Introduction

Breast cancer is the most common type of cancer affecting women around the world, presenting huge challenges to our healthcare system and society at large. Breast cancer doesn't discriminate. Everyone—whether man, woman, or non-binary—is born with some breast tissue, which means anyone can be affected. Breast cancer begins when the cells of the milk-producing ducts or glands in the breast become mutated and start dividing uncontrollably. These cells can form a tumour that may be felt as a lump. Earlier, the average age of onset of breast cancer was in the 50s or older. But in the last 20-30 years, it has been appearing at a younger age than before, with more aggressive biological features, and often at later stages of the disease.

What are the Different Types of Breast Cancer?

Invasive Ductal Carcinoma (IDC) • The most common type • It begins in the milk ducts & then invades the surrounding breast tissue or distant body organs. • Forms a distinct lump Lobular Carcinoma • The second most common type • It originates in the milk-producing glands (lobules) and can spread beyond them. • Not always form a distinct lump, so it is difficult to detect on mammograms. Ductal Carcinoma In Situ (DCIS) • It is a pre-invasive or pre-cancerous condition where abnormal cancer cells are present within the milk ducts. • If left untreated, some, not all, cases of DCIS might progress to invasive cancer. Other less common types are: Inflammatory Breast Cancer - Rare and aggressive one Paget's Disease of the Breast - This rare type affects the nipple and areola Molecular Subtypes: • Hormone Receptor-Positive • HER2-Positive • Triple-Negative

What are the Symptoms of Breast Cancer?

The following are some common signs and symptoms of breast cancer: • A new mass or thickening in the breast or underarm • Change in the size, shape, or appearance of the breast • Dimpling, redness, or pitting of breast skin (like an orange peel) • Nipple changes, including inversion, discharge, or pain • Persistent pain in any part of the breast • Unexplained swelling or shrinkage, especially on one side

What are the Causes of Breast Cancer?

Experts don't know what triggers the mutation in the cells of the breast tissues. But they explain that some factors might increase your risk of developing breast cancer. These include: • Age: Risk increases with age, though in India, we see a concerning trend of younger women being affected • Family history: Having first-degree relatives with breast cancer • Genetics: Especially in the BRCA1 and BRCA2 genes • Personal history: Previous breast tumour or certain non-cancerous breast diseases • Dense breast tissue: Makes detection more difficult and increases risk • Lifestyle choices: Sedentary lifestyle, excessive ultra-processed food intake • Obesity: Particularly after menopause • Alcohol consumption: Risk increases with the amount consumed • Hormone replacement therapy: Particularly combined oestrogen-progesterone therapy • Late pregnancy or no pregnancy: First pregnancy after age 30 or never having given birth

How to Diagnose Breast Cancer?

• Physical examination: Doctors might examine your breast and underarm area • Imaging tests: Mammography, ultrasound, MRI • Biopsy: Removing a sample of cancerous cells for laboratory testing • Genetic testing: For those with strong family history

What is the Treatment of Breast Cancer?

The treatment depends on several factors, including: • Cancer stage • Type of cancer • Involvement of other organs • Your preferences Treatment options are: Surgical Options • Lumpectomy: Removing the tumour with some of the normal surrounding breast tissue • Mastectomy: Removing the entire breast • Axillary lymph node dissection or sentinel node biopsy: To check if the cancer has spread Radiation therapy: Using high-energy beams to destroy cancerous cells Chemotherapy: Uses chemo drugs to kill cancer cells Hormone therapy: For hormone receptor-positive tumours Targeted therapy: Attacks specific abnormalities in cancer cells and kills them Immunotherapy: Boosts the immune system to fight cancerous cells