Nafisa distinctly remembers the day she felt the lump in her breast while she was doing a routine breast self-exam. It was small, just the size of a gooseberry, and it was painless. Time had seemed to come to a standstill. She was a few days short of her fifty third birthday. She immediately saw her physician and in a few days she had confirmation that it was a breast cancer.

What is breast cancer?

Cancerous cells are abnormal cells which grow uncontrollably. Cancer of the breast is one of the most common cancers in women. Four out of five breast cancers occur in women over age 50.

The good news is that, if found early, breast cancer is a treatable and curable disease. Early detection is the key to a cure. The cancer usually starts as a small lump. If not treated, with time the lump may grow and spread to nearby areas, such as the skin or the lymph nodes under the arm. In advanced cases, the tumour may spread to vital organs such as the liver, brain, lungs, and spine. If breast cancer is found early, before it spreads, it can be cured.

How does it occur?

The cause of breast cancer is not known. Any woman can get breast cancer, but some women are more likely to develop it than others. Factors that increase your risk of having breast cancer include:

• having a mother or sister with breast cancer
• starting menstruation at a young age or going through menopause in your 50s
• being over age 50
• never having given birth or having your first child after age 30
• a history of radiation exposure to the area of the breasts
• estrogen/progesterone therapy
• obesity

There is currently no definite evidence that taking birth control pills for a long time causes breast cancer.

What are the symptoms?

Most often the first sign of breast cancer is a lump in the breast. The lump is found commonly in the upper, outer part of the breast. It is not usually painful. Other signs of breast cancer include:

• color change, dimpling, or puckering of the skin in an area of the breast
• a change in the size or shape of the breast
• fluid discharge from the nipple
• lumps felt in the armpit.

How is it diagnosed?

Most women find their own breast cancers, either by accident or from a breast self-exam. Sometimes breast cancers are found at a routine physical exam or on a screening mammogram. Mammograms can detect some cancers before a lump can be felt. They detect about 90% of cancerous lumps.

It is important to remember that most breast lumps are not cancer. Often they are fluid-filled cysts in the breast tissue that get larger and smaller with the menstrual cycle. They can also be benign tumours called fibroadenomas. It is important that every lump must be checked, especially if you are over the age of 40. After the examination by your physician, you might be asked to undergo any or all of the following tests:

• mammogram
• ultrasound scan
• a fine needle aspiration or surgical biopsy.

Both a fine needle aspiration or a formal biopsy, are methods to detect cancerous cells or tissue.

Receptor tests:

Since breast cancers can be dependent on estrogen or progesterone for their growth, a receptor test is done to see if hormones make the cancerous cells grow more.