Breast Cancer

Yumnam Samita Devi *

1: Introduction to cancer : Cancer is a disease caused by the abnormal growth of the cells. It is generally presented in the form of Lump. This cells has the potential to grow uncontrollably and invade the nearby structure , organs and nodes. Sometimes its character is very difficult to identify in the beginning of the disease and generally manifested when the disease becomes more aggressive. Many at time patient gets wrong treatment due to poor differentiation.

Types of tumor : 1. Benign tumor – Non Cancerous and 2. Malignant tumor – Cancerous

2: Signs and symptoms of cancer :

2.1: Seven warning signs of cancer : Since the manifestation of the cancer symptoms are generally late, we can always alert ourself with the knowledge of C-A-U-T-I-O-N – seven warning signs of cancer.
C – Change in bowel and bladder pattern;
A – A sore that does not heal;
U – Unusual bleeding or discharge;
T – Thickening or lump in breast or elsewhere;
I – Indigestion;
O – Obvious change in size, color, shape or thickness of a wart, mole or mouth sore and
N – Nagging cough or hoarseness of voice.

2.2: Other signs and symptoms that may be associated with cancer or may not be, but should not be neglected :

1. Blood in cough;
2. Blood in sputum;
3. Blood in urine;
4. Blood in stool;
5. Lump in breast;
6. Unexplained weight loss;
7. Loss of Appetite;
8. Unexplained fatigue/ tiredness;
9. Persistent headache;
10. Nausea and vomiting for no specific reason;
11. Low grade fever constantly or intermittently;
12. Heavy night sweats;
13. Problems in urination;
14. – Fowl smell vaginal discharge;
15. Back pain constantly or intermittently prolong menstruation period;
16. Unexplained body pain or ache more than 4 weeks;
17. Changes in skin – new mole that increases in size 7mm, irregular shape, itching, crust and bleeding (may be normal, but can also be melanoma)

3: What is Breast Cancer ?

Breast Cancer is an uncontrolled growth of the breast cells, which may be due to normal mutations or abnormal changes of the cells, as a result a lump or a tumor is formed in the breast. The tumor may be Benign or Malignant. Benign tumor are non-cancerous, and may not require treatment, but require follow up and observation. Malignant tumor are cancerous and need immediate treatment.

4: Signs and symptoms of Breast Cancer :

1. Painless lump in breast;
2. Lump in Axilla;
3. Breast pain;
4. Skin changes (Ulceration, redness, nodules, Peau d’Orange skin) and
5. Nipple (Discharge, inverted, Eczema and retraction)

5: Screening, investigation and diagnosis and monitoring test :

5.1: Screening protocols : Test done to rule out any lump or changes in breast which can be a matter of suspected cancer
Puberty to 30’s – Breast Self Examination optional, Clinical breast exam every three years, as part of general physical and no mammogram
40 to 49 – Breast self exam optional, Clinical breast exam annually as part of general physically and Mammogram every year for patient with family history of breast and ovarian cancer)
50 to 74 – Breast self exam optional, Clinical breast exam annually, as part of general physical and Mammogram every year)
75 and above – Regular screening as long as an individual is in good health
Women of all ages – Breast self exam recommended, Clinical breast exam every 6-12 months, as part of general physical, Talk to your doctor for an individualized program.
You may benefit from starting screening earlier and using other screening tools, such as Ultrasonography, Mammogram and MRI

5.2: Investigation and diagnosis :

a) Breast Self Examinations (BSE);
b) Clinical Breast Examinations (CBE);
c) Ultrasonography (USG);
d) Mammography;
e) Fine Needle Aspiration (FNAC);
f) Core Biopsy;
g) Blood Test and
h) MRI and CT scan.

a) Breast Self Examinations (BSE) : BSE is one of the most effective way to catch the breast lump is an early stage. Individual should stand in front of a mirror and see both the breast and looks for visual signs of 1. Dimpling, 2. Swelling, 3. Redness and 4. Discharge.

