Breast Cancer on Rise in Greater Mangaluru

  •   Fri, Oct 19 2018
  •   By Dr Suresh Rao

October 19, 2018

October is the month for breast cancer awareness. Global level efforts are directed at highlighting the importance of breast awareness, education and research. Today, breast cancer is the leading cause of cancer in women both in the developed and less developed countries and its incidence is increasing. In India, breast cancer accounts for about 14% of new cases. It is estimated that 508000 women died in 2011 due to breast cancer worldwide. Breast cancer is not exclusive to women as men are also afflicted. However, when compared to men, breast cancer is seen in very high proportions in women than men.

With regards to the causative factors, one of the most important aspects that need to be considered is familial history. Breast cancer increases the risk by a factor of two or three with familial history. Some mutations, particularly in BRCA1, BRCA2 and p53 result in a very high risk for breast cancer. However, these mutations are rare and account for a small portion of the total breast cancer burden. In addition to this reproductive factors associated with prolonged exposure to endogenous estrogens, such as early menarche, late menopause, late age at first childbirth are among the most important risk factors for breast cancer.

Prolonged use of exogenous hormones also exert a higher risk for breast cancer. When compared with non-users, use of oral contraceptive and hormone replacement therapy increases the risk. Reports also suggest that 21% of all breast cancer deaths are attributable to alcohol use, overweight, obesity, and physical inactivity. Control of specific modifiable breast cancer risk factors as well as effective integrated prevention of non-communicable diseases that promotes healthy diet, physical activity, control of alcohol intake, overweight and obesity, could eventually have an impact in reducing the incidence of breast cancer. Breastfeeding has a protective effect and needs to be promoted.

Breast cancer is one of the easily detectable cancer. The breast self-examination includes regular and systematic palpation of the breast by a woman herself to assess for any abnormality. It is strongly suggested that after the age of 20, a woman must do breast self-examination every month, and evaluated by a clinician, at least once every two years till she attains 40 years of age.

Most common symptoms of breast cancer include:

• Swelling of all or part of a breast (even if no distinct lump is felt)
• Skin irritation or dimpling (sometimes looking like an orange peel)
• Breast or nipple pain
• Nipple retraction (turning inward)
• Redness, scaliness, or thickening of the nipple or breast skin
• Nipple discharge (other than breast milk)

In addition to this, it is recommended that women above 40 years undergo clinical examination and radiological imaging using mammogram every year. Women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or longer. The American cancer society recommendations for the early detection of breast cancer varies depending on a woman’s age and include mammography, as well as magnetic resonance imaging (MRI) for women at high risk.

Observations at Mangalore Institute of Oncology (MIO) and other centers of India suggest that women as young as 30 years are also being detected with cancer of the breast. At MIO, we believe that empowering women with knowledge and training in breast self-examination is vital as this process needs to be done every month by the individual which is useful in detecting early changes in the breast. Efforts are always on spreading awareness of the disease in the community. This is because prevention is always better than cure and breast cancer where a growth of lump/cancer can be detected easily in early stages. Since its inception in the year 2011, MIO has been active in spreading awareness on breast cancer and efforts are made to educate people on the signs and symptoms. In addition to this MIO, has been undertaking cancer detection camps for detection of breast cancer. The results have been very encouraging as in addition to clinical examination and mammography, the women who have attended these programs have been taught breast self-examination to spread awareness in their family, locality and society at large.
By Dr Suresh Rao
Dr Suresh Rao is the chief of Radiation Oncology department at Mangalore Institute of Oncology (MIO) and is an expert in external-beam radiation therapy and brachytherapy.
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Comment on this article

  • Jyothi Lobo, Mangalore

    Mon, Nov 05 2018

    Mr Rudolf Rodrigues, Mumbai,

    This is in response to your concerns on the usefulness of mammogram and the controversies associated. Yes, there are plethora of reports that express mammogram is not useful and also that the diagnostic industries have had a role similar to the HPV vaccine controversy. However, till date, neither the National Cancer Institute (https://www.cancer.gov/types/breast) nor International Agency for Research in Cancer (http://publications.iarc.fr/Book-And-Report-Series/Iarc-Handbooks-Of-Cancer-Prevention/Breast-Cancer-Screening-2016 https://www.iarc.fr/en/meetings/handbooks/index.php)

    two of the world’s premier cancer centers which stipulate the guidelines have not debunked the usefulness of mammogram in the detection of breast cancer. Further Indian Council for Medical Research (ICMR) has also mentioned about the use of mammogram in breast cancer detection and screening (https://www.icmr.nic.in/sites/default/files/guidelines/Breast_Cancer.pdf). Considering the guidelines from three premier agencies it is imperative that we follow them. I kindly request you to have a read through the links.

  • Rita, Germany

    Mon, Oct 22 2018

    Thank you for brunging this article in daijiworld Hope many women make use of this and go to doctors for a early diagnose and profit it from staying away from this earlier.Many women dont go to doctor with this thema more out of shame ,fear,and not having proper knowhow about it.Mammography from the angel of a patient ,Ican only say please do it earlier than later.It can save a life or prlong your life .

  • Rudolf Rodrigues, Mumbai

    Sun, Oct 21 2018

    With due respect to the doc, would like to put the
    latest views on mammograms from various studies around the world:
    Group of top medical experts admits mammography does more harm than good
    One year after this review was published, a second one published in The New England Journal of Medicine (NEJM) came to a similar conclusion. A team of medical professionals that included a medical ethicist, a clinical epidemiologist, a pharmacologist, an oncologic surgeon, a nurse scientist, a lawyer and a health economist, decided that the medical industry’s claims about the benefits of mammography are essentially bunk.

    They found that for every 1,000 women screened in the U.S. over a 10-year annual screening period beginning at age 50, one breast cancer death would be prevented, while a shocking 490 to 670 women would have a false positive, while 70 to 100 would undergo an unnecessary biopsy. Between three and 14 of these women, the study found, would also be over-diagnosed for a non-malignant form of cancer that never even would have become “clinically apparent.”

    This study out of Switzerland corroborates another out of Canada – the 2014 Canadian National Breast Screening Study – which concluded in lockstep with the others that mammography screenings do not reduce mortality rates from breast cancer any better than a simple physical examination. In other words, the procedure is completely unnecessary, and in many cases exceptionally harmful. And on and on the list goes, with data out of Norway and elsewhere confirming that mammography isn’t all that it’s cracked up to be. U.S. data spanning the course of nearly 40 years shows that more women are over- or misdiagnosed with breast cancer because of mammograms than are successfully early-diagnosed with breast cancer in such a way as to protect against metastasization. This represents an exceptionally poor track record that calls into question why mammography continues to be used when it clearly doesn’t work.

  • Jenifer, Mangalore

    Sat, Oct 20 2018

    Thank you Dr. Rao, for this very informative article.

    The disease has become so common that these days every house next-door has a cancer case.

    People, please take advantage of cancer camps organized by various institutions, MIO too is one of them. Such camps don't charge you anything, and they offer ample support if anybody is tested positive. If you are to go for tests yourself upon suspecting something, it will cost you very dearly.


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