Breast cancer
The most common cancer in women in India. Found early, it is very treatable, and many women can keep their breast.
What is breast cancer?
Breast cancer starts when cells in the breast grow out of control. It can spread to the lymph nodes in the armpit and, later, to other parts of the body. It mostly affects women, but men can get it too.
Warning signs
- A lump in the breast or armpit, usually painless
- A change in the size or shape of the breast
- Dimpling, puckering or redness of the skin, or skin that looks like orange peel
- A nipple that has newly turned inwards
- Discharge from the nipple, especially if it is bloody
- A rash or crusting on or around the nipple
Screening and breast awareness
Know how your breasts normally look and feel, and see a doctor about any change. Women aged 40 and above should ask their doctor about regular mammograms. Women with a strong family history may need screening earlier.
How it is diagnosed
- Clinical examination of both breasts and armpits
- Mammogram and breast ultrasound
- Core needle biopsy: a small tissue sample taken with a needle, usually under local anaesthetic
- Receptor tests on the biopsy (ER, PR and HER2), which guide which medicines will work
- Scans to check for spread, when needed
Treatment
Treatment is planned around the type and stage of the cancer. It usually combines several of these:
- Breast-conserving surgery, which removes the lump with a margin of healthy tissue and keeps the breast
- Mastectomy, which removes the breast, with the option of reconstruction
- Sentinel lymph node biopsy, which checks the first few lymph nodes in the armpit so that the rest can be left alone when they are clear
- Chemotherapy, hormone therapy and targeted therapy, before or after surgery
- Radiotherapy, usually after breast-conserving surgery
Endoscopic and robotic breast surgery
In selected cases, breast cancer surgery can be done endoscopically or robotically. The operation is done through small cuts placed away from the breast, often in the armpit, where the scars are hidden. It can be used for nipple-sparing mastectomy with immediate breast reconstruction, and for removing lymph nodes from the armpit. Whether it suits you depends on the size and position of the tumour and on your breast size. Dr. Suraga will advise you.
Recovery
- Most women go home within a few days of surgery.
- Gentle arm and shoulder exercises start early to keep movement normal.
- Follow-up visits continue for several years.
Common questions
My lump is painless. Does that mean it is not cancer?
No. Most breast cancers are painless. Any new lump in the breast or armpit should be examined, whether it hurts or not.
Will I have to lose my breast?
Not always. Many women are suitable for breast-conserving surgery, where only the lump and a margin of healthy tissue are removed, followed by radiotherapy. Where a mastectomy is needed, breast reconstruction can be discussed.
Is breast cancer hereditary?
About 5 to 10 in every 100 breast cancers are linked to an inherited gene change, such as BRCA1 or BRCA2. If several close relatives have had breast or ovarian cancer, genetic counselling and testing may be advised.