different amounts of radiation to be given to different areas. The risk of side effects is lower with IMRT because healthy tissue in the area gets a lower dose of radiation.
- IMRT is not available in all radiotherapy treatment centres.
Volumetric modulated arc therapy (VMAT)
- This is a type of IMRT. The radiotherapy machine rotates round the area being treated, continuously changing the shape and intensity of the radiation beam
- Chemotherapy: Chemotherapy uses drugs to destroy fast-growing cells, such as cancer cells.
- Immunotherapy: Uses the body’s own immune system to fight cancer.