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In India, Breast cancer has been ranked the no: 1 cancer affecting 1 in 28 Indian women. The prevalence of breast cancer has risen; the reports state that every 4 minutes, a woman in India is getting diagnosed with breast cancer, and every 13 minutes, a woman dies due to breast cancer.

Breast cancer is regarded as advanced cancer since it produces a high mortality rate. Still, the truth is that most Indian women express no serious attitude towards the early warning signs and are unaware of the screening tests.

How Is Breast Cancer Developed?

Breast cancer develops due to abnormal cell division of cells present in breasts. The cells grow rapidly out of control compared to the healthy cells leading to the formation of a lump or a tumor. The gene mutation is the chief factor that induces this accelerated cell division of breast cells.

Breast cancer can affect one or both breasts. The mutation can affect any cells in the breasts, and breast cancer can be classified based on its origin and location.

While breast cancer can evolve from various parts of the breast, it can either develop from the milk-producing glands or in the ducts connecting with the nipple. Cancer can sometimes begin from the fatty tissues in the breasts.

Types Of Breast Cancer

There are various types of breast cancer that are classified based on the origin of the tumor, growth, and nature of the tumor. Knowing the type of breast cancer can help your oncologist determine the suitable treatment option since cancer therapy is highly personalized.

In general, breast cancer is categorized broadly into two types
1. Invasive breast cancer
2. Non-invasive breast cancer

Invasive breast cancer: It is a type of cancer where the cancerous cells have invaded the surrounding breast tissues. Based on the origin, invasive breast cancer can occur in either of two types.

  • Invasive ductal carcinoma: It is the most commonly occurring breast cancer that accounts for about 80% of breast cancer cases. The invasive ductal carcinoma evolved in the milk ducts that connect the lactating lobules to the nipple.
  • Invasive lobular carcinoma: This type of breast cancer has its roots in the milk-producing glands in the breasts.
  • Triple-negative breast cancer: It is defined as an aggressive type of breast cancer where the hormonal receptors such as estrogen and progesterone test negative. In addition, this type of breast cancer also lacks
  • HER2 proteins in the cancerous cells. Because of this nature, this has become the most difficult to treat among the types of breast cancer
  • Inflammatory breast cancer: It is a kind of breast cancer where the tumor growth blocks the lymph vessels in the skin that covers the breasts. As the name states, the breasts become inflamed/ swollen, tender, and appear red in color. Inflammatory breast cancer does not cause tumor formation. Instead, it affects the lymph vessels and spreads instantly. This is otherwise called aggressive breast cancer.
  • Metastatic breast cancer: This is regarded as the final stage of breast cancer, where the cancerous cells have spread to the neighboring parts of the body and are affecting other organs.

Based on the genes and hormones involved, breast cancer is further classified into:

  • HR negative and HER2 positive breast cancer
  • HR-positive and HER2-negative breast cancer

Researchers and oncologists state that identifying the types of gene mutation involved in the development of breast cancer helps craft a cancer therapy specific to that type of breast cancer. By doing this, the survival rate of breast cancer can also be improved.

HER2-positive breast cancer: This type of breast cancer is highly progressive that expresses rapid development of cancerous cells. There is a major part played by the receptor called Human epidermal growth factor receptor 2 (HER2). HER2 are proteins involved in breast cancer development. If the cancer tissues are tested with HER+ve, it means that cancer has developed as a result of overexpression of HER2 proteins.
If breast cancer is labeled as HR+ve, it indicates estrogen and progesterone (the female hormones) are involved in the growth of breast cancer cells. In hormone receptor-positive breast cancer, the estrogen sends signals and fuels the multiplication of breast cancer cells.

Non-invasive breast cancer:

  • Ductal carcinoma in situ: In this type, cancer has originated in the milk ducts but has not spread beyond that. It is labeled as a preliminary stage of invasive breast cancer.
  • Lobular carcinoma in situ: It is a type of breast cancer where cancer has not extended beyond the milk-secreting glands, and it is mostly a benign form of breast cancer.

