Dr Anamika Jha, MD

Lately, there’s a lot of talk about breast cancer awareness which gets one anxious and confused. This is not overemphasised, considering the increase in the number of breast cancer cases worldwide, making it the most common malignancy among women (Globocan 2020). Studies show that one in eight women has chance of developing breast cancer during her lifetime.
Factors which increase the risk of developing breast cancer include personal and family history of the same, certain genetic mutations, obesity and postmenopausal hormone therapy, among others. Prevention and early diagnosis are the mainstay of reducing the disease related disability and death. Regular physical exercise, healthy diet and maintaining appropriate weight are preventive measures which reduce the risk of not only breast cancer but other more common cardiovascular diseases.
The fact that this disease is highly curable when detected early and treated in time, highlights the role of screening studies. Screening means women without symptoms undergoing examinations like mammogram with the aim to detect early disease. Methods for screening include breast self-examination, the steps of which are easily accessible on the web, clinical breast examination and mammography. Breast self-examination must be done once in a month by women themselves while clinical examination needs visiting related medical professional once in three to six months.
Mammography involves an extremely low dose of radiation exposure to the breasts and is the only established screening modality with proven impact on reduction of breast cancer effects. In the west, protocols have been implemented with screening mammography being done annually or once in two years from the age of 40 or 50 years. Younger age of breast cancer patients in our subcontinent suggests the need for annual mammograms starting from 40 years of age.
In our scenario, there are other more pertinent issues related to mother child health and infectious diseases which take most attention of policy makers and put breast cancer screening on the backseat. With lack of such public health screening programmes, it is necessary to increase awareness and promote opportunistic or individual screening. Of course, mammogram is not foolproof with misses on one hand and over diagnosis on the other, leading to unnecessary intervention.
Any breast disease related symptoms like lump, nipple discharge particularly red colored fluid, skin or nipple changes should not be ignored or postponed for a later more convenient time. You must seek urgent medical advice and may further need to undergo a mammogram or sonography. Diagnostic mammography should be done first in those older than 40 years as the breast density reduces with age and increases its sensitivity. Ultrasonography (often called video X-ray) is recommended for younger symptomatic patients and is complimentary to mammography in older ones especially when higher breast density renders it ambiguous and less sensitive.
Ignorance is definitely not bliss! Being aware is necessary and the first step on this long road towards reducing the impact of breast cancer. Addressing your symptoms timely, getting screening examinations and mammograms at regular intervals will not only put your mind at peace but can also save from more serious disease. So, ladies do “choose to challenge” yourself and push your limits for breast cancer screening and developing healthy habits for a better you.