Breast Cancer

Breast cancer occurs when cells in the breast begin to grow abnormally and out of control. These cells usually form a tumor that can often be felt as a lump or seen on an imaging test like a mammogram.

It is the most common cancer in women worldwide, but it can also occur in men — though this is rare. The good news is that breast cancer is highly treatable when caught early, and survival rates have improved dramatically over the past few decades.

There are several types of breast cancer depending on which cells in the breast become cancerous:

• Ductal carcinoma: The most common type. Starts in the cells that line the milk ducts.
• Lobular carcinoma: Begins in the milk-producing glands (lobules). Can be harder to detect on mammograms.
• Inflammatory breast cancer: A rare but aggressive type where the breast appears red and swollen.

Having a risk factor does not mean you will get breast cancer — it means your chance is higher than average. Many women with risk factors never develop breast cancer, and some women with no known risk factors do. Understanding your risk helps you make informed decisions about screening.

• Age: Risk increases as you get older, especially after age 40. Most breast cancers in India are diagnosed in women over 45.
• Family history: Having a first-degree relative (mother, sister, daughter) with breast cancer roughly doubles your risk. Inherited gene mutations like BRCA1 and BRCA2 significantly increase risk.
• Hormonal factors: Early menstruation (before 12), late menopause (after 55), never having children, or having your first child after 30 can increase risk due to longer estrogen exposure.
• Lifestyle factors: Obesity (especially after menopause), physical inactivity, alcohol consumption, and hormone replacement therapy can all contribute to increased risk.
• Previous radiation: Radiation therapy to the chest area before age 30 (such as for Hodgkin's lymphoma) increases breast cancer risk later in life.

Early breast cancer often has no symptoms at all — which is why screening is so important. As the cancer grows, you may notice changes. Be aware of these warning signs:

• A lump or thickening in the breast or underarm area that feels different from the surrounding tissue. This is the most common sign.
• Change in breast size or shape — one breast becoming noticeably larger or lower than the other.
• Nipple discharge — especially if it's bloody or occurs without squeezing.
• Skin changes — dimpling (like an orange peel), puckering, redness, or flaking of the skin on the breast or nipple.
• Nipple changes — a newly inverted (turned inward) nipple or a change in nipple position.
• Persistent breast pain — while most breast pain is not cancer, pain that doesn't go away should be evaluated.

If you notice any of these changes, see a doctor promptly. Most breast lumps turn out to be benign (non-cancerous), but it's always better to get checked early.

Breast self-examination (BSE) helps you become familiar with how your breasts normally look and feel, so you can notice changes early. While it's not a substitute for professional screening, it is an important part of breast awareness.

When to do it: Once a month, ideally a few days after your menstrual period ends (when breasts are least tender and swollen). Post-menopausal women can pick any fixed day each month.

How to check:

• Visual check: Stand in front of a mirror with arms at your sides, then raised overhead. Look for changes in shape, size, skin texture, or nipple position.
• Touch (standing): Using the pads of your three middle fingers, press firmly in small circular motions over the entire breast and armpit area. Cover the area from collarbone to bra line, and from armpit to cleavage.
• Touch (lying down): Repeat the same circular motions while lying flat — breast tissue spreads more evenly in this position, making it easier to feel deeper lumps.

Treatment for breast cancer depends on the type, stage, and molecular characteristics of the tumor, as well as your overall health and preferences. Most patients receive a combination of treatments.

• Surgery: The most common first step. Lumpectomy removes only the tumor and a small margin of tissue. Mastectomy removes the entire breast. Breast reconstruction is possible after mastectomy.
• Chemotherapy: Uses drugs to kill cancer cells throughout the body. Often given before surgery (neoadjuvant) to shrink the tumor, or after surgery (adjuvant) to eliminate remaining cells.
• Radiation Therapy: Uses high-energy beams to destroy cancer cells in a specific area. Usually given after lumpectomy to reduce the chance of recurrence.
• Hormonal Therapy: For hormone receptor-positive cancers (the most common type). Drugs like tamoxifen and aromatase inhibitors block the hormones that fuel cancer growth. Often taken for 5-10 years.
• Targeted Therapy: For HER2-positive cancers, drugs like trastuzumab (Herceptin) specifically target the HER2 protein that drives cancer growth. These are precision medicines with fewer side effects than traditional chemotherapy.
• Immunotherapy: Helps your immune system recognize and attack cancer cells. Currently used for certain types of triple-negative breast cancer.

A breast cancer diagnosis affects not just your body, but your emotions, relationships, and daily life. Taking care of your mental and physical well-being during treatment is just as important as the medical treatment itself.

• Emotional Support: It's normal to feel scared, angry, or overwhelmed. Talk to family, friends, or a professional counselor. You don't have to be brave all the time — it's okay to ask for help.
• Nutrition During Treatment: Eat a balanced diet rich in fruits, vegetables, and protein. Stay hydrated. If you have trouble eating due to treatment side effects, a nutritionist can help create a plan that works for you.
• Follow-Up Care: After treatment, you'll have regular check-ups — usually every 3-6 months for the first few years, then annually. These include physical exams, mammograms, and blood tests to monitor for recurrence.
• Support Groups: Connecting with other breast cancer survivors can be incredibly helpful. Many hospitals and organizations offer in-person and online support groups where you can share experiences and find encouragement.

You are more than your diagnosis. Many women lead full, active, and joyful lives during and after breast cancer treatment. Take it one day at a time.