Breast cancer is the most common cause of cancer in women in the world. It is alarming to note that the incidence has also been on a steady rise over the years. Breast cancer when detected early can be treated and the outcome is improved. Early stage breast cancer may not present with any signs. Unlike other types of cancer such as the gut or lung, breast cancer patients are very well most of the time. Hence, so many patients and their loved ones find it hard to accept when the diagnosis is first made.
Breast cancer screening is advised for women above the age of 40 years. Mammogram refers to x-rays of the breasts which is advised yearly and every two years for women above 40 years and 50 years of age respectively. The procedure is mildly uncomfortable but able to save lives as it aims to detect any early staged cancer. Younger women are encouraged to do an ultrasound scan of the breasts. Common presentations of breast cancer are breast lumps, nipple discharge, and distortion of the breast, which indicates a late sign.
A lot of myths prevail in the community about breast cancer.
“I don’t have pain so it cannot be cancer.” However, 90% of breast cancers are painless.
“My parents do not have cancer, so I am not at risk.” Almost 80% of breast cancers are not hereditary, again indicating that only a minority are affected due to the cancer genes in the family.
“I may lose my breast if I see the doctor, which will be embarrassing.” This statement is not true as breast cancers can be operated on while still preserving the breast. Surgical techniques have advanced over the recent years to consider the aesthetic outcome of the operated breast. More options are now available to preserve the breast with new techniques when cancer is picked up, especially in the early stages. From the late 90s, the advent of Oncoplastic Breast Surgery and select breast surgeons specially trained in this sub-specialty helps to allow to preserve more “normal” looking breasts post-treatment.
Treatment of breast cancer has improved in the last two decades resulting in a higher survival rate. A multidisciplinary approach has led to this positive outcome. This refers to management of breast cancer patients by a team of different sub-specialties including the breast surgeon, the medical oncologist, the radiation oncologist, breast care nurse, physiotherapist and breast cancer support groups. The other phobia which the affected family and patient have is the adverse effects of chemotherapy. It will be heartening to know that the latest investigation tools allow testing to determine whether chemotherapy can be omitted in some cases. In the past, most women were subjected to chemotherapy even if they are diagnosed with early staged breast cancer. The side-effects of chemotherapy has also seen a dramatic improvement over the decades due to better treatment regimens and new drugs which are more specifically targeted to the cancer cells.
Life after Breast Cancer
Most women with breast cancer can move on to their normal lives after the initial treatment has been completed. In fact, some younger women even return to their workforce while undergoing chemotherapy if they are physically fit enough. Sometimes loved ones of the patient are often over protective and are not supportive for them returning to work or their usual activities. However, once treatment is completed, breast cancer survivors are actually encouraged to return to their usual activities and hobbies as it is better for them from a holistic point of view. Exercising and meeting up with friends and colleagues take their mind away from the stigma that they have cancer, allowing them to integrate back into society well.
Dr. Radhika Lakshmanan
MBBS, MMed (Surgery), FRCS (Edinburgh)
Dr. Radhika Lakshmanan is a general surgeon with more than 20 years of surgical experience. Her sub-specialty interest lies in the treatment of breast diseases ranging from management of benign breast disorders such as breast cysts, lumps, nipple discharge, lactation problems, screening, male breast disorders and breast cancer. She pursued her sub-specialty interest in Oncoplastic Breast Surgery & Breast Cancer management in Nottingham Breast Institute, United Kingdom. As a breast specialist trained in Reconstructive Breast Surgery, her surgical technique allows for removal of cancer tissue while attaining the optimal aesthetic outcome.