Yes, we are living longer than we ever have before; human life expectancy has been on the rise for a while now, thanks to advances in medicine. Food security, antibiotic usage, and good management of lifestyle diseases (think BP, sugar and cholesterol) have played a role in this better quality of life.
Having said that, these new-age advances haven't made us completely disease or age-proof. With screen overuse comes diminishing vision; with increased stress, our hair goes prematurely white, and the availability of easy processed food means that our stomachs continue to expand too fast. And yes, there is also the constant threat of cancer and all that it entails.
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Bombarded with too much information and with a nudge from Dr Google, every symptom can fit into some cancer bracket. Scary news — for instance, how starting menstrual periods at a young age equates to a higher chance of breast cancer — bother us endlessly. So it's time to dive into this realm further and explore the most common cancer in India: Breast cancer.
Breast cancer is as common as it comes, ending up being the most common cancer among women, both in India and internationally.
Think back to when we found ourselves deciding for Angelina Jolie whether she should or should not be getting a breast removal surgery (called mastectomy) as a preventive measure. Jolie carried the mutation in theBRCA1 gene, which increases the chance of breast cancer in the woman. Jolie, who saw her own mother succumb to this form of cancer, wanted to be cautious and prevent it from the root. No breast equals no breast cancer. As simple as that, isn't it?
While not everyone needs to resort to such drastic measures, early action can play a key role in the treatment of the disease. Here are some things you should keep in mind.
So how does one know?
Breast cancer presents as a painless lump which often goes ignored in the first couple of years. As the disease progresses, the skin can get involved locally. The cancer is tethered to the skin, which causes tiny dimples in the skin, giving it an uncanny resemblance to an orange skin. Hence the term peau d'orange (orange skin in French) for this presentation of breast cancer. A newly inverted nipple is also a symptom. Besides the local symptoms, the woman can have lymph node involvement. This will present as round swellings in the neck, above the collar bone and in the armpits of the patient.
Risk factors for breast cancer
Breast cancer thrives under the influence of the hormone estrogen. So throughout your life, whenever you have been under the flux of this hormone or conditions which increased the hormone in your body, can contribute to breast cancer. For instance, getting your first period before the age of 12 exposes the developing breast to a good 3-4 years of extra estrogen. Along the same lines, late menopause is going to put you in the same spot. Hormone therapy to prevent the irritating symptoms of menopause also puts a woman at risk.
Breastfeeding protects one from breast cancer as estrogen levels are super low during breastfeeding. Having no babies is a risk factor, and likewise, pregnancy affords protection from it. Getting pregnant after the age of 30 can also up your chances of developing the disease.
Genetic history of breast cancer is a huge risk factor, as are obesity and excess alcohol intake. But these are just contributory factors, and there is no hard and fast rule that you will develop breast cancer just because you fall into any of these categories.
How to manoeuvre the breast cancer scare?
Are you over 40? Or even 30+? Did you read too many articles about cancers? Or did I just scare you with my previous few paragraphs? Let’s guide you through the OPD for breast cancer now, shall we?
First things first- do a self-breast examination monthly. It is important to know how your breasts are in the normal state for it to be easier for you to detect any changes if, unfortunately, they were to occur. The best time to do one would be after your period end. But if your periods are irregular, then just pick a date and stick to it every month.
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Stand in front of the mirror with your top and bra off and compare them. A little asymmetry is normal, and you will know what your normal looks like. The next step is to raise your arms above your head and observe for any visual changes. The third step of inspecting your breasts with your hands on your hips. After inspection, it's time to feel around for any new knots or lumps. Press with the pads of your finger and feel for changes by going around the breast in a circle. Not every lump is cancer. If you do feel new lumps, make sure you get them checked by your OBGyn.
Another important and more effective way of screening for breast changes is the mammogram. It is essentially an x-ray of your breast tissue to look for any abnormalities. If anything seems fishy, then your doctor will advise a biopsy or needle aspiration to assess for any cancerous cells. As per the CDC, screening yearly after the age of 40 is recommended. If you have a family history or other breast diseases in the past, your doctor may offer to screen before you hit 40.
Long story short- google less, self-examine more and see your doctor regularly.
Dr Farah Adam Mukadam is a Bengaluru-based family physician and author of Newborns and New Moms. She vlogs on Instagram and YouTube as Dr Farah_Momstein