Feel the breasts with the finger pads – The process covers the entire breast, including the “arm Pit” of each breast. Women that are not breastfeeding gently squeeze each nipple and check for any discharge.
1. Vertical strip pattern: Involves moving the fingers up and down over the breast.
2. Pie-wedge pattern: Starts at the nipple and moves outward.
3. Circular pattern : Involves moving the fingers in concentric circles from the nipple outward.

Ideal time of doing BSE: 1) Just after the end of menstruation because the breasts are likely to be less swollen.
2) Postmenopausal or have irregular cycles might do a self-exam once a month regardless of their menstrual cycle.

Steps of BSE :
Step 1: Stand in front of mirror with hands down looking at your breast.
Step 2: Now, raise your arms and look for the same changes.
Step 3: Stand in front of mirror with your shoulders straight and your arms on your hips

In Step 1, 2 & 3 Here’s what you should look for:
1. Breasts that are their usual size, shape, and color, 2. Breasts that are evenly shaped without visible distortion or swelling and 3. Dimpling, puckering, or bulging of the skin.
Step 4: Put one hands above head and examine your breast by the opposite hand.
Step 5: Squeeze your nipple and see for any discharge.
Step 6: Finally, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast.
Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a circular motion, about the size of a quarter.

b) Clinical Breast Examinations( CBE) : It is done by health care providers who are well trained in this field (may be doctor or a nurse). This is one of the method of early detection of Breast Lump or cancer.
c) Ultrasonography Breast (USG) : USG is one of the method to identify breast lump or tumor. It is advisable in woman younger than 35 years who have dense breast tissue.
Mammography may give false in result due to thick and dense breast tissue and if there are full of milk glands .
This tool can be used for both the purpose 1. Screening and 2. Diagnostic.

Indications : 1. Age below 35 yrs.
2. Pregnant Mother.
3. Breast Feeding
4. Suspected rupture of Implants
d) Mammography : It is an X-Ray of Breast. Mammogram combine with USG gives better understanding of the disease.
This tool can be used for both the purpose 3. Screening and 4. Diagnostic.

e) Fine Needle Aspiration ( FNA) : FNAC is one of the biopsy technique. The health care provider use a small gauze needle to pierce the mass and withdraw the fluid and send for study.
This procedure is inferior in comparison with core biopsy. However in certain cases this works well, depending on the type of the tumor. e.g palpable tumor mostly cystic in content. A negative FNA does not rule out a Breast Cancer.

f) Core Biopsy : Core biopsy is much more definitive study in comparison with FNA. In this procedure the area is anesthetized with local anesthesia and a large gauze needle inserted into a spring loaded device the physician or the train nurse pulls the trigger on the device that directs the needle into the mass . One or multiple core can be obtained by repeating the procedure.

g) Blood Test : As per advice by doctor base on the presenting condition of the individual and associated disease
h) MRI and CT scan : Advice as per condition of the individual. Has a role in staging patient with proven.
These are very expensive diagnostic too just to rule out the breast cancer.
But helpful in staging of a new diagnosis case. Also useful in early detection of unknown cancer in breast.
Diagnosis of Breast Cancer rarely done in patient with metastasis disease to find a small focus of primary carcinoma in the breast

6: Staging of Breast Cancer :

Staging is the process of finding out how widely the cancer is spread when detected for the first time.
Staging is an important factor for choosing the right treatment and also to determine the prognosis. There are different stages of the Breast Cancer. Staging of Breast Cancer depends on the following criteria- Tumor, Lymph Node and spread to distant regions (metastasis).
1. Size of the Tumor, 2. Involvement of the Lymph Nodes and 3. Status of the spread of the disease so calls Metastasis.

7: Treatment and monitoring test, complications :

7.1 Treatment :
1. Surgery – for a Localized disease,
2. Chemotherapy – in all stages of the disease,
3. Radiotherapy – to control the local disease after surgery as well as to palliate painful disease,
4. Endocrine Therapy – when indicated and
5. Palliative- when the disease has spread and patient need to be comforted and relieved from pain.

