Are You At Risk For Breast Cancer? Don’t Wait Until It’s Too Late!

Women in India and around the world continue to succumb to breast cancer, even though it can be detected early. An interview with Dr. Randeep Singh

Women in India and around the world continue to succumb to breast cancer, even though it can be detected early. Stay aware!

The past five years survival rate for breast cancer is over 90%, if it is detected at an early stage (i.e. stage 1 and 2). Yet, women around the world continue to fall prey to a disease that can and should be detected early.

Why? And what can we do about it?

October is Breast Cancer Awareness Month. In an effort to raise awareness about breast cancer, and clarify the many doubts and misconceptions all of us have, Women’s Web presents a series of interviews with medical professionals all through October.

breast-cancer-awarenessIn the first interview of this series, we meet Dr. Randeep Singh, MD, DM who is a Medical Oncologist currently working as a Medical & Hemato-oncologist Consultant at Max Superspeciality Hospital in Delhi.

In this discussion, he talks about early detection of breast cancer, and what women should know about it.

You can also now read the subsequent interviews in this series on:

What is really meant when we talk about ‘early detection’ of breast cancer? From what age are women susceptible to Breast Cancer?

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Dr. Randeep Singh: Breast cancer can be detected at the pre-cancerous stage, where it is known as ductal carcinoma in situ (DCIS), but more commonly it is detected in the first stage of cancer. Such detection of breast cancer at the precancerous stage or the first stage is called early detection.

On an average, women above the age of 50 years in India are susceptible to breast cancer but women with certain high risk factors such as a strong family history of breast cancer, no children or no breast feeding can suffer from it a decade earlier too.

Young women with a family history of cancer and genetic factors need to be tested early and must conduct regular self examination.

What factors make one more susceptible to breast cancer?

Dr. Randeep Singh: The following are the risk factors for breast cancer:

  • A family history of breast or ovarian cancer
  • Use of oral contraceptivesthat consist of a high level of estrogen in the pills
  • Not Breast Feeding
  • Not Having Children
  • Undergoing Hormone Replacement Therapy
  • Obesity

Age makes a difference, with women between the ages of 40 to 70 years being most susceptible; for women younger than this (20 – 40 years onwards), if they are afflicted by breast cancer it is usually due to hereditary and genetic factors.

Is early detection of breast cancer something that all women can do easily? What is the process of early detection and screening for Breast Cancer?

Dr. Randeep Singh: Early detection becomes easy if you follow these two steps:

  • Yearly mammography (or specialized x-ray of the breast), which can be done easily for all women. This test is less sensitive in younger women (less than 40) or women with a less fatty breast . Mammography is the most acceptable and effective method of breast cancer screening worldwide.
  • Self breast examination done each month, followed by an annual visit to the doctor can also be followed in low resource countries such as India. Here is an illustration of the correct way to conduct a breast self examination.

The self examination is important as that is the only way in which women can bring the signs and symptoms of breast lump to the notice of a health care provider at the earliest.

The self examination is important as that is the only way in which women can bring the signs and symptoms of breast lump to the notice of a health care provider at the earliest.

You can either ask your family doctor or oncologist for help in doing a breast self exam, or use one of the many useful web resources such as the ASCO website for patients or the ESMO website for patients, for more information on breast cancer.

Does early detection make a difference in the treatment and outcome of breast cancer? What are the outward signs of Breast Cancer that one can see or feel?

Dr. Randeep Singh: Yes, it makes a significant difference in showing better results due to treatment and the relapse is significantly less in early stage disease (Stage 1 & 2). In very early stages only surgery as a treatment suffices, with no need of any chemotherapy or radiotherapy.

Some outward signs of breast cancer to worry about are:

  • A lump in the breast
  • Gradually increase in the size of the lump
  • Painless Progressive lump
  • Bloody nipple discharge
  • Any change in the shape or size of the breast/ nipple
  • Any sweeling / lump in the underarm ( Axilla)

From what age and how often should women get breast cancer screening done at a hospital or with a specialist?

Dr. Randeep Singh: From the age of 40 to 70 years, women can undergo annual mammography,but not all women are in a position to – it depends upon the socioeconomic and educational status; probably, about 30-40% of women know about breast cancer screening and mammography.

Is it possible to avoid breast cancer, given the high incidence?

Dr. Randeep Singh: It cannot be avoided in the true sense but some of the modifiable risk factors can be reduced such as obesity and hormone replacement therapy containing high dose estrogen pills, or not breast feeding. In cases such as hereditary breast cancer, it cannot be avoided in the true sense but can be diagnosed early by available screening methods as stated above. Genetic counselling plays a vital role in avoiding hereditary breast cancer.

In cases such as hereditary breast cancer, it cannot be avoided in the true sense but can be diagnosed early by available screening methods as stated above. Genetic counselling plays a vital role in avoiding hereditary breast cancer.

What is the incidence of breast cancer in India? Do you see any changes in the awareness of spreading awareness against this disease?

As per the latest statistics in the Globocan 2008 put out by the World Health Organization (WHO),the incidence is 25.8 (age standardised rate) per 100,000 women in India. There is agradual improvement in spreading awareness. One of the results of such awareness is that at my institute, for example, we have started observing and diagnosing aroundone-fourth of breast cancer cases in early stage i.e. stage 1 or 2.

There are also now Indian cancer support groups such as this one.

As Dr. Randeep Singh highlights, the importance of breast self examination and observing our breasts for any changes is paramount. This October, I urge all women to conduct regular breast exams and check for any lumps and changes – and consult a medical professional soon if you notice such changes. Dr. Randeep can be contacted at [email protected]

Images of woman wearing pink ribbon, and breast cancer awareness banner via Shutterstock

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