Stages Of Breast Cancer

The TNM staging tool is the common tool used in determining the stages of breast cancer.

  • Stage 0: It is regarded as non-invasive breast cancer where the cancer cells are present only in the milk-producing ducts and have not spread to the surrounding tissues. This stage is also known as in situ cancer.
  • Stage I A: The tumor in this stage is invasive and small but has not reached the lymph nodes.
  • Stage I B: In this stage the cancer has reached and spread to the lymph nodes and its size is more than 0.2mm and less than 2mm.
  • Stage II A: This stage typically describes invasive cancer where,
    • There is no tumor in the breast. However, the cancer has spread to one to three axillary lymph nodes, but has not reached the other distant body parts.
    • The tumor size is 20mm or lesser than that and might have spread to one to three axillary lymph nodes.
    • The tumor is between 20m-50mm and has not spread into the axillary lymph nodes.
  • Stage II B: In this stage,
    • The tumor is between 20m-50mm and has also spread to one to three axillary lymph nodes.
    • The tumors have developed to more than 50mm in size, but has not reached to the axillary nodes.
  • Stage III A: The tumors have developed to more than 50mm in size and spread to 4-9 axillary lymph nodes. However, it has not spread to nay body parts.
  • Stage III B: Breast ulceration will be noticed as the tumors have spread to the chest wall. The cancer here might have spread to about 9 axillary lymph nodes.
  • Stage IIIC: The cancer has spread to more than 10 axillary lymph nodes or lymph nodes near the collarbone or internal mammary lymph nodes but not into other body parts.
  • Stage IV (Metastatic breast cancer): Cancer has spread to distanced lymph nodes and affected the nearby organs.

Causes & Risk Factors Of Breast Cancer

  • Chronic Intake of birth control pills and Hormonal Replacement Therapy: Long-term consumption of contraceptive pills during the menstruating phase and Hormonal replacement therapy in the post-menopausal phase fuels the risk of breast cancer in women.
  • High Body Mass Index: Generally, women tend to gain weight post-menopause. The reason behind this is that due to the decline in estrogen levels in the body, there is a decline in the metabolism rate. Due to this factor, there is a spike in insulin levels, which is also a causative factor for breast cancer.
  • Sedentary Lifestyle: Women having an inert lifestyle are either overweight or obese, which causes a lot of reproductive hormone disruption and raises the inflammation in the body, which acts as the aggravating factor in the development of breast cancer.
  • Reproductive History: Women who have had their first full-term pregnancy later in their 30s or women who have not got pregnant during their menstruation phase are slightly at a high risk of developing breast cancer
  • Breastfeeding: Studies have put forward the fact that breastfeeding your baby for a minimum of 6 months to 1 year can decline the chances of developing a breast cancer
  • History of radiation therapy: Women who have had lung diseases and got exposed to radiation therapy in the chest region are at greater risk of getting breast cancer.
  • Menstrual History: Women with premature menarche (<12 years) and late menopause (> 55 years) can have an increased risk of breast cancer in their lifetime.
  • Genetics and family history: It has been proclaimed that BRCA 1 and 2 gene mutations account for breast cancers as they run through the families. If you have a family history of breast cancer or ovarian cancer, you are at a high risk of developing breast cancer.
  • Age: The risk of breast cancer tends to increase in older women; most breast cancer cases are found in women older than 55.
  • Lifestyle factors: Women who consume alcohol have a strong association with hormone-positive breast cancer because alcohol can elevate estrogen levels.

Emerging Factors Causing Breast Cancer

Research suggests that there is an established link between breast cancer that is developed among younger women and exposure to certain substances. The following are those cancer-causing agents:

You are at greater risk of developing breast cancer if you have got exposed to below mentioned

  • Exposure to chemicals present in the cosmetics
  • Consuming foods that are treated with pesticides, hormones, and mercury
  • Women who consume a lot of grilled meats and food prepared at high temperatures or smoked foods can elevate their breast cancer risk.

