Screening and healthy lifestyle key to fighting breast cancer

Breast cancer has trumped cervical cancer to become the most prevalent malignancy among women in India. Among steps needed to reduce potential lifestyle risk factors are adequate weight management, physical exercise, avoiding late first pregnancy as well as encouraging breast feeding practices, says Dr Avinash Pandey, Consultant Medical Oncologist, Yashoda Hospitals in Hyderabad.

“A number of factors contribute to this rising burden including urbanisation and changing lifestyles including reduced physical activity, late onset of pregnancy, reduced breast feeding practices and obesity,” says Dr Pandey.

“Mass breast cancer awareness programme with early detection and prompt referral can save many lives. Effective early individualised therapy guided by trained multidisciplinary specialists can go a long way in reducing the burden,” adds Dr Pandey.

Trends show that in developing countries that are going through societal and economic changes, the shift towards lifestyles typical of industrialised countries leads to a rising burden of cancers associated with reproductive, dietary, and hormonal risk factors.

Due to novel discovery in molecular genetics, every patient can be assigned to a special discrete group which makes her assessable to receive maximum benefit to a selected combination of therapy. Such approach of individualised tailored therapy improves the probability of cure while minimising adverse effects and futile costs. However, the major challenge in India is to ensure screening of general population to help in prompt detection of early pre symptomatic stage breast cancer.

“For women with average risk, monthly breast self examination (BSE) along with 3 yearly clinical breast examination (CBE) after 25 years and annual CBE with mammography yearly after the age of 40 years is recommended. Women with increased risk determined with risk prediction model require early and more vigilant screening with six monthly CBE beginning at 30 years of age,” says Dr Pandey.

Majority of early breast cancer patients can preserve the affected breast after undergoing breast conservation surgery provided they agree to receive subsequent radiotherapy. The sequencing of therapy proceeds from surgery to chemotherapy followed by radiotherapy. Patients also receive adjuvant hormonal therapy if deemed necessary for a period ranging from 5 to 10 years.