Breast cancer awareness month: Uniting for hope, empowerment and change

Breast Cancer Awareness Month, observed annually in October, is an initiative to spread awareness and celebrate strength and progress in the ongoing fight against this life-altering disease. It is a time when the world comes together, shedding light on the critical importance of early detection, education, and progress made in breast cancer research.
Understanding the magnitude
To understand the need for breast cancer awareness, we must first confront the daunting statistics that reveal its widespread impact. According to Globocan (an online database providing global cancer statistics), in 2020, it was the most-diagnosed cancer worldwide, with over 2.26 million new cases reported. Tragically, it also accounted for 6.85 lakh deaths in the same year. These numbers highlight the pressing need for proactive measures to reduce incidence and mortality rates.

The disparity in breast cancer incidence between developed and developing nations is striking. In developed countries, higher rates can be attributed to factors such as delayed childbirth, fewer pregnancies, increased use of hormone replacement therapy, and lifestyle choices such as high-fat diets and reduced physical activity. This underscores the need for targeted awareness campaigns that address specific cultural and socioeconomic factors in different regions of the world.
A disease without discrimination
Although breast cancer predominantly affects women, it is important to note that men are also susceptible. In 2020, approximately 2.2 million cases were diagnosed in women and 41,000 in men. The gender difference in the incidence of breast cancer is complex and often linked to hormonal variations. Women produce significantly higher levels of estrogen, a hormone that plays a key role in the development of many breast cancers.

For men, the stigma surrounding breast cancer leads to delayed diagnosis, which can result in worse outcomes. Thus, Breast Cancer Awareness Month serves as a crucial reminder that breast cancer is not exclusive to women and that awareness and education are equally vital for men.

Uncovering the risk factors
The exact causes of breast cancer remain elusive, but scientists have identified numerous risk factors that contribute to its development. One of the most significant factors is age. As women grow older, their risk of developing breast cancer increases, making regular screenings an essential tool for early detection. Women with a family history of breast cancer are also at a higher risk, particularly if close relatives have been diagnosed with the disease. This genetic predisposition may be due to mutations in genes such as BRCA1 and BRCA2, which are known to elevate the risk of breast cancer significantly.

Lifestyle choices also play a vital role in determining an individual's risk. Obesity, lack of physical activity, and excessive alcohol consumption have all been linked to an increased risk of breast cancer. Fortunately, these risk factors are modifiable, meaning healthier habits can help mitigate risk. Maintaining a balanced diet, engaging in regular exercise, and limiting alcohol intake are important preventive measures that can contribute to reducing the likelihood of developing breast cancer.

Racial and ethnic disparities also exist in breast cancer incidence and mortality rates. Black women, for instance, are statistically more susceptible to aggressive forms of breast cancer compared to their white counterparts and often face higher mortality rates. This highlights the urgent need for culturally tailored awareness programmes and equitable access to healthcare for early detection and effective treatment.

The power of listening to your body
One of the keys to combating breast cancer is early detection, and this requires knowing the warning signs and understanding the importance of acting on them. Breast cancer often starts subtly, with symptoms that may not be immediately noticeable. However, the most common sign is a lump in the breast. Women should regularly perform breast self-examinations to become familiar with their bodies and identify any changes as early as possible.

Changes in breast appearance, such as alterations in size, shape, or skin texture, may also indicate breast cancer. Additionally, any unusual nipple changes, such as retraction or bloody discharge, should prompt immediate consultation with a healthcare provider. Early intervention can make a significant difference in the prognosis of breast cancer, and awareness of these symptoms empowers individuals to seek medical attention without delay.

Empowering women with knowledge
Breast cancer's greatest adversary is early detection. The earlier it is discovered, the higher the chances of successful treatment. Several methods are available to facilitate early diagnosis:
Breast Self-Examination (BSE): Women are encouraged to perform BSE monthly, ideally seven to 10 days after menstruation. This practice allows women to become familiar with their own breasts and quickly notice any abnormalities.
Clinical Breast Examination (CBE): Conducted by healthcare professionals, CBE is an important step in the early detection of breast cancer, providing a thorough physical assessment of the breasts.

