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Prevent breast cancer

Published : Saturday, 3 November, 2018 at 12:00 AM Count : 774
Dr.Farah Jabin Chaity

Dr. Farah Jabin Chaity MBBS  Anwer Khan Modern Medical College

Dr. Farah Jabin Chaity MBBS Anwer Khan Modern Medical College

Anwer Khan Modern Medical College
In general, we can call it as a tumour or growth in breast tissues, that grows uncontrolled with or without any precipitating or risk factors.
Breast cancer is the second most common cause of death from cancer in women. It is estimated that 41,400 people (40,920 women and 480 men) will die from breast cancer this year.
In Bangladesh,the incidence rate of a breast cancer was about 22.5 per 100000 in females.
Although the risk is bit lower,Breast cancer remains the most common cancer among women in Bangladesh.It has become a hidden burden which accounts for 69% of cancer death in women.
The results of the Maternal Mortality Survey conducted by the National Institute of Cancer Research and Hospital in Bangladesh showed that 21% of total number of death among women between 15 and 49 years old age was due to breast cancer.
Sign and symptoms:
*    Painless hard lump in breast
*    Bleeding or unusual discharge from nipple
*    Persistent itch and rash or ulceration around the nipple
*    Skin over the breast is swollen and thickened
*    Skin over the breast is dimpled and puckered
Nipple is pulled in/retracted
RISK FACTORS:
*    Geographical: accounting for 3-5% of all deaths in women in western world and 1-3% in developing countries.
*    Age: extremely rare below the age of 20 but steadily rises and by the age of 90 about 20% women get affected less than 0.5% of patient with breast cancer are male.
*    Gender: less than 0.5% of patient with breast cancer are male.
*    Genetic: A women's risk of breast cancer nearly doubles if she has a first degree relative(mother,sister,daughter) who has been diagnosed with breast cancer study says that less than 15% of women who got breast cancer have a family member diagnosed with it!
P    Diet: excessive intake of alcohol and diet low in phytoestrogens increases chance of breast cancer.Coffee and tea consumption have been hypothesised both to increase and to decrease developing breast cancer.
*    Endocrine: Common in nulliparous women. On the other hand,having 1st child at an early age appears to be protective and increased risk of breast cancer has seen with postmenopausal women.
*    Previous radiation exposure
*    Previous personal history of breast cancer
*    Early menarche and late menopause
*    Association of BRCA 1 and BRCA 2 gene

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Diagnosis:It includes-
*    Clinical (sign and symptoms)
*    Imaging:
*    Mammogram
*    Ultrasound scan
*    MRI(Magnetic Resonance Imaging)
*    Pathology:
*    Core cut biopsy
*    FNAC
These three termed as TRIPPLE
ASSESMENT
Treatment:
*    Breast conservative surgery
*    Lumpectomy/wide local excision(removal of cancer and a small amount of surrounding tissue)
*    Quadrantectomy(removal of more tissue than lumpectomy)
*    Mastectomy (removal of whole breast)
*    Other treatment option includes:
*    Radiotherapy
*    Systemic therapy
*    Chemotherapy
*    Hormonal therapy
Prevention:
Lifestyle changes have been shown in studies to decrease breast cancer risk even in high-risk women. The following are steps you can take to lower your risk:
*    Limit alcohol- The more alcohol you drink, the greater your risk of developing breast cancer. The general recommendation - based on research on the effect of alcohol on breast cancer risk - is to limit yourself to less than 1 drink per day as even small amounts increase risk.
*    Don't smoke- Accumulating evidence suggests a link between smoking and breast cancer risk, particularly in premenopausal women. In addition, not smoking is one of the best things you can do for your overall health.
*    Control your weight- Being overweight or obese increases the risk of breast cancer. This is especially true if obesity occurs later in life, particularly after menopause.
*    Be physically active- Physical activity can help you maintain a healthy weight, which, in turn, helps prevent breast cancer. For most healthy adults, the Department of Health and Human Services recommends at least 150 minutes a week of moderate aerobic activity or 75 minutes of vigorous aerobic activity weekly, plus strength training at least twice a week.
*    Breast-feed- Breast-feeding might play a role in breast cancer prevention. The longer you breast-feed, the greater the protective effect.
*    Limit dose and duration of hormone therapy- Combination hormone therapy for more than three to five years increases the risk of breast cancer. If you're taking hormone therapy for menopausal symptoms, ask your doctor about other options. You might be able to manage your symptoms with non-hormonal therapies and medications. If you decide that the benefits of short-term hormone therapy outweigh the risks, use the lowest dose that works for you and continue to have your doctor monitor the length of time you are taking hormones.
*    Avoid exposure to radiation and environmental pollution- Medical-imaging methods, such as computerized tomography, use high doses of radiation. While more studies are needed, some research suggests a link between breast cancer and radiation exposure. Reduce your exposure by having such tests only when absolutely necessary. 



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