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BREAST CANCER AWARENESS: The Disease, its Symptoms and More

According to a 2018 report of WHO (World Health Organization), Breast Cancer has been estimated to have caused deaths of 627,000 women worldwide. It is the most frequent cancer among women which impacts 2.1 million women each year causing the greatest number of deaths (WHO).

Breast Cancer is a disease which causes uncontrollable division of cells in the breast which develop cancer. It is classified according to the area of breast in which cancer develops. Breast consists of three essential parts which are lobules (the milk producing glands), ducts (tubes carrying milk to the nipple) and connective tissue (fibrous fatty tissue which surrounds and holds these parts). Breast cancer mostly begins in the ducts or lobules, but it can also occur within the connective tissue. The cancer cells often invade other healthy breast tissue and can travel to the lymph nodes under the arms. These lymph nodes are a primary pathway that help the cancer cells to metastasize.

TYPES

Breast cancers occur in two categories mainly Invasive and Non-invasive. According to the Cancer Treatment Centers of America, Invasive or infiltrating breast cancer cells break through normal breast tissue barriers and spread to other parts of the body through the bloodstream and lymph nodes. Whereas Non-invasive or in situ breast cancer cells remain in a location of the breast, without spreading to the surrounding tissue, lobules, or ducts.

Most of the common types of breast cancers are as follows:

  • Ductal Carcinoma in situ– (DCIS) is a non-invasive condition in which the cancer cells are confined to the ducts in your breasts.
  • Lobular carcinoma in situ– (LCIS) is a cancer that grows in the milk- producing glands of your breasts.
  • Invasive ductal carcinoma– (IDC) begins in your breast’s milk ducts and then invades nearby tissue in the breast, spreading to the other nearby organs and tissues.
  • Invasive lobular carcinoma– (ILC) it develops in your breast’s lobules and invades nearby tissues.

Other rare but aggressive types of breast cancers:

  • Inflammatory breast cancer– (IBC) is a condition in which cells block the lymph nodes near the breasts making the lymph vessels unable to drain properly, creating a tumor. It can progress very quickly.
  • Triple-negative breast cancer– this condition is diagnosed when a tumor lacks estrogen receptors, lacks progesterone receptors, and doesn’t have additional HER2 proteins on its surface. This type of cancer tends to grow and spread more quickly than others. (This cancer is difficult to treat because hormonal therapy for breast cancers is not effective).
  • Metastatic breast cancer– is a stage 4 breast cancer, in which the breast cancer has spread from your breast to other parts of your body, such as bones, lungs or liver. It is an advanced stage of breast cancer.

(Although it is very rare, breast cancer is also an issue for men along with women.)

STAGES OF BREAST CANCER

These stages are divided based on the size of the tumors and its growth. It has mainly five stages from 0- developing of the cells to 5- fully grown tumor (Holland, 2019).

 SYMPTOMS

The symptoms of breast cancer differ from person to person. It is even observed that initially some people might not have any signs of the cancer at all. The following are the signs and symptoms of the breast cancer:

  • A lump in the breast or surrounding area, or under the arm
  • Thickening and swelling of part of the breast
  • Irritation or dimpling of breast skin
  • Redness or flaky skin in the nipple area or the breast
  • Pulling in of the nipple or pain in the nipple area
  • Nipple discharge other than breast milk, including blood
  • Any change in the size or the shape of the breast
  • Pain in any area of the breast

*Although these symptoms can happen with other conditions too but still if they are worrisome it is always best to consult your doctor. *

TREATMENT

Doctors often categorize breast cancers as early, locally advanced, and metastatic breast cancer. The early diagnosis of the disease makes it less expensive and is manageable properly and it also improves prognosis and quality of life. The treatment also involves a screening method. This method consists of testing women to identify breast cancer before the symptoms appear. It uses screening like Mammography– uses low-energy X-rays to identify abnormalities in the breast, Breast MRI, Clinical Breast Exam (CBE)- examination of both breasts performed by a trained health professional, and Breast Self-Exam-to keep yourself in check regularly so that you can be able to detect difference if any easily. If even after Mammogram and ultrasound your doctor is unsure if you have breast cancer, they may conduct a test called breast biopsy.

