The first question a patient almost always asks me is, “Doctor, are you sure I have breast cancer? It can’t be, because no one in my family ever had it!” It becomes quite difficult for me to answer that question, mainly because we still don’t have very clear answers! The fact is, most patients developing breast cancer in our country fall in the sporadic/ non- familial category. A very small minority of patients have a strong family history ( blood relatives- mother/ sister, developing it before the age of 60).
Interestingly, most Indian patients do not even fall in the High risk category: early menarche ( the start of one’s periods), late menopause (cessation of one’s periods), obesity, having no children, not breastfeeding , multiple miscarriages/ abortions and alcohol/tobacco consumption. (These risk factors are now on the rise in the urban population, but I still see quite a few of my patients without these risk factors)
So, the million dollar question remains: who can get breast cancer?
The answer: Anyone can.
I must confess, we still don’t know what really causes cancer.
Gene mutations, urbanisation, changing dietary habits, environmental factors, increased longevity may all be playing their part, but we can’t pinpoint a single cause as the most important one. So, how does one protect oneself from developing it? I feel the most sensible thing to do is to pick up a problem before it has developed into one and nip it in the bud. You may ask me how.
Breast self examination:
The single most but often neglected test. Examine your breasts every month, preferably a week to 10 days after your periods (when they are least tender or lumpiest) in front of the mirror, preferably while bathing. Look out for any subtle skin, nipple or areolar changes or retraction. Gently squeeze the nipples to look for any clear or bloody nipple discharge.
These are basic techniques of examination. The examination has to be carried out with the flat of your hand. A distinct lump will feel like a marble rolling between your hand and your chest.
A very basic but important investigation, recommended for women over the age of 40. However, if I suspect a problem, I may ask for it, irrespective of the age. Most women cringe at the thought of having a mammogram, but I feel it is a very important test, more so because it can often pick up cancers before they form a lump in the breast. The impact of early detection is enormous, as early breast cancer has a much better prognosis.
A lot has been written about diet and lifestyle and breast cancer is no different. A well-balanced diet, with regular exercise in any form, is the best medicine one can give oneself.
To summarise, anyone at any age can develop breast cancer. Early detection by self-breast examination, a regular mammogram and investment in diet and exercise can help you in preventing and treating breast cancer effectively.