Experts Disentangle Taboo Around Breast Cancer

Breast cancer, a hormone driven cancer in which breast cells grow abnormally and form tumours, occurs in 1 out of every 21 women. If left untreated, it can spread throughout the body and become fatal, as cancer cells can spread into nearby breast tissue (invasion). This creates tumours that cause lumps or thickening.

Early detection

Kanchan Kaur, Senior Director- Breast Surgery, Medanta shared facts about the early investigation of breast cancer by saying, “Breast cancer has a very high cure rate but unfortunately, in India, it is detected in late stages in 80 per cent of the cases. Since the breast is an external organ, the self-detection method is also efficient through the symptom of a painless lump. Breast cancer at a young age accounts for about 16 per cent in India, hence regular examination by a clinician should occur.” She further said that mammogram screening in a specialised centre in the 40’s would also help in detecting an early-stage case of breast cancer.

According to the World Health Organisation (WHO), in 2022, there were 2.3 million women diagnosed with breast cancer and 6 lakh and 70,000 deaths were recorded globally. Breast cancer occurs in every country of the world in women at any age after puberty but with increasing rates in later life.

Latest advancements in surgical techniques

The first study that started for breast conservation or lumpectomy took place in the 1970s. In lumpectomy the breast is saved and only the lump with the margin is removed, and armpit lymph nodes are addressed. Such studies have provided a very good robust data of 25 years of follow-up which tells that it is equivalent to having a whole breast removal (mastectomy), as long as radiation therapy is taken along with it.

Karishma Kirti, Consultant, Breast Specialist and Oncoplastic Surgeon, Jaslok Hospital said that, “Breast conservation surgery saves the breast by removing the lump, with the margin and also doing the axillary surgery. However, it has very long-term effects on body image, confidence, self-esteem and sexual well-being, hence these need to be at the forefront.” She further stated that women with breast cancer who go through immunotherapy, advance chemotherapy, radiation machines and techniques are living longer and good lives, and hence, it is very important to focus on survivorship and keep them in mind.

Reconstruction post-surgery

“Breasts are life for a child, pride for a woman, passion for a man and enigma for a surgeon. Whenever a woman undergoes mastectomy, a very big symbol of femininity is taken away. It has a psychological and social impact as well. Breast reconstruction tries to restore the confidence and body image,” said Sukhdeep Singh, Principal Consultant, Plastic, Aesthetic and Reconstructive Surgery, Medanta.

Singh also mentioned that reconstruction options include autologous, where the tissue is taken from abdomen or back and other options is implant-based.

Psychological impact of breast cancer

“The first step towards psychological aspects begin in the oncological setup where the diagnosis takes place. The myth that every cancer is not treatable should be eradicated with awareness. Patients should prioritise themselves and diagnosis should be done in a clinical setting, while decisions for the treatments should be mutually agreed,” said Harsha Agarwal, Head, Psycho Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi. Agarwal went on to say that the patient should be transparently informed about newer treatment techniques and myths around them. The fear of recurrence and survivorship could lead to depression. Hence, a transparent discussion and shared-decision making is crucial during these stages.

These insights were shared during the BW Healthcare World's Oncology Summit, highlighting the collaborative efforts of experts in advancing breast cancer care.