*The Breast Cancer organization has provided with a five step breast self-exam which includes standing in front of the mirror and checking your breasts and the underarms area carefully, raising up your arms while looking in the mirror to look for any signs of fluid coming out of the nipples, and lying down on bed and checking for any signs of lumps or severe pain.*

After these tests breast cancer is diagnosed other tests are done to check the growth of cancer cells within the breast or other parts of the body, this is called the staging process. Staging is determined by the spread of the cancer in your body and is the basis for the further treatment.

The treatment depends on the kind of breast cancer and its growth. It consists of Surgery– to cut the cancer tissue, Chemotherapy– use of special medicines to shrink or kill cancer cells, Hormonal therapy– to block cancer cells from getting the hormones they need to grow, Biological therapy– to help the body’s immune system to fight cancer cells or control the side effects of treatments, Radiation therapy– use of high-energy rays to kill the cancer cells. Other complementary and alternative medicines like meditation, yoga and supplements like vitamins and herbs are also used additional to the standard treatments.

*Patients in India have an affordable option today for avoiding the chemotherapy for expensive tests with the test called Can Assist Breast offered by an Indian company OncoStem Diagnostics. *

Awareness regarding breast cancer is necessary especially amongst those who live in the rural areas and are not as vocal about their health issues. Many organizations have been campaigning for the spread of the pink ribbon to show solidarity and support for those fighting against breast cancer. As we have already seen cancer treatments need to be regulated in order to minimize or terminate the threat but due to the current COVID-19 crisis followed by the lockdown there has been a considerable slowdown in clinical services as well as the patients coming for cancer treatment which has resulted in delaying of care and this would have serious adverse consequences. To deal with this the government has come up with sharing its practices and guidelines for cancer treatment during the pandemic with all hospitals in India by creating a series of webinars available through the National Center Grid.

Dr Kinner C Shah, Director, Department of Surgical Oncology, SAL Hospital, Ahmedabad is of the opinion that the patients should not delay diagnosis as- “early diagnosis is the best way to beat breast cancer”. India’s statistics show that in the year 2018, 162,468 women in India were newly detected with breast cancer and it accounted for 27.7% of all newly detected cancers in women. This means one in four newly detected cancer in women in India was breast cancer. Whereas, 87,090 women died due to breast cancer in India, and it accounted for about 23.5% of all cancer related deaths in women in India, the current mortality rate of breast cancer in India is 50%. Breast cancer is the commonest cancer in urban women in India and second most common in rural women. According to Dr Shah, the number might rise dramatically by 2030 due to urbanization and changing lifestyles. In today’s India, early stage breast cancer patients can avoid chemotherapy and selected Stage 1 and 2A patients can be prescribed a prognostic test. In times like these avoiding the immunosuppressive chemotherapy could be advantageous for the patients’ both mental and physical health.  International guidelines have suggested certain measures on how to treat breast cancer patients during the Covid-19 pandemic which include actions of screening patients and hospital staff for COVID-19 to follow ups through teleconsultation to limit hospital crisis and reduce exposure to the pandemic. Battling Breast cancer is a tough job but if we stand together and support our sisters and brothers and let them know they are not alone in this and we are with them in spite of the corona-crisis it will help and boost up their faith to deal with and fight their fight against cancer sooner (bureau, 2020).

 

 

References

bureau, E. n. (2020, 6 25). Express Healthcare. Retrieved from expresshealthcare.in: https://www.expresshealthcare.in/blogs/dr-kinner-c-shah-how-does-treatment-for-breast-cancer-change-during-covid-19-times/422251/

Holland, J. H. (2019, 11 14). healthline. Retrieved from healthline.com: https://www.healthline.com/health/breast-cancer

WHO. (n.d.). Breast Cancer. Retrieved from who.int: https://www.who.int/cancer/prevention/diagnosis-screening/breast-cancer/en/

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