Symptoms Of Breast Cancer

  • Formation of lumps in the armpits
  • Dimpling of breasts
  • Abnormal discharge from the nipple
  • Inflammation or redness present around the nipple
  • Pain in breast regions
  • Peeling of skin around the nipple
  • Changes in the appearance of the nipple
  • Change in size or shape of the breasts

Breast Cancer Screening

Breast cancer screening is conducted in a healthy individual to find if there is any risk of underlying cancer.

The NCCN guidelines have recommended screening tests for women to identify the presence of precancerous risk of developing breast cancer based on their personal medical history and family history.

Screening Guidelines for Breast Cancer In India:

Recommendation for early detection of Breast Cancer in women with no family history of breast cancer.

Age 25– 40 years: Clinical Breast Examination ("CBE") By Physician Every three years and mandatory self-breast examination every month right a few days after your menses to find any abnormality in the appearance of breasts.

Age >40 years: Annual CBE & Option to begin annual mammogram screening. For post-menopausal women, performing a self-breast examination at the beginning of every month is advised to become a holistic practice and avoid skipping the routine.

It is best to begin the annual mammogram screening right after 40years because, in post-menopausal women, the fatty tissues tend to dominate and make the breasts denser, which is a factor for developing breast cancer. However, you should consult a doctor and schedule your mammogram.

Women at any age who have a Family History of breast cancer or history of exposure to radiation.

Self-breast examination: Breast cancer is treatable if detected at an early stage. Women must regularly perform self-breast examinations monthly to become familiar with their breasts and watch for abnormalities such as lumps or discharge. Report to the doctor if you observe changes in the appearance of your breasts or if you experience pain.

Clinical Breast Examination: Annual clinical breast examination is performed by a trained medical professional An MRI test will be conducted to have a picture of the breast and determine the tumor's presence.

Age > 25 Years: CBE & Annual Mammogram Screening for women who have received radiation therapy to the chest region previously to treat other diseases.

Age >35 Years: CBE, Breast MRI & Annual Mammogram Screening for women with a family history of breast cancer or ovarian cancer.

Breast Cancer Diagnosis

A breast cancer diagnosis is generally made after having any symptoms or if the screening tests suggest the possibility of cancer. Not all the tests mentioned below are needed for all, and the types of diagnostic tests required to depend on the individual's type of cancer, signs and symptoms, age, and result of the previous exams.

Your physician may start by performing a breast examination that involves checking breasts and armpits and looking for any abnormalities. If your doctor finds anything suspicious, they may order diagnostic imaging tests to examine further. The health care professional will ask about your medical history, family history, and symptoms.

Imaging Tests: Initially, the imaging test mammogram (or) ultrasound is performed to look for abnormalities in the breast, and sometimes both may be used.

A diagnostic mammogram is similar to a screening mammogram; the only difference is that it takes more x-ray pictures of the breast. It can look for abnormal growth. Ultrasound utilizes sound waves to create pictures of the breast. For women under age 35, the doctor may only recommend an ultrasound as a mammogram is not effective as ultrasound in women with dense breasts. The ultrasound can help distinguish the solid cancerous mass from fluid-filled cysts.

Breast Magnetic Resonance Imaging (MRI): MRI creates a detailed picture of the breast, which may be performed along with a mammogram to screen for breast cancer in high-risk patients. After cancer has been diagnosed, MRI will determine how far the cancer has spread.

The biopsy is often the sure way to find cancer:

If the doctor suspects cancer from the imaging test results, they will perform biopsies. In a biopsy, the sample of cells from the breast will usually be collected using a needle and analysed in the laboratory to confirm the diagnosis. There are various biopsies depending on the needle size used to collect a sample and/ or the procedure used. The most common type of breast cancer detection is an image-guided core needle biopsy.

If the cancer is diagnosed, additional tests such as bone scan, PET scan, blood tests, hormone receptor test, or HER2/Neu test will be done to detect the stage and grade of cancer. From this, your doctor will recommend the best effective treatment and prognosis.

