Dear Doctor,

I am 23 years old and worried about breast cancer as it runs in my family. I haven’t had any check-ups yet. Should I start now? How often should I go and what signs should I look out for?

Sarah

Dear Sarah,

Breast cancer does tend to occur due to hereditary factors and can run in families among close blood relatives.  Other risk factors are not having children or having children late in life, not breastfeeding babies, hormonal contraceptives, use of estrogen after menopause, use of alcohol, and et cetera, lack of physical activity and obesity also predispose one to greater risk of breast cancer. As such, breast cancers are more common with advancing age, but can occur rarely in twenties as well. Breast cancer occurring in young age is more aggressive and spreads more rapidly to other body parts like another breast, backbone, lungs, to mention a few.

Once diagnosed and treated in early stages, breast cancer is treatable. After treatment, affected person can have good quality of life even up to old age. 

Self-examination of breasts by inspecting and feeling them is the easiest way to diagnose breast cancer early in the stages, when it is curable. For this, one should stand in front of the mirror with both hands placed on the hips and chest extended forwards slightly. After inspecting them closely, feel with hands, keeping hand and fingers flat on chest in all four quadrants of breasts.

A palpable painless lump in the breast, hard mass, change in the colour, shape or size of breast, puckering of skin around nipple, persistent itching around nipple,  unexplained, sudden bloody discharge from nipple, palpable swellings in one or both armpits or above shoulder bone, are some of the common signs of breast cancer. 

Mammography (special kind of X-ray) helps in detecting breast cancer in early stages. From 45 to 54 years of age it is recommended to be done once every year. But in women older than 55 years, it is recommended to be done once every two years. However, in case of doubt, it can be done at any age, including young age. Mammography will show the image of a mass, but a biopsy is needed to   confirm whether it is malignant or not.

Dr. Rachna   Pande is a  specialist in internal medicine.