Pooja (name changed to protect identity) - a 25 year old, felt a lump in her breast. She visited a gynaecologist who advised several tests, including a sono-mammogram. But the results were not clear and nobody suspected breast cancer for a 25 year old. Later, she decided to take the opinion of an oncologist, as the lump did not subside. She visited the Asian institute of Oncology, where Dr Dhairyasheel Savant suspected that it was a non-cancerous lump but wasn’t sure. She was advised to get the lump surgically removed. A week later, she underwent lumpectomy and the tissue was sent for frozen biopsy.

She tested positive for breast cancer
Post-surgery, she is fighting valorous battles. She has been recommended 8 chemotherapy sessions followed by radiation therapy. She feels terrible nausea, acidity and tiredness at least for a week following the chemo sessions. Weight loss is also noticed. She is advised a normal diet minus the junk foods, iron tablets to prevent anaemia and life-long vitamin supplementation. Her key message for the community is “Go for regular clinical breast examination, don’t ignore even the smallest cues that you notice in your breasts, however young you may be. Your doctor would be the best judge to decide the course of action. Have trust in your doctor and God.”

Pooja’s incidence is one among many others. The incidence of breast cancer among youngsters is on a steady rise with every passing day.

Cancer among younger women... What’s different?

• Mammary tissue of a younger woman is dense and hence it becomes difficult to detect any lump formation. By the time the detection is made, the cancer is often at an advanced stage.
• Breast cancer in younger women is often aggressive and less responsive to treatments.
• Most women believe that they are too young to get breast cancer and often ignore warning signs like lump or unusual discharge.

Risk factors of breast cancer 

• History – can be a personal history of non-cancerous breast disease (radiation treatment) or a family history (any first degree relative- mother, sister or daughter).
• Genetic defect – BRCA1 or BRCA2 specific gene mutation.
• Gail Index score – a score of at least 1.7% (The Gail Index uses risk factors such as age, family history of breast cancer, age of first menstrual period and first pregnancy, and number of breast biopsies to calculate a woman's risk of developing breast cancer within the next five years).
• Other factors – Obesity, heavy alcohol intake, high intake of red meat, race, first time users of oral contraceptive pills, sedentary lifestyle.

Screening for breast cancer
Dr. Dhairyasheel Savant, Oncologist and re-construction surgeon, advises the following screening procedures.

• Breast self-examination: It is recommended that all girls above 20 years of age perform breast self-examination on the day after their last menstrual period, on a monthly basis.
• Clinical breast examination: Annual clinical breast examination to rule out any risks for women above 20 years of age.
• Mammograms: Ideally recommended for women over 40 years of age or for women with a strong family history, above 20 years of age.

Treatment for breast cancer
The course of treatment is usually based on the extent of disease and general health of the woman and personal circumstances. Surgery is usually followed by any of the therapies like hormonal/ chemo/radiation. Two commonly performed surgeries are:

• Lumpectomy: Removal of the cancerous lump and some amount of the surrounding tissue. Following this, the patient is usually advised chemo/ radiation therapy
• Mastectomy: Complete removal of the breast surgically and sometimes followed by artificial breast re-construction if the patient wants and can afford it. The patient is usually advised hormone therapy or chemotherapy after the mastectomy to destroy remaining cells and to prevent recurrence.
• Anti-estrogen medication and quarterly health check-ups may also be advised after either of the surgeries.

Life after the cancer treatment
Dr. Pendharkar, Cancer Specialist, says “People are becoming more literate. Parellely, the medical awareness is also rising. People are becoming more health conscious and are being educated. Thus, they go for regular health checkups, evaluate their complaints and definitely seek medical opinion. With advances in Diagnostic and laboratory facilities, what may have once been regarded as tuberculosis or some other problem is properly being diagnosed as cancer. Thus the standard of patient education has definitely gone up but there are still miles to go.” 

Be aware, be conscious and spread the word, as that is the only way to fight breast cancer effectively!

*Image courtesy: © Thinkstock photos/ Getty Images