Every year, millions of women are diagnosed with breast cancer. It is one of the most common cancers amongst females and poses a major risk for women.

According to World Health Organization, ‘In 2020, there were 2.3 million women diagnosed with breast cancer and 685,000 deaths globally’.

Unfortunately, in Pakistan women lack appropriate awareness about breast cancer due to a range of multifaceted barriers such as socio-cultural factors that inhibit women from breast cancer screening, diagnosis and treatment. As per research, 1 in 9Pakistani women have become patients of breast cancer. Dr. Misbah Masood, Cancer Specialist quoted, ‘In 2020, 2.26 million people were diagnosed with cancer with the highest number of incidence of breast cancer. Besides, he said,' as many as 0.8 million women died of breast cancer in the year 2020.’

As October is Breast Cancer Awareness month, we would be discussing breast cancer with Dr. Rufina Soomro (Breast Surgeon, General Surgeon and Activist). She has conducted many seminars on breast cancer to raise awareness about the disease and reduce its risk amongst women. As per research, 89% of breast cancer patients are diagnosed at a later stage and 59% at an advanced stage due to a lack of awareness in Pakistan.

Signs & Symptoms

These are the common signs and symptoms of breast cancer:

•        A breast lump or thickening that feels different from the surrounding tissue

•        Change in the size, shape or appearance of a breast

•        Changes to the skin over the breast, such as dimpling

•        An inverted nipple

•        Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple

•        Nipple bleeding or discharge

•        Swelling in armpit or collarbone

Most lumps are not painful and cancerous. However, women should visit a doctor for an examination if they notice a lump in the breast.

Diagnosis

Self-Examination

According to National Breast Cancer Foundation, women should perform a breast self-exam at least once a month. The correct way to perform the exam is by checking:

1.        Inthe Shower: With the middle fingers, check the breast and armpit area for any lump, thickening, hardened knot, or any other breast changes.

2.        In font of Mirror: Inspect your breasts visually and by raising the arms high overhead. Look for any changes in the contour, any swelling, or dimpling of the skin, or changes in the nipples.

3.        LyingDown: Place a pillow under the right shoulder and the right arm behind the head. Using the left hand, move the pads of the fingers around your right breast gently covering the entire breast area and armpit. Repeat the same steps for the left breast.

Mammogram

Doctors use mammograms, a type of X-ray to detect early breast cancer. It produces images that can help a doctor detect any lumps or abnormalities, sometimes up to three years before it can be felt. Dr. Rufina explains that mammograms after the age of 40 are necessary. Women ages 40 to 50 should go for an X-ray every two years and every year after the age of 50.

Biopsy

The doctor extracts a sample of tissue and sends it to the laboratory for analysis. The diagnosis helps to stage cancer and shows whether the cells are cancerous. If they are, a biopsy indicates which type of cancer has developed, including whether or not the cancer is hormone-sensitive.

Stages

'According to World Health Organization, Pakistan has the highest cancer mortality rate and breast cancer ranks amongst the top 20 for the cause of death.' says Dr. Soomro.

Typically, cancer is categorized into 4 stages and these depend on the size of the tumour and whether it has spread to lymph nodes or other parts of the body. The four stages are:

Stage1: At this stage, the tumour measures up to 2 centimeters (cm) across. The disease is small in size and sometimes it cannot be felt. However, an X-ray can detect it.

Stage2: The tumour is 2 cm across, and it has started to spread to nearby nodes or is 2–5 cm across. At this stage, it is curable with multiple treatments consisting of surgery, chemotherapy, radiation therapy and hormonal therapy.

Stage3: The tumour is up to 5 cm across, and it has spread to several lymph nodes. Stage 3 cancer is curable; however, the risk that cancer will grow back after treatment is high.

Stage4: The disease has significantly advanced and has spread to distant organs, most often the bones, liver, brain, or lungs. This stage is difficult to treat.

RISK FACTORS

‘A Woman is at risk for breast cancer at all times,' says Dr. Soomro. Age is one of the biggest risk factors. As the age increases, the risk of breast cancer increases in women.

Another risk factor is a family history or first-degree relatives who have had breast or ovarian cancer might have a genetic transfer. Women who took hormone replacement therapy or oral contraceptives for longer periods without doctor consultation can develop symptoms of breast cancer. Other factors include body weight, healthy diet, alcohol consumption, smoking and menopause.

TREATMENTS

Breast cancer treatment can be highly effective, achieving survival probabilities of90% or higher, particularly when the disease is identified early.

The treatment usually depends on the type and stage of cancer. Dr. Rufinaexplains, 'surgery is to remove the part from the breast’. However, other treatments include chemotherapy – medication through drips, radiation therapy to control the disease in the breasts. If the cancer is large, it is treated by mastectomy (complete removal of the breast). Factors affecting the type of treatment a person has will include the age of the person, overall health and medical conditions of the individual.

CONCLUSION

Breast cancer does not always cause noticeable symptoms, especially in the early stage. The changes occur only in the look and feel of the breasts.

Since it is hard to detect the signs, regular breast exams and screenings can help detect the symptoms early.

Lifestyle changes also play a huge role in preventing breast cancer such as following a healthy diet with fruits and vegetables, exercising regularly, avoiding smoking and alcohol and maintaining healthy body weight.

Dr.Soomro encourages women to pay attention to their bodies and maintain regular self-exams and mammograms. If they notice something unusual, they must see a doctor immediately.

Call 021-3713 2273 to book a consultation with Breast Surgeon Dr. Rufina Soomro today.