7.2 Monitoring test : Monitoring test depends on the presenting condition of the patient at the time of follow up.
Following test may advise – 1. USG, 2. Mammogram, 3. CT, 4. MRI, 5. Bone Scan and 6. Blood Test.

7.3 Complications of the treatment : There are Short term and long term complications some of the common complications are 1. Pain, 2. Reduce movement of hand (generally shoulder joint), 3. Seroma Formation ( collection of fluids in Surgical site) and 4. Swelling of hand (Lymphedema)

8: High Risk Group For Breast Cancer :

1. Woman age between 30 to 70 years,
2. Early Menstruation,
3. Late or no pregnancy,
4. Menopause after 55 yr,
5. Dense Breast,
6. Personal history of Breast Cancer,
7. Family history of Breast Cancer,
8. Family Infrastructure,
9. Breast disease,
10. Physically inactive
11. Obesity,
12. Oral Contraceptives Pills,
13. Alcohol & Smoking,
14. Dietary Pattern and
15. Stress.

* Yumnam Samita Devi wrote this article for The Sangai Express
The writer is Ward In-Charge and Breast Care Nurse, TATA Medical Center, Kolkata
This article was posted on July 29, 2017.

* Comments posted by users in this discussion thread and other parts of this site are opinions of the individuals posting them (whose user ID is displayed alongside) and not the views of We strongly recommend that users exercise responsibility, sensitivity and caution over language while writing your opinions which will be seen and read by other users. Please read a complete Guideline on using comments on this website.

