What Is Breast Cancer?

Breast cancer develops from a cancerous (malignant) cell which develops in the lining of a duct or lobule in one of the breasts. Breast cancer can also develop in men, although this is much less common than breast cancer in women.

“It’s a disease where cells in the breast grow abnormally and out of control”, says Dr Talat Masroor Senior Consultant and Head of Department, Obstretics and Gynecology at RAK Hospital, Ras Al Khaimah.

Breast cancer is one of the most common cancers among women in the United Arab Emirates and worldwide and according to Dr Miriam Klimek, Consultant Obstetrician and Gynaecologist at Mediclinic Al Sufouh, “One out of 8 women will develop breast cancer during her lifetime. The average age at the time of diagnosis is around 64 years old, but about 30 percent are younger than 55 years old at that time.” 

Dr Azhar Schett, Consultant Obstetrics and Gynecologist, Prime Hospital says, “According to the World Cancer Research Fund International, breast cancer is the second most common cancer in women and men worldwide. In 2012, it represented about 12 percent of all new cancer cases and 25 percent of all cancers in women.” 

How To Reduce The Risk Of Getting Breast Cancer

Even though a lot depends on genes and other multiple factors, one should avoid smoking and alcohol to reduce the risk of getting breast cancer. Woman should exercise regularly once they hit menopause. It is also suggested that breastfeeding decreases the risk for breast cancer. 

Dr Marlain Mubarak, Consultant OBGYN and Head of BSGE Endometriosis Centre, Canadian Specialist Hospital says, “Women who have children and are well and breastfeed their babies have higher protection against breast cancer. About 1 in 20 cases of breast cancer are caused by a faulty gene which can be inherited. The faulty gene causes development of breast cancer under the age of 50. In such cases we can offer genetic testing. The genes are called BRCA1 and BRCA2 which are the most common faulty genes. 

Dr Ilardia Saredi, Family Medicine Specialist at Allied Medical Centre says, “A healthy lifestyle with exercise, no alcohol or smoking can help reduce the risk of breast cancer. Breastfeeding is also a protective factor against breast cancer". 

While there is a little one can do to reduce the risk of breast cancer, according to Dr Talat Masroor of RAK Hospital, early screening and detection is the key to ensure that the treatment begins early, significantly raising the chances of complete cure.

How Can We Detect Breast Cancer Early?

Breast examination and breast screening plays an important role in early detection and treatment. It should be done at least two to three times a year, and ideally every month between the 6th and the 10th day after your period begins

Dr Miriam Klimek, of Mediclinic Al Sufouh says, “For every woman, self-examination on a regular basis is recommended. Women without increased risk, age 20 to 39 should have a clinical breast examination every 
2 to 3 years. Women over 40 years old should have annual clinical breast examination, in combination with mammogram every two years.”

Symptoms for breast cancer can vary from person to person. However, there are some common early warning signs of breast cancer, including skin changes such as swelling, redness or other visible differences in one or both breast, change in the shape of one or both breasts or general pain in any part of breast. 

Dr Azhar Schett of Prime Hospital says, “Some common, early warning signs of breast cancer include nipple discharge, other than breast milk, lumps or nodes felt on or inside of the breast, irritated or itchy breasts, changes in touch (may feel hard, tender or warm), peeling or flaking of the nipple skin, a breast lump or thickening, redness or pitting of the breast skin (like the skin of an orange.” 

Dr Kinda Douaidari, Breast Interventional Radiologist and Head of Breast Care Department at HealthBay Polyclinic says, “Mammogram can detect breast cancer up to 18 months before it is large enough to be felt either by the woman herself or by a doctor. In breast imaging we adopt a multimodality approach for Personalised Breast Screening. Mammogram is still the Gold Standard for Breast Screening, but there are other new modalities which helps in early detection and diagnosis of breast cancer, including :
- 3D mammogram Tomosynthesis which provides images of the breast in "slices" from many different angles, it’s far more sensitive in finding small abnormalities.
- Automated breast Ultrasound 3D is a computerised acquisition of the whole breast which enables 3D dimensional images.
- Breast Biopsy to check a problem seen on a mammogram, such as a distortion in breast tissue, or to find out if a breast lump or mass is cancer (malignant). A biopsy is a small piece of tissue that is removed by a special needle and checked in a pathology lab.
- Tomosynthesis is a better mammogram, using this new 3D mammogram increased breast cancer detecting rate by 34% in comparison to digital mammogram.” 

