October has been labelled as breast cancer awareness month throughout the world every year. In 1990 “Pink Ribbon” was introduced globally as a symbol of breast cancer to express solidarity with patients and as a cardinal insignia to draw attention towards its gravity, reinforcing preventive measures to be taken at all levels.
This year’s theme is ‘Keeping Her in The Picture’, a call to everyone to look out for the well-being of the important women in their lives.
Mankind has a very long history of breast cancer. The disease was footnoted more than 3,500 years ago by the ancient Egyptians. In 460 B.C. Hippocrates described breast cancer as a humeral disease caused by the excess of black bile.
The breast is made up of three main parts which are lobules, ducts, and connective tissue. The lobules produce milk, ducts are tubes that carry milk to the nipple. The connective tissue consists of fibrous and fatty tissue which holds everything together. Most breast cancers begin in the ducts or lobules.
The most common symptoms of breast cancer are, a mass or lump, a painless hard mass with irregular margins but sometimes breast cancers are round, tender, soft, Puffiness of all or part of the breast, dimpling of skin looking like an orange peel, pain in the nipple or breast, red, flaking or thickened breast skin, nipple retraction nipple discharge, swollen lymph nodes sometimes a breast cancer appears in armpits or around the collar bone even before this tumour in the breast is large enough to be observable
Unlike other cancers which are mostly hidden inside the body, breast lumps tend to mark themselves as visible or palpable masses hence getting the attention of both the patient and health professionals making early diagnosis, treatment and therefore excellent prognosis.
The exact cause of breast cancer is not known however certain risk factors are associated with its development being a female is the main risk, others include, increasing age, failure to get pregnant, family history of breast, fallopian tube, ovaries or peritoneal cancers, history of breast cancer in other breast, radiation exposure, female who have mutated BRCA1 and BRCA2 genes responsible for cancer, obesity, starting of monthly period at a younger age for example before age 12 side by side menopause in relatively older age, first child at an older age for example giving birth to first baby after age 30 or more, Drinking alcohol and cigarette smoking.
A biopsy is another diagnostic test which is used. Some breast tissue is removed and examined in biopsy. It describes the cancerous and non-cancerous nature of the cells. Diagnosis of breast cancer also helps in determining the size, spread and aggressiveness of invasive or noninvasive cancer.
Although clinical and self-breast examinations (SBE) are not effective strategies for diagnosis, it is still suggested in countries with limited resources having no other screening methods in the reach.
Compared to developing countries, breast cancers in high-income countries are diagnosed at early stages and hence have better prognoses. Western countries have declining or stable incidence rates and decreasing mortality rates that may be attributed to readily available screening and other services.
Multiple dimensions are considered while devising treatment plans for cancer management like age, overall health of patient, type, stage, grade of cancer, other medical conditions, socioeconomic status, preferences of the patient and availability of the various therapeutic facilities in the region.
Surgery includes a Lumpectomy which involves removing the tumor and small amounts of healthy tissue around it. Spread of cancer can also be prevented by lumpectomy and this may be an ideal option if the tumor is small in size and easy to detach from its adjacent tissues. Mastectomy is the other surgical intervention which involves removing the lobules, ducts, fatty tissue, nipple, areola, and some portion of skin. Sometimes removal of lymph nodes and muscles in the chest is carried out as per requirement.
Breast Reconstruction and Cosmetic surgery can be performed following the mastectomy procedure to reconstruct the breast to give it a natural look. This can help a lady handle the psychological impacts of breast removal. Moreover, depending upon different factors single or combination of treatment options as highlighted above can be used. According to a study, the use of breast implants is safe and there is no risk of getting breast cancer from breast cosmetic implants.
The low and middle-income countries report a majority of deaths where most women are diagnosed in advanced stages of breast cancer due to reasons that these regions lack resources, offer poor access to cancer screening and prevention programs, lack of awareness about the disease, fear of surgery, chemotherapy, cultural, social and religious taboos and getting other traditional nonscientific treatments thus fuelling the morbidity and mortality rates.
It is a well-documented fact that in spite of being the leading cause of death in women around the globe since 1989 improvements in screening and treatment have been enhancing women’s quality and quantity of life.
Breast cancer risk can be reduced by regular exercise, a healthy diet containing abundantly fresh vegetables, fruit, and nuts, keeping a healthy body mass index (BMI), restraining postmenopausal hormone therapy, and avoiding excessive alcohol intake and cigarette smoking.
In this age of information technology, various modern awareness tools are available like The Breast Cancer Health line Apps etc connecting to online breast cancer communities thus gaining support and advice through group consultations.
Asia is at the top ranking in breast cancer cases among all geographical regions with Pakistan, China and India occupying the three uppermost positions respectively.
The early finding remains the keystone of breast cancer control programs. If discovered early, with adequate diagnosis and treatment, there is an excellent opportunity for the healing of breast cancer. Contrarily, if spotted late, the curative treatment is no choice. In such cases, only palliative management is there to soothe the misery of patients and their families.