What is Cancer ?

Cancer being Synonymous with Death is a Myth

1. Cancer grows continuously.
2. Cancer tends to spread to different sites of body – called metastases.
3. Without effective treatment, it will shorten patient's life.
4. It is a genetic disorder.

What are the common types of Cancer ?

What is Breast Cancer ?

Breast is made up of glands and fat. Glands of the breast are made up of cells. They normally grow and recede, controlled by hormones. When some cells become abnormal their growth cannot be controlled. They build up into a swelling called Breast Cancer.

Breast Cancer Risks

Age - the risk increases with age. It is less common below 40 years. Age at first complete pregnancy - increases if it is over 30 years. Length of fertile period – menopause at 55 years has twice the risk than menopause at 45 years. Diet and alcohol – are contributory causes. Family history – 5% to 10% of Breast Cancer is familial.

Cases of Breast Cancer in 1994 (by age)

Methods of detecting Breast Cancer

1. Breast Self-Examination (BSE) once a month. This can be aided by "Can-Scan".

Recommendation for BSE Once a month for women from age 40 onwards. When should one do BSE? It should naturally be done when the breast is smaller in women having menstruation, i.e. just after the period. In post menopausal women it can be done on a fixed day of each month.

• Complete steps for conducting BSE are given in CanScan. CanScan also predicts broadly, risk of Breast cancer.
2. Examination by health worker/doctor.
3. Mammography, usually after 50 years of age, periodically.
• It is an X-ray of the breast Screening mammography is key to early detection, i.e. looking for cancer in a woman who has no obvious symptom of disease.
4. Ultrasonography and FNAC (Fine Needle Aspiration Cytology).
• Ultrasonography scanning is now a part of breast examination. It is helpful to find precisely the site for FNAC and biopsy. It can differentiate between cyst and solid lesion. It can be done easily, a number of times, with no radiation.
• FNAC can be done conveniently without even local anaesthesia by a disposable syringe attached with a fine needle. The aspirates are spread over slides and examined under microscope for abnormal cells.
5. Biopsy: It means examination of tissue under microscope.
• The tissue from the suspicious area can be achieved by various methods. It is usually done in clinic under local anaesthesia by a specially designed instrument. It confirms the diagnosis of breast cancer.

Mammography

FNAC

Trucut Biopsy

Breast Awareness

What are the treatments of Breast Cancer ?

1. Surgery: – varies from excision of lump to whole breast. It may include axillary gland also.
2. Radiotherapy: involves killing of cancer cells by radiation. In breast cancer modern high energy radiotherapy is used for remaining cancer cells in breast or armpit. Appropriate doses should be used accurately for satisfactory treatment. The radiation should not cause unacceptable tissue damage. Treatment usually given over three to five weeks. Top up doses may be given later using electron therapy or some times by inserting radioactive wires. This is very useful when tumour is small and breast is conserved.
3. Chemotherapy involves treatment by (a) hormones and (b) anticancer drugs.
1. Hormone treatments can be done in four ways depriving cancer cells of their hormones required for their survival.
1. In pre-menopausal patients ovaries may be removed by excision, radiation or blockade with drugs. In modern treatment removal of ovary by surgery have been abandoned.
2. Anti-oestrogen compound such as Tamoxifen widely used.
3. Progestogens in high dose.
4. Antiaromatase - compounds inhibit the enzyme aromatase important for oestrogen productions after menopause.
2. Anticancer drugs : They kill cancer cells. These drugs are used to prevent recurrence also for example in younger patients with lymph glands in armpit affected. They are used when the disease has recurrence locally or in other parts of body. Several drugs are used in various combination with good result.

How successful are the treatments ?

What are the after effects ?

Conclusion

CanScan

What does CanScan do ?

For accurate risk factor calculations and a recommendation by the program, correct information must be provided. This plays an important role for further self-supervision and will be very helpful to your Doctor.

Step by step instructions for Breast Self Examination are given in the CanScan program.

References

1. Evaluation of CanScan was done on 591 women in early 1999 at Regional Cancer Centre, Thiruvanthapuram by Dr. Ramani Wesley, Associate Professor of Community Oncology, Post Box 2417 Thiruvanthapuram 695011, India.

© 2000-2004 Santanu Pal. All rights reserved.

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Dr. Sambhu Pal MBBS (Calcutta), FRCS (Edinburgh)  President - Indian Association of Surgical Oncologist -1995. Vice President - Indian Association of Surgical Oncologist 1993-1994. Member of Executive Committee - Indian Association of Surgical Oncologist 1989-1991 Member of Indian Association of Cancer Chemotherapist. Member of Association of  Surgeons of India.

Breast Cancer in India

• UK Breast Cancer Awareness Campaign
• Cancer Help UK: Breast Cancer Overview