Breast cancer accounts for 27 per cent of all cancers in women in India, with the incidences rising in the early thirties and peaking at ages of 50-64 years. It is estimated that one in 28 women is likely to develop breast cancer during her lifetime. Although the probability of developing breast cancer rises with age, in India, incidences of breast cancer has increased in younger people — females below 40 years, including working women in urban areas. Early·onset breast cancer also tends to be more aggressive than late·onset. In spite of the latest surgical techniques and chemotherapy drugs, morbidity and mortality rates are high and they have remained so for many years. The only way to bring the mortality rates down is by detecting breast cancer at the
early stage.
Most breast-cancer-related tests fall into one or more of the following categories — Screening tests (such as yearly mammograms) are given routinely to people who are not suspected of having breast cancer with the purpose to find breast cancer early, before any symptoms can develop and the cancer usually is easier to treat. Diagnostic tests (such as biopsy) are given to people who are suspected of having breast cancer, either because of symptoms they may be experiencing or a screening test result. Monitoring tests are done once breast cancer is diagnosed to determine the treatment and also after treatment to monitor the body. Monitoring tests also check for any signs of recurrence. In addition to these tests, women themselves can also try to feel any existence of lumps or thickenings above and below the collarbone.It is advised for women to have a clinical breast exam every one to three years starting at age 20 and every year starting at age 40. A clinical breast exam may be recommended more frequently if they have a strong family history of breast cancer.
Breast self-examination is also a good way to find the symptoms of breast cancer. When practiced regularly, one learns to differentiate between normal tissue and the abnormal new change in the breast. The warning signs of breast cancer are not the same for all women. Some common warning signs are: painless hard lump which does not move, change in the size or shape of the breas, dimpling or puckering of the skin, Itchy, scaly sore or rash on the nipple, pulling in of your nipple or other parts of the breast, bloody nipple discharge from one side.
Digital mammogram with tomosynthesis is a superb tool to detect even very small cancer. Most women shy away from mammogram because of pain of the compression. Digital mammogram is less painful and radiation dose is 40 to 50 per cent less as well compared to conventional mammography methods. With advanced technologies like 3D Tomosynthesis, the breast can be reviewed in 1 mm slice which enables breast cancer detection at a much earlier stage.
The overall cancer projection data shows that the number of cases will be almost double by 2020. There is an urgent need for strengthening the existing diagnostic/treatment facilities, which is inadequate and unable to handle the current load of cancer in India.
Yojana Nalawade is Proprietor & Radiologist, Nutan Mammography Centre Mumbai
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