Breast cancer is the most common cancer among the Indian Population, yes ‘population’ not just Indian women. It accounts for 1.62 lakh out of 11.5 lakh new cancer patients every year in our country or in other words, 14% of all cancers in the country irrespective of sex. This should give us pause for thought. Nowadays every one of us knows someone in our family or friends who have been diagnosed with breast cancer. So how can we be alert and aware about? Read on.
What causes this rampaging disease?
There is a wide variety of reasons such as early menarche, late menopause, late childbirth, not having any children, obesity, alcohol, family history of breast cancer which may be a sign of hereditary genetic mutations. Breast cancer predominantly occurs in women and old age, but it can also occur in men. This could be because of genetic mutations and hereditary traits.
How do I know if I have breast cancer?
Breast cancer like all cancers usually sneaks up stealthily on unsuspecting individuals. It may be first noticed as a painless mass felt accidentally while bathing which keeps increasing in size to the point where it can become quite large, multiple in number, ulcerate the skin of the breast or make it look like an orange peel. Sometimes, but not always there may be a discharge from the nipple. If you have any of the above-mentioned signs, it would be advisable to consult your family Physician or an Oncologist.
How can I reduce my risk of getting breast cancer?
There are some risk factors that are beyond your control, like age of menarche or menopause, female sex, old age, genetic mutations. Then there are risk factors very much under your control like adequate breastfeeding, avoiding hormonal replacement treatment, being physically fit, avoiding alcohol and tobacco, avoiding junk food, and eating healthy. If there is a strong family history of breast cancer, consult an Oncologist and get checked for any genetic mutations. In case any mutations are detected specific steps can be taken as advised by an Oncologist to reduce the incidence of breast cancer. Besides these steps, scientific evidence suggests that all women above the age of 40 should undergo a screening mammogram once in two years. This helps in identifying early-stage breast cancer which is amenable to cure, thereby reducing death by breast cancer by up to 30%. Examine yourself, at least once a month. Examine both breasts for any skin changes, palpable lumps, bumps, and nipple discharge. Every day saved in diagnosing breast cancer enables the patient to live longer and have a better quality of life.
How has Covid impacted Breast Cancer?
Covid per se does not cause breast cancer, but it has impacted the stage of presentation and caused treatment delays. Patients who felt a small lump in their breast avoided coming to a hospital fearing coronavirus infection and over time the disease increased in size and spread to nearby organs. This means a patient who in the natural course of events would have presented with curable Stage I/II breast cancer ultimately presented with an incurable Stage IV disease. Secondly, patients with cancer are more susceptible to Covid infection due to the disease itself and side effects of breast cancer treatment like lesser immunity. Death due to covid infection has also been higher in breast cancer patients. Hence it is very important that breast cancer patients be more careful of their surroundings and minimize their interactions with people to avoid getting infected by the virus. Thirdly covid infection during treatment makes further treatment impossible as cancer treatment can aggravate Covid infection and any such break in the treatment adversely affects end result of treatment in terms of cure and long-term survival.
I am diagnosed with breast cancer, can I take the Covid vaccine?
It depends on what stage of treatment you are in. A patient who has completed all treatment and is in good health can very well get vaccinated. For patients who are inactive treatment, consult your Oncologist. During chemotherapy, there is some suppression of the immune system, so vaccines may not elicit the same immune response as in a normal person giving a false sense of security.
How can I safely get treated for breast cancer during the pandemic?
It is very important that you seek help if you think you have a symptom suspicious of breast cancer. If you have a fear of coming to hospitals, numerous platforms for teleconsultation are available nowadays, the first consultation can be done remotely, but a clinical breast examination if needed can only be done in person. If any tests are advised like Mammogram or needle biopsy, they can be scheduled in such a manner that your stay in a hospital is kept to a minimum.
Has Covid changed breast cancer treatment protocols?
Not much really. The core treatment remains the same. During peak covid times, what changed was that breast reconstructive surgeries were discouraged. Surgery for breast cancer involves either removing the breast entirely or removing only the tumor and preserving the rest of the breast, also known as breast conservation surgery. For women who are motivated to retain the shape of their breasts, reconstruction options are available, either in the form of implants or tissue from other parts of the body. As this procedure was deemed nonessential to treatment, it was generally deferred to ensure that patient spent minimal time in hospital and went home early.
Is breast cancer curable?
Yes, very much so if the patient presents at an early stage, especially Stage I and II. For such patients chances of cure are high with the proper treatment and good compliance to treatment. For stage III patients, the prognosis is mixed. The aim of treatment in such patients is curative, but the chance of a recurrence can be around 30- 40% especially if they are young and carry aggressive disease profiles, so they have to be on close follow up. For patients with Stage IV disease, the aim of treatment is to control not cure, but I am happy to say that with the advent of new and advanced drugs, what was a matter of months to live has become years. Motivated compliant patients continue to survive longer with the right treatment.
So, though I started with the gloomy picture of the alarmingly high number of new breast cancer patients every year, I will conclude on a happy note by saying that treatment is rapidly advancing. Today we are able to cure more breast cancer patients than before and for those who cannot be cured, we are able to give a much longer lifetime with a good quality of life. The take-home message is one of hope and determination to beat cancer at all odds.
As an unknown author said, “At the end of the day all you need is hope and strength. Hope that it will get better and strength to hold on until it does.”. Help is at hand, we at Dr. Mehta’s hospitals are at your disposal to answer your queries and treat you and your loved one in the best way possible. Thank You.
Dr. L Manikandan
Consultant, Surgical Oncologist
Dr. Mehta’s Hospitals.