Earliest awareness of breast carcinoma and prevention | By Dr Yasin Khan Durrani


Earliest awareness of breast carcinoma and prevention

THE breast cancer is the most common cancer diagnosed in women, rarely occur in men as well.

But it is far more common in women. Breast cancer awareness and research created advances in the diagnosis and treatment.

The number of deaths associated with it is steadily declining in the world, largely due to earlier detection and better understanding.

The statistics have shown that the incidence of breast cancer is considerably rising n Pakistan as compared to other Asian countries. Women one out of nine are at the risk of developing breast cancer.

Approximately 40,000 women die from breast cancer in our country, while 90,000 (50 per /100,000) patients are diagnosed as new cases every year. Incidentally, doctors have noticed earlier in young women after puberty.

A breast lump or thickening that feels different from the surrounding tissue, a change in size, shape or appearance to the skin, such as dimpling, inverted nipple, pigmentation of the area surrounding the nipple, redness or pitting of the skin, even if a recent mammogram was normal. It is advisable to make an appointment with your doctor for prompt evaluation

The breast cancer occurs when some normal breast cells begin to grow abnormally especially in milk-producing ducts (invasive ductal carcinoma).

These cells divide more rapidly than the normal healthy cells and continue to accumulate, forming a lump or a mass.

Cells may spread (metastasize) to lymph nodes mostly under the axils or to other parts of your body like bony tissue even documented in the eyes, inciting inflammatory process.

There are many types of breast cancer, it may begin in the glandular lobular tissue (invasive lobular carcinoma).

Researchers have identified hormonal, lifestyle and environmental factors that may increase the risk of breast cancer.

But it’s not clear why some women who have no risk factors develop cancer, yet other people with risk factors never do so. It’s likely to be caused by a complex interaction of your genetic makeup as well.

Doctors estimate that about five to ten per cent of breast cancers are linked to gene mutations passed through generations of a family. A number of inherited mutated genes can increase the likelihood of breast cancer.

The most well-known are gene 1 (BRCA1) and gene 2 (BRCA2) which significantly increase the risk of both breast and ovarian cancer.

If you have a strong family history of breast or other cancers, your doctor may recommend a blood test to help identify specific mutations in BRCA or other genes that are being passed through your family.

But having one or even several breast cancer risk factors do not necessarily mean that they will develop breast cancer. 70% of our population live in rural areas that lacks necessary medical facilities and have social, economic, cultural constraints, barrier to the timely diagnosis and treatment.

The risk of breast cancer increases with age and you are likely to have an increased risk of breast cancer, if you’ve had in other breast. And if your mother, sister or daughter had been diagnosed with breast cancer, particularly at a younger age, your risk of breast cancer is increased.

Still, the majority of people have no family history of the disease.
Certain gene mutations increase the risk of breast cancer, can be passed from parents to children.

The most well-known gene mutations are referred to as BRCA1 and BRCA2. These genes can greatly increase your risk of breast cancer and other cancers. If you have received radiation treatments to your chest as a child or at younger age, your risk of breast cancer is increased.

Being obese increases the risk of breast cancer and beginning of period before age 12 increases your risk of the disease.

If someone delayed menopause at an older age, you’re more likely to develop breast cancer and women who gave birth to their first child after 30 have an increased risk of breast cancer.

Women who have never been pregnant have a greater risk of breast cancer than do women who have had one or more pregnancies.

Women who take hormonal medications with estrogen and progesterone to treat the signs and symptoms of menopause, have also an increased risk of breast cancer.

The risk of breast cancer decreases when they stop taking these medications. Drinking alcohol increases the risk of breast cancer.

Prevention: Making changes in your daily life style may help reduce your risk of breast cancer, timely screening of breast and mammograms, breast self-exam helps in diagnosis and timely treatment.

If there are new changes like lumps or other unusual signs in your breasts, talk to your doctor promptly.

However, breast awareness can’t prevent breast cancer, but it helps you to better understand the normal changes that your breast undergoes and identifies any unusual signs and symptoms. Limit the amount of alcohol you drink to no more than one drink a day.

Exercise most days of the week for at least 30 minutes. Limit post-menopausal hormonal therapy which may increase the risk of breast cancer. If it is important, use the lowest dose of hormone for the shortest period.

Maintain a healthy weight by reducing the calories in-take. Choose a healthy diet supplemented with vegetables like ginger, turmeric, minerals like Magnesium and omega 3 from fish especially salmon, olive oil and mixed nuts, whole grains, legumes, instead of refined sugar, red and processed meat.

Use fruits regularly as most of the fruits especially peaches and apples reduce risk of developing breast cancer by 41%.

In advanced countries, women with a very high risk of breast cancer choose to have their healthy breasts surgically removed (prophylactic mastectomy).

—The writer is a retired professor from Rawalpindi Medical University and Hon Professor of China’s Tianjin University.

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