Breast Cancer – Overview

– A painless lump in the breast is the most common symptom.
– Other less common symptoms include
– Nipple changes ( Retraction, Discharge )
– Skin Changes ( Redness, Dimpling )
– Swelling in the armpit

Not all breast lumps are Cancers.

There are abnormalities in the breast that can present as a lump, even if it is not a cancer.

The best way to know that, is to have a consultation with a Surgeon.

A Surgeon can assess whether a lump is Cancer or not, and can advise as necessary.

Pain is extremely rare in early Breast Cancers.

It is the painless lumps that should worry us more.

The exact reason why some women develop Breast Cancer is not known.
However, some risk factors are known to be associated with Breast Cancer.
The most important of these include
– Unhealthy Lifestyle
– Obesity

– Maintain a healthy weight
– Be physically active
– Follow Healthy dietary practices
– Breastfeeding is protective

The first step is to understand the nature of the breast abnormality.

This can be done with
– Physical Examination
– Special X-rays called Mammogram

If the above procedures point towards a suspicion of Cancer, additional tests may be needed.

These include
– Examination of the breast tissue by a small biopsy (This helps to know if the lump is cancer or not )
– Additional scans like CT Scan, PET Scan etc (These help to know if the tumor is limited or has started to spread)

Breast Cancers can react to certain hormones like Estrogen. It can be predicted by the identification of certain molecules in the cancer cells called Receptors.

Presence of absence of these receptors ( called ER, PR, HER2 ) helps us to understand the aggressiveness of the cancer, and in deciding the ideal treatment.

In Short, yes.
Cure depends on
– Stage of the Cancer at First Consultation
– Aggressiveness of the Cancer
– Effectiveness of the treatment
– Compliance to the treatment

Timely treatment and rigorous follow-up has resulted in many patients being cured from Breast Cancer.

A PET Scan is a special type of scan that can detect the spread of cancer anywhere in the body.

It is usually combined with a CT scan.

PET scan may be needed in some patients before starting treatment, if the cancer is big, or appears aggressive.

Very early stage cancers may not require PET Scan. Your doctor will be able to decide this.

There are 2 broad types of Surgery done to tackle Breast Cancer.

– Mastectomy – Removal of the entire breast
– Breast Conservation Surgery – Removal of tumor alone, without removing the breast-

The size of the tumor and relative size of the breast are taken into account, before the Surgical Oncologist decides which type of Surgery is ideal for you.

Surgery helps to tackle visible disease.

But the cancer can come back after surgery, from invisible cancer cells that can not be identified by any scans.

Treating these invisible cancer cells is very important in achieving a cure.

The treatments used for this purpose include:
– Chemotherapy
( Drugs that tackle growing cancer cells anywhere in the body )

– Radiation Therapy
( X-rays that neutralize cancer cells in operated area )

– Hormone therapy
( Pills that prevent Cancer cells from growing, by opposing hormone effect on them )

– Targeted Therapy
( Cancer specific drugs tailored according your cancer type )

– Immunotherapy
( Drugs that make your immune system fight against the cancer cells effectively )

Your oncology team will be able to decide, which of these treatments is required for you, and in which sequence.

Based on the initial size and extent of the cancer, giving Chemotherapy first is useful in some patients.

This helps to reduce the size of the tumor, if it is too big for surgery at first. Surgery is still essential in such patients to achieve complete removal of the tumor.

It is common for someone on Chemo treatment to feel tired.

They may have occasional side effects like vomiting, but majority of the patients tolerate the treatment well.

Hair loss is common with Chemo drugs used for Breast Cancer.

Hair loss starts around 3 weeks from the start of Chemotherapy.

However, it is only temporary hair loss.

The hair will regrow in normal fashion around 3-4 months after Chemo is over.

Radiation therapy uses X-rays to treat the invisible cancer cells in the operated area. It is a very effective treatment to prevent the cancer from coming back at the initial site.

You may need Radiation, if the tumor is beyond a certain size, or if the tumor has spread to lymph nodes in the armpit. Your Oncology team will advise you regarding it.

Having Radiation therapy is no different than taking an X-ray. It is a completely painless procedure.

The duration of treatment depends on the Stage and Receptor status of the tumor. Some patients may require tablets to prevent the cancer from coming back, and they may have to take the medicines for a few years, for successful treatment.

Most of the Health insurance plans cover costs of cancer care. Most of the expenses can be minimised, if one has Health Insurance.