How To Do Self-Examination At Home?

If you still on your menstruating, you should do your breast self-examination within the first two weeks of your menstrual cycle. First, stand up in front of a mirror with your hands on your hips. Watch for difference in the size of the breasts, alteration of the shape, redness or other skin alterations, any bulging or retraction and retracted nipples. Wet your hands or take some body lotion and go in a lying position. Now palpate both sides clockwise to detect any lumps and do not forget to examine the armpits as well.

National Breast Cancer Foundation recommends the following technique for breast self-examination:

1. In the shower
Using the pads of your fingers, move around your entire breast in a circular pattern moving from the outside to the centre, checking the entire breast and armpit area. Check both breasts each month feeling for any lump, thickening or hardened knot. Notice any changes and get lumps evaluated by your healthcare provider.

2. In front of a mirror
Visually inspect your breasts with your arms at your sides. Next, raise your arms high overhead. Look for any changes in the contour, any swelling, or dimpling of the skin, or changes in the nipples. Next, rest your palms on your hips and press firmly to flex your chest muscles. Left and right breasts will not exactly match, few women's breasts do, so look for any dimpling, puckering, or changes, particularly on one side.

3. Lying down
When lying down, the breast tissue spreads out evenly along the chest wall. Place a pillow under your right shoulder and your right arm behind your head. Using your left hand, move the pads of your fingers around your right breast gently in small circular motions covering the entire breast area and armpit. Use light, medium, and firm pressure. Squeeze the nipple; check for discharge and lumps. Repeat these steps for your left breast.

What Are The Different Cancer Treatments Available?

The treatments used depend on the cancer itself, its size and stage (whether it has spread), the grade of the cancer cells, and whether it is hormone responsive as well the age, general health and personal preferences for treatment. Dr Miriam Klimek of Mediclinic Al Sufouh says, “ The treatment depends on the kind of breast cancer, the size of the tumour, the affected lymph nodes and if the cancer has already spread to other organs. In most of the cases the first step is an operation, followed by further treatment such as radiation and medical therapy. Common therapy include anti-hormonal treatments, antibody treatment is less frequent. For advanced stages chemotherapy might apply.”

Which Women Are More Likely To Have A Breast Cancer?

The risk for breast cancer increases with age and density of breast tissue. Women over the age of 50 have 80 percent likelier chance.

Dr Miriam Klimek of Mediclinic Al Sufouh says, ”Smoking, alcohol, hormone replacement for a duration over 7 years as well as obesity and lacking physical exercise are also known risk factors. Apart from that, menstruation at an early age, late menopause, childlessness or first pregnancy at an elder age as well as precancerous lesions or radiation in childhood increase the risk.”

Dr Talat Masroor of RAK Hospital says, “Women who got their periods very early in life and menopause later in life are more susceptible to breast cancer. Similarly women who did not have children or had them after the age of 30 also run a high risk since their oestrogen level is high - some breast cancers are stimulated by oestrogen. Other risk factors include alcohol consumption, smoking and obesity.” 

Myths Associated With Breast Cancer

Anything that lacks medical evidence is considered a myth. It’s always important to consult your doctor and follow their advice. 

Dr Marlain Mubarak of Canadian Specialist Hospital says, “There are several myths associated with risk of breast cancer such as drinking milk (or dairy) causes breast cancer, finding a lump in the breast means breast cancer, men do not get breast cancer; it affects women only and antiperspirants and deodorants cause breast cancer. The most dangerous myth is that mammogram or breast biopsy can cause breast cancer to spread. “ 

Dr Talat Masroor of RAK Hospital says, “There are several myths associated with breast cancer. For example, people often think that use of perfumes and antiperspirants, and bruises on the breast can cause the cancer which is not the case. Similarly some people believe that herbs can cure the cancer which, again, is a false claim. Moreover, contrary to general perception, young women are also susceptible to breast cancer, especially if there’s a 
family history.” 

This Breast Cancer Awareness Month, educate yourself on breast cancer, do self-assessment and book an examination to give yourself peace of mind. 

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