Mammography: Mammography is widely regarded as the gold standard for detecting breast cancer at an early, more treatable stage. Women between 40 and 45 are advised to begin regular mammographic screening, with those at higher risk considering earlier initiation.
Ultrasound and MRI: To further evaluate abnormalities found during mammography or in individuals with dense breast tissue, ultrasound and MRI may provide additional, detailed breast images.
When an abnormality is detected, healthcare professionals may employ a "triple assessment" approach, which includes imaging (mammography and ultrasound), a clinical exam, and a biopsy. This comprehensive evaluation ensures that any concerns are thoroughly investigated, allowing for accurate diagnosis and appropriate treatment planning.

Navigating treatment
The treatment of breast cancer is not a one-size-fits-all approach; rather, it is tailored to the specific characteristics of the cancer, the stage of the disease, and the individual preferences of the patient. Treatment options include:
Surgery: Surgery remains the most common approach, involving either the removal of the entire breast (mastectomy) or just the tumour (lumpectomy). Advances in reconstructive surgery have also provided many women with the option to regain breast appearance after a mastectomy.
Radiation Therapy: High-energy beams are used to target and destroy cancer cells. Radiation therapy may be used before surgery to shrink tumours or after surgery to eliminate any remaining cancer cells.

Chemotherapy: Chemotherapy involves using medications to destroy cancer cells. It can be administered before surgery to shrink tumours or prevent a recurrence.
Hormone Therapy: Certain types of breast cancer are fueled by hormones like estrogen and progesterone. Hormone therapy blocks these hormones, slowing the growth of hormone-sensitive tumours.
Targeted therapy: Unlike chemotherapy, which affects all rapidly dividing cells, targeted therapy attacks cancer cells by interacting with molecules involved in tumour growth.

Immunotherapy: A newer treatment option, immunotherapy helps the body's immune system recognize and attack cancer cells, offering hope for some patients with advanced or treatment-resistant breast cancer.
Beyond these medical interventions, emotional and psychological support is essential in a patient's journey. Counselling, support groups, and the care provided by family and friends are invaluable, helping patients navigate their diagnosis and treatment with hope and strength.

The role of advocacy and research
Breast Cancer Awareness Month is more than an observance — it is a movement that empowers individuals, fosters hope and drives progress in research and treatment. The strides made in breast cancer research are thanks to the tireless efforts of scientists, healthcare professionals, advocates, and survivors who have contributed to raising awareness, funding research, and advancing the development of new treatments.

October: A month of unity, empowerment and hope
As we embrace the vibrant pink of October, we do so as a symbol of awareness and as a beacon of hope, empowerment, and change. Breast Cancer Awareness Month is an opportunity for communities around the world to unite in support of those affected by breast cancer, celebrate the resilience of survivors, and honour the memories of those we have lost.

It is a time to educate ourselves and others, spread awareness about the importance of early detection, and contribute to the ongoing fight against this disease. Whether through fundraising, participating in awareness events, or simply having conversations about breast health, each of us can make a difference.
Let us renew our commitment to a future where breast cancer is no longer a threat, where early detection is accessible to all, and where treatment options continue to evolve. By embracing knowledge, supporting research, and standing together, we can transform the journey of breast cancer into one of hope and triumph.

"I am strong": A collective pledge
Breast Cancer Awareness Month is a testament to survivors' strength, researchers' determination, and unity's power. As we honour the courage of those battling breast cancer and remember those we have lost, let us also celebrate the progress made in prevention, early detection, and treatment.
(Dr Deepthi is a specialist in early cancer detection and prevention at Oncure Preventive and Healthcare Centre, Kannur)