Breast Cancer Treatment

Depending on the individual's overall health, type and size of breast cancer, whether the cancer is sensitive to hormones or not, and the patient's preference, the doctor may recommend the treatment options. The major treatment types for breast cancer include surgery, radiation therapy, chemotherapy, hormonal therapy, targeted therapy, and immunotherapy, and you may receive one or a combination of these treatment types.

Surgery is often the major treatment.

Surgery is often the major treatment in patients with breast cancer, and the type of surgery each patient undergo differs based on the location and size of the tumor, whether the cancer has spread or not, and certain other factors. There are two major breast cancer surgery types:

Lumpectomy/ Breast-conserving surgery/ wide local excision: In a lumpectomy, physicians will remove the tumor & a small amount of healthy tissue surrounding it. This surgery is preferred for early-stage small tumors. When lumpectomy is performed for large tumors, other therapies, such as chemotherapy, will be given before surgery to shrink the tumor size so that the tumor will be completely removed by lumpectomy.

Mastectomy: In a mastectomy, all breast tissue will be removed. If the woman has a greater risk of developing cancer at the other breast, the other healthy breast may also be removed through surgery.

Physicians may remove nearby lymph nodes (sentinel lymph nodes), which are the first part to become cancerous when the breast cancer begins to spread. Health care professionals will perform this to check whether cancer has started to spread to other body parts. When the sentinel lymph node is found cancerous during this procedure, the doctor may remove several lymph nodes to check how far the cancer has spread.

Breast reconstruction is the surgical procedure done during or after the mastectomy to rebuild the look and shape of the new breast. There are several breast reconstruction techniques. Some procedures introduce implants, and some involve using healthy tissues from other body parts to recreate the breast.

Radiation therapy:

Radiation therapy involves the application of high-energy beams such as x-rays or protons to kill cancer cells. It is often done after chemotherapy or surgery to destroy any remaining cancer cells. But it may also be done before surgery to make the treatment effective. Typically, a machine will pass the energy rays towards the body parts during radiation therapy, or the radioactive material can be placed inside the body to stop cancer cell growth.

Radiation therapy is usually performed after one month from the completion of major treatment and is done three to five days per week for up to three to six weeks. Each session lasts for a few minutes. You will probably receive radiation to the entire breast tissue after a lumpectomy or to the chest wall if you have undergone a mastectomy.


Chemotherapy is the use of medications to stop cancer cell growth. It can be given before surgery to shrink the tumor size or after the surgery to kill any remaining cancerous cells. If there is a high risk of cancer recurrence (a chance that cancer will come again), chemotherapy can be given to reduce the recurrence risk.

In patients with metastatic breast cancer (cancer has spread to other body parts), chemotherapy can help lower the symptoms and improve the quality of life. Most chemotherapy medicines are given through infusion and involve up to 8 cycles, and each cycle (treatment session) will have a treatment and rest periods. Chemotherapy medications are often combinations; two or three drugs may be given at once.

Hormonal therapy/ Hormone blocking therapy:

Hormones such as estrogen or progesterone found naturally in the body stimulate the growth of certain breast cancers. Those cancers are termed hormone-receptor-positive cancers. Hormonal therapy involves using medicines or surgery to block the hormones from binding to the cancer cells or stop the body from producing those hormones.

Usually, it is given after surgery, chemotherapy, or other forms of treatment to reduce cancer recurrence. Hormonal therapy may also be given before surgery to decrease the tumor size. When other treatment options are unsuitable, hormonal therapy is the only treatment for cancer management.


Our disease-fighting immune system can identify and destroy any abnormal cells and prevent some cancerous growth. But cancer cells blind the immune system and prevent it from attacking them due to their genetic changes and proteins. Immunotherapy is the use of drugs that can help the immune system to attack cancer cells. Pembrolizumab is one such approved drug for treating triple-negative breast cancer. It will be given before and after the surgery alone or with chemotherapy medications.

Targeted therapy:

Targeted therapy can precisely identify and target the genes or proteins involved in the growth and multiplication of cancer cells and stop cancer growth. It helps to treat certain breast cancer types that were previously hard to treat. Targeted therapy may be given after surgery to decrease cancer recurrence. In advanced breast cancer cases, targeted therapy drugs can help slow cancer growth and improve the patient's quality of life.

