Breast cancer detection Why Timing Matters

Breast cancer remains a leading cause of cancer among women, but early detection can dramatically improve outcomes. The earlier it is detected, the better the chances of effective treatment. In fact, for many women, recognising the signs and getting timely screenings has made all the difference.

Meera, a 45-year-old teacher, came to us after she noticed a small, painless lump while performing regular self-breast examination. Despite being healthy and having no family history of breast cancer, she consulted a doctor. A mammogram was scheduled, and although she had her reservations about it, the results showed an early-stage tumour. Because Meera acted swiftly, her cancer was caught at stage 1, allowing for treatment with curative intent. Today, Meera is cancer-free, a testament to the power of early detection.

Cases like that of Meera emphasise the importance of regular breast health checks. Experts recommend that women should begin performing self-breast examination in their 20s, familiarising themselves with what is normal for their breasts. Regular self-examination can help in noticing if any change occurs. While self-examination is a great first step, clinical breast exams and mammograms play a critical role in detecting tumours that are too small to be felt.

Clinical breast exams are typically recommended starting at age 30. Mammograms should begin around the age of 40 for women at average risk. Females at average risk have a lower breast density, lack of reproductive or lifestyle risk factors, such as late menstruation, early menopause, minimal alcohol consumption and minimal radiation exposure to the chest (particularly in younger years). However, those at a higher risk, such as having a family/genetic history of breast cancer — may need to start screening earlier. That’s because genetics is an important risk factor in breast cancer.

Role of genetics: Family history and genetic mutations can significantly increase a woman’s risk of developing breast cancer. This was the case with Rachna, a 37-year-old marketing professional. Rachna had always known that her maternal aunt and grandmother had battled breast cancer, but she did not think it would happen to her at such a young age. When her aunt suggested genetic testing, Rachna agreed. Her tests showed that she carried the BRCA1 mutation — a genetic marker that dramatically raises the risk of breast and ovarian cancer.

Armed with this information, Rachna consulted us. While she did not have any symptoms then and her investigations were also normal, considering her high risk of developing cancer due to genetic factors, a follow-up plan was created that included frequent screenings and lifestyle changes. True to this vigilance, a mammogram and MRI at age 41 detected a small tumour in one of Rachna’s breasts. Like Meera, Rachna’s cancer was caught early, allowing for a combination of multi-modality treatment. Today, she is on the road to recovery. Her story illustrates how understanding genetic risk factors can empower women to take preventive steps, possibly even before any symptoms appear.

For those with a family history of breast or ovarian cancer, genetic counselling can help determine whether testing is appropriate, and can guide decisions about screenings or preventive measures such as risk-reducing surgeries.

The experiences of women like Meera and Rachna highlight the importance of individualised screening plans. Whether it is family history that prompts earlier medical screening or the simple habit of self-examination to check for any irregularity, early detection can be lifesaving. For women diagnosed at earlier stages, treatment is often less aggressive, and survival rates are higher.

Breast Cancer Stages and Treatment Options

Breast cancer is classified into stages, from 0 to 4, based on how far it has spread. Here’s a simple breakdown:

• Stage 0: The cancer is small and hasn’t spread outside the breast ducts. It’s often treated with surgery or radiation.
• Stage 1 & 2: The tumour is still small, but it may have reached nearby lymph nodes. Treatment usually involves

  surgery, radiation, and sometimes chemotherapy or hormone therapy.

• Stage 3: The cancer has spread to more lymph nodes, but not to distant organs. Treatment is more aggressive, often combining surgery, radiation, chemotherapy, and other therapies.
• Stage 4: The cancer has spread to other body parts like the lungs or liver. While it’s not curable, treatments can help

  control it and improve the quality of life.

— The writer is vice-chairperson, oncology, Max Super Speciality Hospital, Patparganj, New Delhi