Breast Cancer Awareness Month 2020: How Is Breast Cancer Diagnosed? Expert Explains

The month of October is observed as Breast Cancer Awareness month. Breast cancer is one of the leading causes of cancer death in Indian women. More than two-thirds of breast cancer patients in India present at an advanced stage at the time of diagnosis. Early detection of breast cancer is the 'cornerstone of breast cancer control' as described by the World Health Organisation.

What women should be aware of?

Women should be aware of important risk factors which may lead to the development of breast cancer

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-Family history of breast cancer in first-degree relatives

-Early age of menarche (<12 yrs) or late menopause (>55 yrs)

-First childbirth at a later age and lack of breastfeeding

-A sedentary lifestyle and associated obesity

-Use of oral contraceptives or hormone replacement therapy

Breast Cancer Awareness Month 2020: Early menstruation can increase the risk of breast cancer
Photo Credit: iStock

Breast self-examination (BSE)

Breast self-examination (BSE) is a procedure where a woman checks her breasts routinely to detect any abnormal swelling or lumps for seeking prompt medical attention. BSE can be done by the woman herself once a month when breasts are least tender, usually 5-10 days from the first day of her last menstrual period. Women who no longer have periods can undergo self-examination on any day in a month.

Self-examination of the breast can be done while standing in front of the mirror while lying down or while taking shower. Tips of fingers are used to palpate the breasts and to get a sense of what a normal breast feels like. Abnormalities can be detected only once a woman is aware of what is normal. The right hand can be used for the left breast and vice versa. Self-examination can be done making circular motions with fingertips covering the entire breast from top to bottom and side to side. Being aware and knowing one's body best and noticing any abnormal changes early is the key to BSE.

Also read: Breast Cancer: What Puts You At A Higher Risk Of Breast Cancer? Know Some Prevention Steps

Clinical Breast Examination

Clinical breast examination (CBE) is done by a clinician to look for any lump or signs of breast cancer in women. Women who have any associated risk factor of breast cancer but are unable to notice any changes themselves can undergo CBE by an expert health care worker to look for any signs of early breast cancer changes. CBE is also done as the first examination in women who have any symptom of breast cancer such as lump, pain, nipple discharge etc.

Women who consult a clinician for breast examination seem to be more aware of breast cancer and in the process, they also learn about the proper methods of self-examination and breast cancer in general. Women with a family history of breast cancer or any sign or symptom of early breast cancer must undergo CBE as a preliminary workup before they go for mammography or other screening modalities.

Also read: Breast Cancer Awareness Month 2020: Early Detection Can Help Save Lives, Here's How

Mammography for breast cancer screening

Mammography is the most common breast cancer screening modality used worldwide. It uses low dose X-ray to capture images of the breast in the form of a radiograph. A radiologist then examines these radiographs (x-ray images) to look for any calcification or opacity in the breast tissue. A final report is generated based on his observation and a BIRADS score is given, which labels a breast tissue as normal, benign or malignant.

In mammography, the breast tissue is compressed between two radiographic plates to enhance the contrast of the radiographic image. The whole process could be cumbersome at times or maybe painful for some women. (We can put a figure for the same)

Mammography has proved to be beneficial in detecting early-stage breast cancer and decreasing breast cancer-associated deaths. However, there are a few limitations of mammography that is not helpful in young women with dense breast. In low and middle-income countries (LMIC) like India mammography poses certain other challenges such as cost, lack of expert radiologist and socio-cultural stigma.

(Dr Chandan Kumar is a Consultant Oncologist at Niramai Health Analytix and a Consultant Oncologist at AIIMS)

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