Breast cancer biggest killer among Indian women: When to get a mammogram, masectomy vs lumpectomy  |  Photo Credit: Thinkstock
New Delhi: Breast cancer is the most common cancer among women in India and for every two women diagnosed with the disease, one succumbs to it, according to the National Institute of Cancer Prevention and Research. Breast cancer can affect anyone although everyone’s risk is not the same. Many celebrities who have or have had breast cancer, including Bollywood actor Ayushmann Khurrana's wife Tahira Kashyap, use their star power to raise awareness about the disease.
To mark World Cancer Day, which is celebrated each year on February 4, Tahira shared a heartwarming message related to her fight against cancer on Instagram. Tahira, who had a mastectomy last year after she was diagnosed with Stage 1 breast cancer, shared a picture of herself showing her bald head, bareback and a scar from her cancer surgery.
Breast cancer accounts for 14 per cent of all cancers in women and its incidence is on the rise even among women in their early 30s owing to sedentary lifestyles, genetics, dietary changes and family history of cancer. Breast cancer originates in the breast tissue when cells start growing abnormally and stop functioning like normal cells. Like other cancers, breast cancer can invade and grow into the tissue surrounding the breast or spread to other parts of the body, when left untreated. Awareness about the disease and timely screening for prevention is critical to early diagnosis and treatment.
Warning signs of breast cancer you should not ignore
- A lump in the breast or underarm that persists after your menstrual cycle - this is often the first apparent symptom of breast cancer. Lumps associated with breast cancer are usually painless, although some may cause a prickly sensation.
- Although lumps are usually painless, tenderness or pain can be a sign of breast cancer.
- A noticeable flattening or indentation on the breast, which may indicate a tumor that cannot be seen or felt.
- Unusual discharge from the nipple that may be clear, bloody, or of another colour.
- Redness or rashes around the nipple.
- Swelling around the collarbone and armpit.
Protection through early detection: When should you have a mammogram?
Self-examine your breasts: Regular self-examination of one’s breasts is recommended after 20 years of age. One should check for lumps in or near the breasts or underarms, change in the colour or contour, change in the skin texture of the breasts (orange peel texture) and observe for any changes in the menstrual cycle.
Get a mammogram: A mammogram is the most common procedure for examining the breasts for cancer. It is an X-Ray and helps in early detection of breast cancer. For a healthy individual, women should discuss screening mammogram with their breast specialist from age of 40 onwards, said Dr Kanchan Kaur, Associate Director, Breast Services, Cancer Institute, Medanta, the Medicity.
Treatment options for breast cancer: Mastectomy versus Lumpectomy - Which is right for you?
Treatment for breast cancer depends on the stage of cancer. Even though breast cancer is non-invasive at a nascent stage, it requires immediate intervention for preventing the disease from progressing to a malignant stage. The most common types of treatment are surgery, chemotherapy, radiation therapy, hormone therapy, and immunotherapy.
Most women with breast cancer undergo surgery supported by chemotherapy as part of the treatment. Different types of breast cancer surgeries are performed for different reasons such as removal of a tumour, restoration of the breast’s shape post-surgery, relieving symptoms of advanced cancer and assessing if cancer has spread to the lymph nodes under the arm. The most common surgeries are mastectomy and lumpectomy. Read - Breast cancer awareness and prevention: 5 habits that may help prevent or reduce your risk of breast cancer
What is mastectomy?
Mastectomy involves removal of the entire breast for removing a cancerous tumour. Unlike radical mastectomies, performed earlier, that comprised removing the breast tissues, skin and chest-wall muscles, the procedures today are not very extensive and are accompanied by immediate or later stage breast reconstruction. Mastectomy is recommended for preventing recurrent breast cancer.
What is lumpectomy?
Lumpectomy, also referred to as breast conservation surgery (BCS), involves removal of the cancerous portion of the breast and an area of normal tissues surrounding cancer. It seeks to preserve the normal appearance of the breast. In most cases, six weeks of radiation therapy is used to treat the normal and unaffected breast tissues post removal of a cancerous tumour. Women who have small, early-stage tumour are the best fit for this surgery.
Mastectomy has a longer duration, is more exhaustive and requires longer hospital stay as compared to lumpectomy which is less-invasive and has shorter recovery time. However, the treatment option depends on the size of tumour and stage of cancer.
At the intersection of Oncology and Plastic Surgery, Oncoplastic surgery combines the latest plastic surgery techniques with breast cancer surgery. The oncoplastic approach allows patients with larger tumors to undergo breast conservation surgery instead of mastectomy, added Dr Kanchan Kaur. While breast conservation surgery may cause deformities in the breast, specialist breast surgeons can make cosmetic improvements by utilising the remaining breast tissue to fill the gap created by removing the lump. This aids the removal of larger lumps without compromising the safety of the procedure.
Coping with breast cancer once diagnosed can be challenging for the patients and their family. The best treatment plan is one that is customised for the patient depending on size and location of the tumour, stage of the disease, and patient’s age, general health, and psychological temperament.