  • Singcha Wuya Won (flower) #3:: Gallery
  • Sunday Cup Football @Lamshang :: Gallery
  • Gurmayum Robert wins gold at World Event
  • Loktak Project & corporate unaccountability
  • Supremacy Of The Party :: NPF
  • Binding the wound: The district row
  • Admission Notice - AiTC, Imphal
  • Inner Line Permit (ILP) Demand : Timeline
  • 'Sexuality & Internet' at Digital Summit
  • Zeliang welcomed support from NPF Minority
  • NSU site and undue communal overtones
  • Tripartite Talk: GOI/GOM/UNC :: Gallery
  • Governor's Cup Fencing :: Gallery
  • 13 Aug @Kangla & BT Park :: Gallery
  • Bruce Dickinson: "son-rise" of Iron Maiden
  • Biren should learn from Mamata Banerjee
  • The globe is in your fist
  • AR I-Day festivities with Myanmar army
  • AR celebrates 71st Independence day
  • Unconstitutionality of TR Government
  • Stadium upgrade for I-League
  • NE film festival in Delhi from Aug 18
  • Myanmarese advised to follow traffic rules
  • The human torch and AFSPA
  • The real taste of Independence Day
  • Mission XI football @ Andro :: Gallery
  • Krishna Janma @ Mahabali :: Gallery
  • Blood Donation for 13 August:: Gallery
  • Mahabali Temple , Imphal :: 360 ° View
  • Graphic & plastic arts of Zeliangrong #3
  • Silence :: Poem
  • Sport Univ: Promises kept but corruption?
  • Job requirements at SKY Hospital
  • Jobs @ National Informatics Centre (NIC)
  • I-Day Celebration at BJP State Office
  • Celebrations amid militant boycott call
  • 3 Manipur terrorists arrested in Delhi
  • NSCN/GPRN condemns raid
  • NSCN-K signing hinges on cross-border..
  • Meira Rally on Patriots' Day #1 :: Gallery
  • Patriots' Day @ Kolkata :: Gallery
  • 26th NAMA Convention Report, Houston, TX
  • Forming Plurals in Manipuri Language
  • Mammography and frequently ask question
  • Indo-Naga Talks 2017 :: News Timeline
  • NPF Office Bearers reaffirm support
  • DAN Co-ordination Meeting Resolutions
  • India and China: From rivalry to enmity
  • For better tomorrows
  • Security forces round up NSCN (IM) cadres
  • Survey 'finds' jumbos in Manipur
  • Kirti Chakra for brave major
  • President medal for IPS officer- Robin Hibu
  • 13 August @Hicham Yaichampat :: Gallery
  • Achingliu, Haokhulan, Hiyaichenbi: eMing
  • Patriots' Day @ Hojai, Assam :: Gallery
  • Protest: malpractices of MPSC :: Gallery
  • On MPSC scam & people defending it
  • 126th Patriots' Day observed in Delhi
  • 126th Patriots' Day observed in Hojai
  • Lajong U-12 to represent India in BRICS
  • Learn something from 2015 experience
  • The district creation headache
  • State Thang-Ta Competition :: Gallery
  • Search operation [Aug 12] :: Gallery
  • 13 August Patriots' Day : Read all about it
  • Thangal General : The Patriot
  • Proxy examination and Wrong politics
  • Women should not live in fear ....
  • Summer Thoughts :: Poem
  • NPF Youth serve Ultimatum to Rio
  • A slap on the face of Christianity
  • U-Morok @ Shirarakhong :: Gallery
  • Dangers of 'Trial by Media' & the MPSC
  • Is Culture of insensible activism taking root
  • Meiteilon never been Tibeto-Burman
  • Mechanized threshing of foodgrains #2
  • ZSUB Foundation Day, Fresher's Meeting
  • Sadar Hills District Demand: News Timeline
  • Breaking the barrier
  • Natural Body Building #3 :: Gallery
  • National Handloom Day @ GHY :: Gallery
  • Chirom Indira shine in hearts of NE Weavers
  • Investigate killings as ordered by SC
  • MSTC CMD met with CM of Manipur
  • Conspiracy behind the toppling game
  • Armed groups attack..a human right abuse
  • Drawing Competition at Khengjoi, Chandel
  • Govt firm on protecting indigenous people
  • Suspension of Operation term extended
  • Rs 100 cr allotted to study NE floods
  • Save the indigenous people cry : Valley..
  • A matter need to ponder
  • Earthen wares of Ningthemcha Karong
  • Indigenous Wrestling @ SPT #2 :: Gallery
  • Awunching Biodiversity Park #3 :: 360 ° View
  • XXVIII State Thang-Ta Competition 2017
  • India's HLPF review of SDGs & Manipur
  • Robotics as career options
  • International Day of Indigenous People
  • Rejoinder Issued By Shurhozelie Liezietsu
  • Hard facts of political crisis (Nagaland)
  • Viewing through one's community
  • Darkening shadows of doubt
  • Ziumi village, Maram Landscape:: Gallery
