In 2008, according to WHO, 4,58,000 deaths were caused by breast cancer worldwide. Cancer Registry, Bangalore estimates a 2.7% annual increase in breast cancer, for the period 1982-2005 (ICMR Report). In India every year, one lakh new cases are diagnosed, 50% of them in advanced stage.
Some important trends over the years are:
- Shift in cancer incidence to younger age, that are more aggressive.
- Detection at a late stage: In USA, 89% of women with breast cancer have a 5 year survival rate (a benchmark for control of cancer). In India, the corresponding figure is approximately 69%. The difference is due to the late detection of cancer in India. This means that at least 20% more women with breast cancer can survive, if cancer is detected early.
- History of breast cancer in siblings, or mother, increases risk.
- History of exposure to radiation.
- Taking hormonal pills like oestrogen, progestins/birth control pills increases susceptibility
- Breastfeeding your baby longer reduces the risk.
- Only women get breast cancer.
- Most breast lumps are cancer.
- Breast cancer occurs in older women only.
- We know what causes breast cancer.
- Men can also be diagnosed with it.
- Only a few lumps are cancer.
- Younger women are also susceptible.
- No, we do not. We know only risk factors.
It is obvious that early detection of cancer, and meticulous treatment can improve survival. Earlier, self examination by women used to be highly recommended. However, research has shown that it did not result in decreased death rates. It was also reported that it led to more invasive procedures, for benign diseases. Self examination is gradually being replaced by the concept of breast awareness.
What should lead to suspicion of Breast cancer?
- A lump growing in any part of breast : most common presentation.
- A change in size.
- Puckering or dimpling of skin . Inversion of nipple .
- Discharge , especially blood stained .
- A lump which does not move freely, or is attached to skin, or underlying muscles, or chest wall.
- Swelling in armpit, or under collarbone.
- Pain is a late symptom of disease, and should not be waited for.