Dr. Mona Naman Shah advocates avoiding smoking, and alcohol, reducing weight, childbearing at the appropriate age, and breastfeeding can help lower the chances of breast cancer.

Q1) What is breast cancer?

Contrary to what the public might think, all breast cancers are not the same. The female breast is made up of lobules that produce milk, ducts that carry that milk, and other secretions to the nipple and fibrofatty-supportive tissue. Breast cancer can arise from any of these tissues and will accordingly be named lobular carcinoma, ductal carcinoma, mesenchymal tumor, etc.
But the commonest cancer arises from the ducts and the commoner one is infiltrating duct carcinoma which has many other subtypes like Hormone positive, Her-2 Neu positive, or Triple-negative breast cancer. There are many other less frequent types as well.

Q2) Who is at risk of getting breast cancer?

It is very important for the public to understand that all cancers are multifactorial. It is an interplay of inherent genetic tendencies to get mutations and outside environmental factors. There are certain non-modifiable factors that can increase the risk of cancers: Female gender- men can also get breast cancer especially if family history of breast cancer and BRCA gene mutation but that constitutes less than 1 percent of the total number.

• Age: No age is immune to breast cancer but in the western population it is more than 50 years unfortunately it is striking our population a decade earlier.
• Dense breast: Dense breast has more chances of having cancers ( bigger breast does not necessarily mean dense breast- it is the increased glandular tissue rather than fat that makes one more susceptible)
• Taller women: A few studies have hinted that taller women have a slightly increased risk of breast cancer.
• Personal history of breast cancer: Women who have had breast cancer have a slightly higher risk of having another breast cancer on the same side or opposite breast.

Q3): What are the main causes behind the fatal disease?

• Smoking: Whether direct or indirect, can increase the chances of breast cancer. So all attempts should be made to discourage it. Smoking can increase the risk of 15-17 types of cancers in the body and increase aggression as well.
• Alcohol: Alcohol consumption can increase the chances of breast cancer along with other 8-10 types of cancers.
• Late Childbearing: The risk of breast cancer increases slightly with increased maternal age and the recommended is having 1st child before the age of 30 years.
• Breastfeeding: Adequate breastfeeding for around 2 years is seen to reduce the risk of breast cancer in women.
• Physical Activity: An analysis of 35 studies found that highly active women had a 14% lower risk of developing breast cancer compared with the least active women.
• Obesity: Increased Body Mass Index can increase the chances of breast cancer in menopausal women by 50%!! Increased BMI can also increase the risk of many other cancers like ovarian and colorectal cancers.
• Prolonged use of HRT: Prolonged use of Hormone Replacement Therapy after menopause or premature ovarian failures is related to increased risk.
• Previous chest eradication: Any chest radiation especially in teens for any disease like Hodgkins lymphoma etc can increase the chances of breast cancer in the future.

Q4) What are the symptoms of breast cancer?

A lump in the breast- The breast tissue extends from the collar bone to the 6th rib and from the midline of the chest to line under the armpit (anterior axillary line). Any lump in this region can be a presentation of breast cancer. Though the majority of lumps would be non-cancerous still a triple assessment is to be carried out by a specialist to rule out cancers before calling it off. Constant pain in one part of the breast or in the armpit- though mastalgias (breast pain) is very common in the breast as it is a hormonal organ any pain that does not decrease or go needs to be evaluated.

Q5) How can the chances of breast cancer be lowered?

Women have to take care of all modifiable risk factors already mentioned like avoiding smoking, and alcohol, staying physically active, reducing their weight, trying to get their first child before the age of 30 years, breastfeeding their children adequately, trying to avoid unnecessary prolonged HRTs, having proper sleep and de-stressing. They should stay aware of any signs and symptoms and go for evaluations or screenings with concerned specialists.

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