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Breast Cancer: Facts and MythsWhat is Breast Cancer?Breast cancer is a common term for a cancerous (malignant) tumor that starts in the cells that line the ducts and/or lobes of the breast. Breast cancer is not one disease; rather it is several diseases that behave differently.What causes Breast Cancer?Breast cancer’s causes are not exactly clear. Studies have identified numerous risk factors for breast cancer in women, including hormonal, lifestyle and environmental factors that may increase the risk of the disease. Other factors include, increasing age, family history of breast cancer, obesity after menopause, presence of certain inherited genetic changes, and use of oral contraceptives. It's unclear why some people who have no risk factors develop cancer, while others with risk factors never do.What are the Types of Breast Cancer?There are several types of breast cancer, and they are broken into two main categories: “invasive” and “noninvasive,” or in situ. While invasive cancer has spread from the breast ducts or glands to other parts of the breast, noninvasive cancer has not spread from the original tissue.What are the Facts and Myths associated with Breast Cancer The root cause of fear of breast cancer is the lack of knowledge about this disease topped by many myths floating around it. Unfortunately there is lot of stigma attached to this disease inhibiting women to reach out to a doctor or even their family members.Myth:It cannot happen to meToday breast cancer is the most common cancer in women in India with 1 in 28 women likely to be affected from age of 40-70 years. So most women have a lifetime risk to develop breast cancer.Myth: It only runs in family:Only 5-10% of breast cancer cases are associated with a family history of cancer on either maternal or paternal side, while majority develop on its own. Inheritance of certain genes( eg : BRCA 1/ BRCA 2) confer an increased risk to develop breast cancer apart from other cancers like ovarian or prostate, however not always. Genetic counselling is warranted in such cases.Myth: It is caused by sugar/ mobile etc:We mostly blame something in our diet or environment that predisposes one to breast cancer. There is a general belief that cancer cells feed on sugar which is not accounted by any research. High sugar intake is indirectly related to weight gain and diabetes which in turn can increase risk to develop cancer in general. Till more data is available we must minimize sugar intake.Radiation emitted by mobile phones is on lower side to be considered significant and not yet proved.Milk, talc, oral contraceptives, hormone replacement therapy, plastic reuse, soy products areother suspected culprit being studied.A few lifestyle changes which surely help in prevention of breast cancer are a healthy diet, regular excercise and weight management along with lower consumption of alcohol and no smoking. Breast feeding is highly protective for breast cancer.Myth: It cannot be detected till it is too lateDetection of breast cancer in it's early stages is very easy with screening mammography and self examination. A regular screening mammography has worldwide prevented deaths due to breast cancer. It leads to early detection and cure as it can then be removed by surgery at the budding stage. It is done annually from age of 40- till 70 years. Women between 25-40 years, only if high risk require annual mammogram. For denser breast MRI breasts is a better modality. Self examination of breasts is the simplest method to detect breast cancer at early stages. One must look and feel for any changes in breast size or shape, overlying skin, nipple, areola or any discharge. Young women must do it on 10-11th day of each menstrual cycle and post menopausal women can do it on any one fixed day of every month. Any suspicious finding can be verified with a physician’s clinical examination.Myth: Mammography is painful/ harmfulMammography is a special x-ray with low dose radiation with no damage to internal organs. The pain is only a slight discomfort for a few seconds as breast tissue is compressed for rays to reach deeper.Myth: Once diagnosed it is a death sentenceIn today's date we have far more survivors than a few decades ago owing to better screening as well as highly advanced multimodality treatment. A typical case of breast cancer needs surgery with or without chemotherapy or hormone therapy and/or radiotherapy. Breast conservation surgery and reconstruction maintains cosmesis. Chemotherapy is well tailored for each patient as per breast tissue biomarkers. Radiotherapy also is being minimized with modern machines and techniques Plethora of research is going on to develop newer treatments especially for advanced cancer. The author of the article is Dr. Anjana Sainani, Consultant Medical Oncology, Jaslok Hospital & Research Centre

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