You are your best defence against breast cancer

Breast cancer thus has become one of the leading cancers amongst women in India. It is also the leading cause of cancer-related deaths among women

Every three minutes, a woman is detected with breast cancer somewhere in the world. In India, more than 150000 women are detected with breast cancer, annually. Unfortunately, over 60% in India are detected at a later stage, making survival difficult. Breast cancer thus has become one of the leading cancers amongst women in India. It is also the leading cause of cancer-related deaths among women. Yet, breast cancer is one such cancer which can be detected early with regular screening and breast self-examination and, if detected early, can be easily treated and the risk to life can be reduced.

Breast cancer control is the collective responsibility of everyone. While the Government of India, through National Health Mission (NHM), is collaborating with several social and private sector organisations for strengthening the screening and awareness programme in the country, and many health sector organisations too are working in the space of early detection of breast cancer, still much more needs to be done.

Concerted steps are needed at the level of an individual to make females aware of the signs, symptoms, importance of self-examination of breasts and regular screening and controllable risk factors from a young age; and at the Government level to help foster a safe environment for screening, early detection through better infrastructure, and create a systemic change through introduction of relevant programmes early on, in schools.

At an individual level, breast cancer can happen due to multiple factors. In the broader scheme, the factors could be divided into two parts – biological and genetic; and lifestyle-related factors. Family history, old age, over production of estrogen, early onset of menstruation, late pregnancy are some of the biological and genetic risk factors. Lifestyle-related risk factors that could lead to breast cancer are being overweight, consumption of alcohol, lack of exercise and prolonged hormone(estrogen) replacement therapy.

Individuals can reduce their risk of breast cancer, by keeping a check on the lifestyle-related risk factors; including keeping their weight under check, exercising regularly, and limiting alcohol intake. Individuals, who are advised hormone replacement therapies, should visit their doctors regularly to keep prolonged consumption of hormonal supplements under check.

To effect an irreversible systemic change, self-breast examination training should be a part of the high-school syllabus. Educational institutes need to ensure that the adolescent girls are made aware about the signs and symptoms, and are taught about self-breast examination. It is also important that at homes, mothers lead by example by conducting self-breast examination, going for regular screenings and taking their daughters to a health-center to get them trained. The Government of India, through NHM, has worked on heart touching campaigns encouraging women to come forward for breast screening; and families to take responsibility of the health of the women in their households.

How to self-examine?

Breast self-examination is a two-step process involving visual examination and palpation. In the first step, the breasts are visually examined for any change in size, shape, colour, any distortion or swelling, any dimpling, puckering, bulging, any change in position of the nipple or any discharge.

In the second step, using the finger pads, the breasts are felt with a firm, smooth touch; from top to bottom, i.e. collar bone to the top of abdomen, and from side to side i.e. collar bone to the cleavage. While palpating, feel the breast for the changes that were visualized. Also, check the breast for lumps and thickening. If the lump is smooth or rubbery and moves around when you push it with your fingers, do not worry about it. But if it is hard, has an uneven shape and is painless, and does not move even on pushing, report it to your healthcare provider, immediately.

Breast self-examination should be started after the age of 20. It should be repeated at the same time, every month. However, this should be done, 7 to 10 days after first day of menstrual cycle. Women above the age of 30 must visit their healthcare provider regularly for annual clinical breast examination. Women with family history and other risk factors could be advised with other screening modalities like mammography, etc.

With collective efforts, it is possible to raise the awareness level and propagate breast cancer screening and self-examination and reduce the burden of this debilitating disease in the country. With regular screenings, it's possible to detect breast cancer in early stages. When detected early, it's possible to save the breast, reduce the duration of the treatment, the cost and also prolong the life of the patient.

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