Hina Khan reveals Stage 3 breast cancer: How early should one go for screening? Is gene testing needed?

Why are more younger women prone to breast cancer?

Younger women who develop breast cancer are likely to have genetic risk factors. They may have inherited mutations in BRCA1 or BRCA2 genes, which increase breast cancer risk. Such risks get aggravated by other triggers like lifestyle, improper diet, obesity, lack of exercise, smoking, overuse of birth control pills or hormone therapies. Endocrine disruptors from chemical pollutants are also being studied. Eleven per cent of Indian women between 35 and 45 develop breast cancer compared to seven per cent in the West. Also patients may not show any symptoms in stages 1 and 2. That explains why you could get diagnosed in later stages. That’s why regular screening, whether you have symptoms or not, is mandatory. Early detection helps you recover completely.

How early should one go for breast screening? Is gene testing mandatory?

Get the first mammogram done at 40 years and then annually. If you have a family history of breast and ovarian cancer, where your kin have also had BRCA mutations, then get tested for genes.

Why do some cancers get detected in the late stages?

Late detection of breast cancer can occur due to a combination of factors, including a lack of screening, dense breast tissue, aggressive interval cancer, misinterpretation of imaging results, patient delay and healthcare system delays.

A rapidly growing lump makes for easy detection but a slow-growing lump or other symptoms could be less obvious. Sometimes, cancers are too small and may not be picked up by the mammogram. At other times, the dense breast tissue may hide them completely. Breast cancer detection is a complex process, and late detection can occur despite best efforts. That’s why we need to include some extra tests as part of the early screening package at age 40.

Why do we need extra tests other than a mammogram?

That’s because some patients may be the first in their families to have it because of mutation of genes and normal cells in their body. Your doctor alone can suggest additional screening procedures depending on individual risk factors and medical history. Other than routine mammography and clinical breast exam, we do ultrasound, which uses high-frequency sound waves to produce images of the breast tissue. It’s often used in addition to mammography to provide a more detailed image of the breast. MRI uses a strong magnetic field and radio waves to produce detailed images of the breast tissue. This is often recommended to women with a high risk of breast cancer or those with dense breast tissue.

There are different types of mammography too. Digital Breast Tomosynthesis (DBT) is a 3D mammography technique that provides a more detailed image of the breast tissue. Contrast-Enhanced Mammography (CEM) uses dye to highlight areas of the breast cancerous tissue.