Breast Self-examination (BSE)
Ideally to be done once a month right after the menstruation because during this time breasts are less engorged. In a menopausal woman, it is to be done regularly every month.
a. Both breasts are to be examined
b. Lie down with arm raised with mattress support behind
c. Palpate using fingers over all quadrants
d. If any doubtful swelling is felt, Consult your doctor
Doctors generally use the TRIPLE ASSESSMENT METHOD for a breast lump.
A. History and Physical Examination:
The doctor will ask about any symptoms you are experiencing like Breast pain or any discharge coming out from the nipple and then the doctor will proceed to examine the breast to look for a breast lump and its surroundings.
The following techniques are used to examine for a breast lump
Dial clock method: In this method, the whole breast is examined as if it was a "dial of a clock" by making circular movements with the pads of the middle 3 fingers of the hand increasing the pressure with each circle.
Vertical Stripe Method: Using the pads of 3 fingers breast, the breast is examined in overlapping vertical stripes with light, medium, and then deep pressure.
Horizontal Stripe Method: Similar to the Vertical Stripe Method where the breast is examined in overlapping horizontal stripes
B. Radiological Investigations:
There is no doubt that imaging modalities are the best investigation when it comes to screening breast masses.
Specific types of scans help in detecting breast cancer, including:
This is a type of X-ray that doctors often use during initial breast cancer screening. It produces images that can reveal lumps or abnormalities. If there is any indication of a potential problem, the doctor usually conducts further testing.
This scan uses sound waves to assist a doctor to differentiate between a solid mass and a fluid-filled cyst. It also helps to visualize the margin of the mass and gives an idea about the compressibility and dimension of the lesion and helps to find out whether it is benign or not. It is preferred in young women, less than 40 years of age, who have dense breasts.
Because it is hard to differentiate between a breast lump and dense connective fibrous tissue in a mammogram. As there is no risk of radiation, it can also be done in pregnancy.
Ultrasounds of the lymph nodes are also done to check for the spread of breast cancer. FNAC (Biopsy) can be done under ultrasound guidance.
Magnetic Resonance Imaging (MRI):
This incorporates different images of the breast to help a doctor identify cancer or other abnormalities. A doctor may suggest an MRI as a follow-up to a mammogram or ultrasound. Doctors may also use MRI s to screen people with a higher risk of breast cancer.
C. Biopsy of Breast Lump:
Once the breast lump is located and confirmed, a biopsy of the breast tissue is taken for histopathological studies which is a confirmatory investigation for breast cancer.
Are You At Risk of Developing Breast Cancer?
Age: The chances of breast cancer increase with age.
Hereditary/Genetics: Women with certain mutations in the BRCA1 and BRCA2 genes have higher chances of developing breast cancer.
History of Breast Lumps: People who previously had breast cancer are more likely to develop it again than a person with no history of the disease.
Dense Breast Tissue: People with dense breast tissue are more likely to be associated with a diagnosis of breast cancer.
Estrogen Exposure and Breast Feeding: Extended exposure to estrogen appears to increase the risk of breast cancer and also could involve starting periods at an early age or entering menopause late. Between these times, estrogen levels in the body are higher. Breastfeeding, especially for over one year, appears to reduce the risk of developing breast cancer.
Body Weight: Obesity after menopause may come up with a greater likelihood of developing breast cancer, possibly due to increased estrogen levels.
Alcohol Consumption: Drinking high amounts of alcohol regularly appears to play an important role in breast cancer development.
Radiation Exposure: Undergoing radiation treatment for various cancers may increase the risk of developing breast cancer later in life.
Hormone Treatment: Studies have shown that oral contraceptives may slightly increase the risk of breast cancer.
Race: As the Centers for Disease Control and Prevention (CDC) report, breast cancer mortality is about 40% higher among Black women than white women. Another research has found that African American women are more likely to die of breast cancer than any other group.
Nulliparity: A Woman who has never given birth has an increased chance of having breast cancer.
Mother's Age At The Time Of First Childbirth: If a woman's age is 30 years or more at the time of her first childbirth, she is considered to have an increased risk of breast cancer.
What Are The Available Treatment Options?
Surgery: Doctors cut out cancer tissue during the operation.
Chemotherapy: To shrink or kill the cancer cells specific medicines are used.
Hormonal therapy: Cancer cells are blocked from getting the hormones they need to grow.
Biological therapy: Works with the body’s immune system by helping it to fight cancer cells.
Radiation therapy: This therapy is carried out by using high-energy rays (similar to X-rays) to kill the cancer cells.
Local treatment: Some treatments, like surgery and radiation, are local, meaning they treat the tumour without affecting the rest of the body.
Systemic treatment: Drugs used to treat breast cancer are considered systemic as they can reach cancer cells almost anywhere in the body. Some can be given by the mouth, injected into the muscle, or put directly into the bloodstream. Depending on the type of breast cancer, different types of medication may be used.
The most common type of treatment is Lumpectomy - The removal of the tumour and a small, cancer-free margin of healthy tissue around the tumour. The maximum of the breast remains. For invasive cancer, radiation therapy to the remaining breast tissue is often recommended following surgery, especially for younger patients, patients with hormone receptor-negative tumours, and patients with larger tumours.
Another treatment is Mastectomy - The surgical removal of the entire breast.
How Much Does It Cost to Treat Breast Cancer Patients?
Breast cancer treatment costs in India are around Rs 5,00,000-6,00,000 ($7,000-8,500). At the national level, the average total spending on cancer treatment was around Rs 1,16,218. In private hospitals, the total cost of cancer treatment was estimated at Rs 1,41,774, while in public hospitals it was relatively low at Rs 72,092.
Disclaimer: Please consult your doctor for the best treatment options for you personally.