Not all cancer types can be treated with targeted therapy. Your doctor will perform tests to determine if you are suitable for this treatment type. Some targeted therapy drugs used to treat breast cancer include palbociclib, abemaciclib, and ribociclib.

Clinical trials test new medicines with equal or better efficacy than standard drugs on people. Your doctor may suggest if you are suitable for and willing to participate in trials.

Complementary therapies such as aromatherapy, acupuncture, or massage can help reduce the pain and improve your emotional well-being along with your major cancer treatment.

Breast Cancer Prognosis

According to the National Cancer Institute, the prognosis is defined as,
"The likely outcome or course of a disease; the chance of recovery or recurrence."

Breast cancer prognosis depends upon various factors such as:

  • Age
  • Overall patient health
  • Hormone receptor (HR) or human epidermal growth factor receptor 2 (HER2) status of the cancer
  • Patient's response to the treatment
  • Recurrence of cancer after its treatment
  • Cancer stage
  • Stage of diagnosis of the cancer

What can be done to increase the survival rate?

Early screening for cancer is the best method to treat it as early as possible, thereby increasing the survival rate. Regular screening practices can help ensure early detection and treatment of cancer.

Tips To Prevent Breast Cancer

  • Swap plastics for glass or steel containers: Avoid cooking food in the microwave oven, as the plastic residues can pass into the food. Limiting the exposure to plastics consists of bisphenol, a cancer-causing substance, and studies state that this exposure causes hormonal disruption in females and leads to the development of breast cancer.
  • Avoid processed or frozen meat.
  • Ensure your daily platter contains fresh fruits, colorful vegetables, and whole fruit
  • Eliminate foods containing trans-fat and refined carbs, such as canned foods, fried chips, and white bread, as it contains a lot of nitrates and salt.
  • Limit your dairy intake since farms are treated with extra hormones, which can eventually lead to an increase in the levels of estrogen in your body
  • Be physically active and include trio workout sessions that include cardio, strength, and stretching to maintain a healthy BMI. Perform your exercises regularly for at least 150 minutes per week.
  • Breastfeed your baby because the longer you breastfeed, the greater the protection from developing breast cancer
  • Get adequate exposure to sunlight and include foods rich in vitamin D such as mushrooms, eggs, fish, almonds, etc.

Breast Cancer FAQs

Questions about breast cancer are extremely common and normal, and there must be no shame in asking questions related to breast cancer.

That said, here's a list of commonly asked breast cancer-related questions.

1. Do men get breast cancer?

Men and women are both prone to getting breast cancer. However, men are less prone to getting breast cancer when compared to women.

2. How to lower the risk of breast cancer?

There are no proven methods that could help prevent breast cancer. However, lowering the risk factors can reduce the chances of developing breast cancer. They are:

  • Being more active physically
  • Maintaining a healthy lifestyle
  • Stopping or reducing alcohol consumption or smoking
  • Breastfeeding
  • Limiting hormonal replacement therapy.

3. How to screen for breast cancer?

Breast cancer screening can be done in the following ways. They are:

  • Self-Breast Examination
  • Clinical examination by a doctor or a nurse
  • Mammography

4. What is a Self-Breast Examination?

A self-breast examination is used to examine the breast and check for changes that might indicate breast cancer.

5. How to perform a Self-Breast Examination?

A self-breast examination can be done monthly by using the following steps:

  • Visual inspection
  • Standing up and inspecting manually
  • Lying down and inspecting manually

6. What is mammography?

Mammography is an x-ray imaging method used to examine the breasts for any abnormality that can be cancerous. The x-ray image of the breast is known as a mammogram and is used as an early screening method for breast cancer.

7. How to diagnose breast cancer?

The following test can be done to diagnose breast cancer.

  • Breast ultrasound
  • Biopsy
  • Breast Magnetic Resonance Imaging

8. Can breast cancer be cured completely?

When screened and treated early, breast cancer can be cured.


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