Breast Cancer

Breast cancer is the commonest cancer in Indian women (particularly urban). It is increasingly diagnosed earlier, treated with a coordinated team, and often cured — especially when caught early. Silence and delayed presentation remain the biggest problems.

Symptoms

• A new lump in the breast or armpit.
• Change in breast size or shape.
• Skin change — dimpling, puckering, redness, orange-peel appearance.
• Nipple change — inward turning, crusting, ulcer.
• Nipple discharge, especially bloody or from one duct.
• Persistent breast pain in one area.
• Swollen node in the armpit or near the collarbone.
• Not every lump is cancer — but every new lump needs evaluation.

Risk factors

• Age — most breast cancers are in women over 40.
• Family history (especially first-degree relative, and early-onset cancer).
• BRCA1 / BRCA2 and other inherited genes.
• Early first period, late menopause.
• No children or first child after 30.
• Less breastfeeding.
• Overweight/obesity, inactivity.
• Alcohol.
• Long-term hormone therapy at menopause.
• Dense breasts.
• Radiation to chest at young age (e.g. for childhood Hodgkin's).

Screening and breast awareness

• Breast self-awareness — know how your breasts normally look and feel; report new changes. More useful than rigid monthly schedules.
• Clinical breast examination by a Health Expert — periodically.
• Mammography from age 40-45, every 1-2 years; earlier if strong family history or high-risk genes.
• MRI for women with BRCA mutations or very high lifetime risk.
• Dense breasts may need ultrasound added to mammography.

Diagnosis

• Triple assessment — clinical exam + imaging (mammogram/ultrasound) + biopsy. Biopsy confirms the diagnosis and subtype.
• Receptor tests — ER, PR, HER2 — guide treatment choice.
• Staging — determines spread; guides planning.

Treatment — team-based, individualised

• Surgery — lumpectomy (breast-conserving) + radiation for many, or mastectomy with or without reconstruction.
• Chemotherapy, hormone therapy, targeted therapy, immunotherapy — chosen based on tumour type and stage.
• Radiation.
• Genetic counselling for suitable women and family members.
• Follow-up — for years after treatment, with regular imaging and clinical review.
• Care at a cancer centre with a full multi-disciplinary team gives the best outcomes.

India-specific practical notes

• Many women in India present at later stages because of delay — cost, transport, fear, or because early signs were dismissed. Any new lump deserves a visit within days, not months.
• Ayushman Bharat PM-JAY and many state schemes cover breast cancer surgery and some systemic treatment for eligible patients. Ask the hospital social worker.
• Be wary of unregulated herbal/alternative "cures" — they are a common reason people present late with advanced disease.
• Support groups (online and in cities) help with practical and emotional navigation — peer support is genuinely useful.