By Dr Sujata Mitra
Breast cancer is the most common cancer in females worldwide. There is a rising trend of breast cancer across the world, including India, where it is the most common cancer among females in urban population accounting for 30% of all female cancers (cervical cancer continues to be the commonest cancer in the rural population). The median age for breast cancer in India is a decade less compared to the western population. About 35-40% Indian patients present with advanced disease and there is a higher proportion of aggressive cancers.
Risk factors for breast cancer are older age, inherited risk due to genetic factors, radiation to the chest wall, oestrogen exposure, obesity and alcohol amongst others. Factors like breast feeding and early pregnancy lower the risk for breast cancer.
Screening helps in early detection of disease, even before the patient is aware of symptoms. In breast cancer, the most accepted method of screening is by mammography. A mammogram is an X-ray of the breast. For many women, it is the best way to detect breast cancer early. Having regular mammograms can lower the risk of dying from breast cancer. The current recommendation for breast cancer screening is as follows: women aged 40 to 49 years with average risk can choose to go for annual screening by mammography, women aged 50 to 74 years with average risk should undergo mammography once every two years. In younger age group, a mammography may be less sensitive due to dense breast tissue.
MRI is a sensitive method for screening patients at high risk for breast cancer. Clinical breast examination is also a screening method to detect breast cancer. A doctor or other health professional carefully examines the breasts and under the arms for lumps or an unusual finding.
The most common presentation of breast cancer is a painless gradually progressive breast lump. All such patients should be evaluated via triple assessment (clinical examination, bilateral mammography and pathological evaluation of the breast lump).
If breast cancer is diagnosed, effective treatment is available in form of surgery, radiotherapy, chemotherapy, hormone therapy, targeted therapy (a type of treatment that uses drugs or other substances to identify and attack specific cancer cells) or immunotherapy (a treatment that uses the patient’s immune system to fight cancer). Decisions about the best treatment are based on certain tests and imaging like oestrogen and progesterone receptor test, HER2/neu test, chest X-ray, CT, Bone scan or PET-CT. These help to determine how well certain treatment will work, how much has the disease spread and how likely it is to recur.
Jamshedpur offers every facility for breast cancer prevention and treatment. Meherbai Tata Memorial Hospital (MTMH) routinely carries out mammography for screening and diagnosis of breast cancer. Dedicated cancer specialists (Medical, Surgical and Radiation Oncologists) are available for consultation in OPD as well as for care of admitted patients. All specialised tests like biopsies, receptor tests, imaging (CT, MRI, PET- CT) are available for diagnosis and follow up of patients. All forms of treatment, namely, radiation therapy, chemotherapy, targeted and immunotherapy are also available, together with specialized lymphedema clinic and palliative care.
In the field of preventive care, Tata Trusts is supporting the National Health Mission (NHM) in strengthening the National Program for Prevention and Control of Cancer in Jharkhand. The outreach team has screened around 3150 beneficiaries for breast cancer. Patients identified through the screening program are referred for diagnosis and treatment to cancer hospitals.
There is help and hope for people diagnosed with cancer. Just reach out!
(Author is Director, MTMH & HOD, Department of Nuclear Medicine, Tata Main Hospital. The views expressed are personal.)