Can you beat breast cancer?
I have seen many women, beating Breast Cancer.
And I wish to share a true story about a patient who did it. She gives us a message to follow.
She was 46 years, a mother of 2 children.
She was asymptomatic and had no obvious risk factors for breast cancer.
What are the major risk factors of breast cancer
- Being a female is considered a major risk factor. But males can get affected up to 1% of all breast cancers.
- Increasing age, as there is a higher risk of mutation to occur in genes of an aged cell in the breast. It is rare to get a breast cancer in less than 25 years of age. In 2017, almost 50% of the new breast cancers were found in the 50 – 69 year age group. There is a substantial increase of breast cancer among over 50 years in Sri Lanka with a highest incidence in the 60 – 65 year age group. (BMC)
- Family history of breast cancer. About 5 – 8% of breast cancers could inherit through generations. In Sri Lanka the incidence of familial breast cancers are found to be much lower than the west.
- Early menarche and late menopause.
- Prolonged use of exogenous female hormones, especially estrogen preparations can lead to breast cancer. This could be as hormonal replacement therapy (HRT) which is commonly prescribed following menopause.
- Nulliparity (not being pregnant) or having the first pregnancy after the age of 30 years. It is well known that pregnancy do have some protection against developing a breast cancer. But it is important to understand this will be beneficial only if a woman gets pregnant before 30 years of age.
- Alcohol consumption.
In spite of having no risk factors or symptoms, she was willing to screen the breasts for unwanted lesions.
In Sri Lanka, there are no community screening programs though breast cancer is the commonest cancer. But there are many educational programs conducted by the Cancer Control of the Health Ministry to educate the public on the importance of self breast examination and voluntary mammographic screening.
In 2017, she did an ultrasound scan of the breasts and axilla with mammography. A non cancerous (benign) cystic lesion was noted in her left breast, which was confirmed with fine needle biopsy. The main reason to do these tests was her willingness.
Cyst is a fluid filled sac within the breast. This could occur with age and are totally harmless and do not progress towards a cancer. The Cysts are never surgically removed but can be aspirated in case if it causes pain due to its size.
Mammographic screening is recommended every 18 to 24 months intervals, depending on the risk factors and respective protocols of the country. My patient was reassured and requested to follow up at the clinic in 18 months. In my country most of the patients tend to drop out during the follow ups especially when they realize that they do not have apparent risk of developing a cancer in the future.
This patient presented at my clinic with a follow up mammography and ultrasound scan after 18 months. In both images there was a suspicious 5mm lesion on the right breast, which was confirmed as an invasive ductal carcinoma of the breast.
These are extremely difficult to palpate by themselves or even by an experience clinician. She was very fortunate to identify this early cancer on the breast.
Can I avoid chemotherapy?
Most women are frightened of chemotherapy. Rather than the pain or vomiting that occurs as early side effects, they fear loss of hair and skin changes that follows after the 2nd or 3rd cycle.
This was her first question after I disclosed her diagnosis. But her willingness to screen periodically paid dividends. Not only she managed to avoid chemotherapy, but she did beat the cancer with over 95% 5 year survival rates.
What treatment was offered to her?
She had only a lumpectomy, in which only the lump was removed. Further she had sentinel lymph node dissection which revealed a negative axillary involvement. The adverse effects and complications from surgery was minimal.
She had positive ER and PR on immunostaining and was further controlled with tamoxifen therapy.
So how did she beat cancer?
The willpower and willingness of women can beat breast cancer. It should be initiated within themselves. No one should ever under estimate that they will not get a cancer, when there aren’t any risk factors. Regular breast self examination and screening is the only way to beat cancer.