It is the most commonly occurring cancer in Women around the world. In Nepal and especially Kathmandu, it is one of the most common female cancer. If detected early, most of these cancers are completely curable. Since Women present in early stage in developed countries, their chances of cure is very high ! Similarly cancers detected by screening process like mammogram are usually of early stage.
During her lifetime, every woman has 1 in 8 chances of developing this disease. Luckily, if we find out it early, can be completely cured.
Each year, more than 15,000 Nepali women are diagnosed with Breast Cancer. In Nepal, because of unawareness, many patients present at an advanced stage – unlike in developed countries.
What are common symptoms ?
Different people have different symptoms.Common symptoms of are
- New lump in the breast
- Swelling in armpit (underarm)
- Swelling or Irritation or dimpling of breast skin.
- Change in shape of nipple
- Blood of fluid coming out from nipple.
- Change in shape of breast
- Pain in breast
Who should be concerned about breast cancer ?
Everyone should be concerned ! Not only woman, very rarely men also can develop this disease If your family member had this cancer, you should be more concerned as it can occur in family. Likewise if you have any symptoms written above, you should be concerned about cancer and meet a doctor.
How to know if you have Cancer or not?
A trained doctor with the help of various test will only be able to tell you if it’s Cancer or not! If you have any suspicious lumps in your breast or armpit, you should definitely go see a doctor. A doctor will do different tests to reach the diagnose .
Most important tests are following:
- Clinical examination
- Imaging test – Ultrasonogram (USG) or Mammogram. Sometimes doctors may ask for MRI of breast .
- Diagnostic test – Fine needle aspiration cytology (FNAC) or Truecut biopsy.
What is the treatment options?
Chemotherapy, Surgery, Radiotherapy and Hormonal therapy are the treatments for Breast Cancer. Furthermore, treatment modalities such as targeted therapy and immunotherapy are upcoming.
Surgery : There are two types of breast cancer surgery. Surgeon may remove whole of breast (Mastectomy) or only part with tumor (lumpectomy). Discuss with surgeon which surgery is better for you.
Chemotherapy : These are anti cancer drugs which are usually given in combination for treatment of breast cancer. Chemotherapy can be given before surgery. It is called Neo adjuvant chemotherapy. If it is given after surgery it is called adjuvant chemotherapy. Common chemotherapy used in this disease are Epirubicin, Cyclophosphamide,Paclitaxel,Docetaxel etc.
Radiotherapy : It use high energy beam produced from Linear accelerator to treat breast cancer. Radiotherapy is integral part of breast conservation therapy in which only cancerous tumor is removed and remaining breast receives radiotherapy. In patient whose breast is removed completely, sometimes radiotherapy is given to chest wall (post-mastectomy radiotherapy) if chances of returning of cancer is high.
Hormone Therapy : This is usually in form of tablets. For hormone receptor positive (ER+ or PR+) patients, these hormonal tablets are prescribed for 5 to 10 years.
Targeted Therapy : These drugs target specific abnormality in cancer cells. For example, several targeted therapy drugs focus on a protein that some breast cancer cells overproduce called human epidermal growth factor receptor 2 (HER2). The protein helps cancer cells grow and survive. By targeting cells that make too much HER2, the drugs can damage cancer cells while sparing healthy cells.
What are molecular markers ?
These are receptors present in cancer cells. Common markers tested in biopsy specimen are ER (estrogen receptor), PR (progesteron receptor) and Her2Neu. Depending on markers, breast cancer is dividend into different subtypes like Hormone positive breast cancer, Triple negative breast cancer etc. Outcome of patient and treatment course depend on these subtype.
Is Breast Cancer Treatment possible in Nepal?
Yes ! All the treatments are available in Nepal. Kathmandu Cancer Hospital has very good outcomes in Breast Cancer. Due to the establishment of newer hospitals, likewise the newer equipments, treatment is as par the international centers. We have dedicated breast oncosurgeon who has done fellowship in Breast cancer surgery. Likewise, our radiation oncologists routinely perform DIBH(deep inspiratory breath hold) technique to save heart during radiotherapy. Our medical oncologists are expert in chemotherapy as well as hormonal treatment, targeted therapy and immunotherapy.
I have more questions ! If you have more questions, please feel free to write to us ! We are very responsive on Whatsapp/Facebook/Twitter and also in emails. Our phone no is 01-5091629