Dr. Niti Krishna Raizada, Senior Director, Medical Oncology and Hemato-Oncologist, Fortis Hospital, Richmond Road, Bangalore
Bloody discharge from the nipple
Retraction of the nipple, flaking skin around the nipple
Erythema i.e., redness of the skin of the breast, bruising that looks like red or purple, or bluish tint
Armpit / underarm swelling because of lymph nodes being affected
Skin texture change like thickening, Dimpling of skin (like an orange peel)
Tenderness / painful breast or nipple area
Size and shape changes of the breast
Rule of Thumb to follow:
Between:
Age 20 – 30 years: Breast self-examination/awareness
Age 31 – 40 years: Clinical Examination by an Oncologist every 6 months
Age 41 – 55 years: Annual Mammogram
Beyond 55 years: Mammogram once in two years
Remember:
- Many conditions can cause breast lumps and the most common of these are fibrocystic changes or breast cysts. These mostly happen in young women and can cause lumps, pain, etc., and are not cancerous.
- Higher risk categories include men/women with genetic mutations like BRCA, PTEN, TP53, etc. Certain families have several members with cancer. Individuals with a strong family history should visit an oncologist/ geneticist to get themselves evaluated. Wherever necessary, after discussing the pros and cons, a blood test is advised to confirm whether there is a genetic link.
- Personal history of radiation in past to the chest for Hodgkin’s disease and certain conditions like atypical hyperplasia or lobular carcinoma in situ increases risk. Regular checkups are recommended for such individuals.
- Most women have breasts that feel lumpy. This can also change during periods, when kids are born or while there is a weight change, or with age, and this is not a worrisome sign.
- India has younger women (between 35-50 years) developing Breast Cancer. The exact reason remains unclear. However, some researchers are also exploring the correlation to IVF and hormone replacement therapies. So, it’s important to be self-aware and get yourself examined regularly.
- 1% of breast cancer is reported in men and so this is not just a woman-centric disease.
- Breast cancer is always treatable and, in most situations it is curable. Please don’t waste time exploring unconventional treatment options and losing the benefit of early diagnosis and early treatment when cancer remains curable.
- Newer diagnostic modalities include-liquid biopsies, molecular imaging, and imaging biomarkers which make treatment more focused and rewarding.
- Certain gene testing assays (like OncotypeDx, and Mammaprint), guide us to whether we can only give hormonal therapies and not chemotherapy.
- We are moving towards an era of organ conservation and so mastectomy is done rarely only when there are locally advanced cancers. In most situations, we recommend breast conservation which has a positive psychological impact on women who have long healthy life post-treatment.
- Newer drugs and newer targets are other promising areas in breast cancer with antibody-drug conjugates and immunotherapy taking a very important role. These newer ammunitions work very well in certain very advanced cancers as well.
- Breast Cancer Survivorship and people living with cancer, which means those who have had treatment in the past and now doing well is the most reassuring aspect of oncology practice when one meets happy families who have successfully dealt with cancer and done well!