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Many people think that if someone in their family or a relative doesn’t have breast cancer then they have less chances of getting it, but the fact is only 5-10 percent of breast cancer is thought to be hereditary.

How is the government helping
raise awareness about breast
cancer?

The government of Nepal is
providing subsidy in hospital expenses
to cancer patients but it hasn’t brought
down the cost of the cancer treatment
itself. If only cancer be detected in
early stage, the burden of the cost will
decline tremendously and this can be
done by all levels of prevention and
launching screening programs which
are today insufficient.

Who is at risk?

If you are a woman then you are at
risk. If you are getting older then you
are at risk of developing breast cancer.
Having a first degree relative (male
/female) with breast cancer or first
degree female relative with ovarian
cancer increases the risk of breast
cancer. Having a first degree
male relative with prostate
cancer may also increase the
risk.
Many people think that
if someone in their family
or a relative doesn’t have
breast cancer then they have
less chances of getting it, but
the fact is only 5-10 percent
of breast cancer is thought to
be hereditary. The most common
cause of hereditary breast cancer
is the inherited mutation in
BRCA 1 and BRCA 2 genes.
There are other risk
factors like early onset
of menarche and late
menopause, age of first child
birth after 30 years, lack of or
less breast feeding, hormonal exposure
like with oral contraceptives or
hormonal replacement therapy, obesity,
heavy and consistent alcohol intake,
previous chest radiation, dense breast
tissue, etc.
Few studies have shown that
women who work late night or have
night shifts for many years have a
small increased risk of breast cancer.
However, being exposed to these
risk factors doesn’t mean that a woman
will get breast cancer. Most females
diagnosed with breast cancer have no
pre existing risk factors.

What is confirmatory diagnosis?

Breast cancer can be confirmed by
Fine Needle Aspiration Cytology or
Core Biopsy. Small amount of cells or issue are removed and studied under
microscope to detect cancer cells.

When detected what are the
options for treatment?

Treatment depends upon the
stage at which the cancer is detected
and the character of cancer. So, the
treatment varies person to person. If
detected early then a surgery is done
to remove a part of a breast including
the cancer and removing the lymph
nodes from the underarm followed
with radiotherapy. This is known as
Breast Conserving Surgery i.e. breast
is preserved and only the tumour is
removed.

Other surgical options include
Mastectomy where the whole breast
is removed. There are Chemotherapy,
Hormonal Therapy and Targeted
Therapy options as well.

How is breast cancer detected
and where should a woman go to
get checked?

Breast cancer can be detected by screening tests like Mammography
where X-rays of breast is taken and
by clinical breast examination. The
patient can visit a General Surgeon
or Onco Surgeon for a clinical breast
examination, and go for Screening
Mammography if she is above 40 years
of age.

What is the survival rate?

In early stages of breast cancer, ten
year survival is more than 90 percent.
However, if the cancer is detected in a
late stage, 10 year survival is less than
10 percent. This is the reason that we
have to detect breast cancer in early
stage to increase the survival rate.
There are myths regarding breast
cancer. People believe that if there is
no pain then it’s not cancer. In fact,
most of the time, breast cancer is
painless. Thinking that breast cancer
occurs in older women is false. Young
women do get breast cancer and it is
aggressive in nature. Believing that
only females have breast cancer is a
myth, males do get breast cancer but is
only about one percent.

How often should women
get checked up for breast
cancer?

The American Cancer Society recommends that
women aged 40 and older should have a mammogram once a
year and clinical breast exam once every three years for ages 20-39 and
every year from age 40 onwards. However, some studies state that yearly
Mammography above 40 years is unnecessary. In our part of the world,
where health structure and resources are limited, WHO encourages clinical breast
examination as a screening modality. A breast self-examination (BSE) is an option and highly encouraged for
women starting in their 20s and is an important self assessment tool in a
country like ours where women can do their breast examination at home once
a month and know how their breasts normally feel and report any subtle
changes to their doctor and seek expert opinion. For women who are still
menstruating, a BSE should be scheduled during the time of the
month when the breasts are the leas  tender. This would be 5-10 days after
the start of their period. For menopause women, they can decide a fixed date of the month and
do it on the next date monthly.