  • Inter School Handball Tournament :: Gallery
  • The Proud Bamboo Tree :: Folk Tale
  • Populated Attitudes :: Poem
  • Marijuana, Mahadev and Maneka
  • Notice for MSc Biochemistry Admissions
  • The Killing Fields :: News Timeline
  • Assam edition of NE India Fashion Week
  • Being different from Cong Govt
  • Cracking down on fraudulence
  • Hanuba-hanubi paan thaba :: Funga Wari
  • ... All The Flowers Gone? #1 :: Gallery
  • Need to bust racket running inside MPSC
  • Will PM Modi betray Assam in No ST, no rest
  • State Level Essay Writing Competition
  • RIST Condolence Function at MU
  • When we stumble and fall
  • Customer Care Executive @ basicP, Imphal
  • Petition for Disqualification of 10 MLAs
  • Cracking down on fraudulence
  • Rape of small newspaper
  • Landscape of Ukhrul District #2:: Gallery
  • Jhulon Nupi Pala Phamsak :: Gallery
  • TR is CM by technicality sans Legality
  • One Day in Heaven :: Poem
  • Libraries Vs Google: Are we heading there
  • ..for electrical distribution rearrangement
  • Lessons to learn from CCpur: public hygiene
  • Angaoba Film Scenes #1 :: eRang
  • Eyek Tamba :: Learn Manipuri script
  • The dawn of cricket in Manipur
  • Lumbini Leikolda Shat-houba Leirang
  • Workshop on MU Reservations held
  • Job posting at C-DAC Silchar
  • Lafikul murdered to stir communal tension
  • Wayward rules of law
  • Indigenous Wrestling @ SPT #1 :: Gallery
  • Tourist Watch Tower, Khongjom #4 :: 360 °
  • Admission for B.Ed at Manipur University
  • The Evening Blues :: Poem
  • A village called Nbena :: Book Review
  • Employment Generating Hands on Skill
  • Unnatural death of Sainik School student
  • Condemns killing of KNO/KNLF leader
  • AR conducts Pre Recruitment Training
  • Makeshift sheds at Lamphel
  • For a clean future generation
  • Mr Maipak Body Building #2:: Gallery
  • CM referring to ST Comm is ultra vires
  • VIP culture out, VVVIP culture in
  • Be an unchained raindrop :: Poem
  • Holistic education : Trends & challenges
  • Jobs - Going Officers Pamjei
  • Providing Various Health Benefit Plans
  • larification to Tokheho's recollections
  • SoO groups in the news for wrong reasons
  • Confession
  • Nongbrang, bank of Thoubal River :: Gallery
  • Pukpha Fest @Tamenglong :: Gallery
  • Binalakshmi Nepram at UN, NYC : 1 Aug
  • Free Computer Course by KEN @ Imphal
  • Where is the justice in mob justice
  • Ishu : Feature Film in Assamese :: Review
  • Flood: State efforts are too little too late
  • Crisis within NPF unfortunate : KG Kenye
  • decision-making body of NPF resolve: 2 Aug
  • NPF Legislature Party Statement : 2 Aug
  • ..honoring martyrs by raising Tri-colour
  • ..strong Opposition: Cong MLA striving hard
  • Battle Of Khongjom & Manipuris in 1891 #3
  • Khongjom War Memorial #2 :: 360 ° View
  • Oops! They've Done It Again!
  • Photography: Career through lenses
  • Mega Marathon Manipur : Download Form
  • Chemical Ecology: Info for college/Univs
  • Jobs - Nursing Aides in Singapore
  • NPF responds to MLAs' demand
  • Overlooking one's own Cabinet decision
  • Potential of our state
  • Drinking joints in a dry State : Liquor tragedy
  • Landscape of Manipur #7: Wallpaper
  • Singcha Wayawon opening #2:: Gallery
  • Meetei bears more tribal characters ...
  • The slumbering Beauty :: Poem
  • Selected to Global Shapers Imphal Hub
  • NPF Legislature Party Meeting on 31st July
  • Indo Myanmar Post Level Meeting at Onzia
  • Notice: Employment Exchange Imphal East
  • The unintended windfall
  • Hepatitis C is upto 95 pc curable
  • Sit-in-Demand : ST Demand Committee
  • Police na maheiroi singda kahenba..
  • Manung Kangjeibung, Kangla :: 360 ° View
  • My visit to Shri Lanka #4
  • 1st Mao Market day @Nagamapal:: Gallery
  • ILP : Students protest [27 July] :: Gallery
  • Shwedagon Pagoda in Yangon #2 :: Gallery
  • Nomination for State Journalist Awards
  • Rare historical stone inscription #1
  • Singcha Wayawon opening #1:: Gallery
  • Huidrom Kirankr- Fellowhsip for Thang-Ta
  • Ethoi Oinam (Actress) #2 :: eRang Photos
  • Echum Lairembi, Khurkhul #3:: Gallery
  • Tapta :: Funga Wari
  • Nungbi Khullen, Ukhrul #1 :: Gallery
  • NH-102 (Maram road) landslide :: Gallery
  • Featured Photo for 2017 #3 :: Gallery
  • Landslide at Jiribam Highway #2 :: Gallery
  • Tribute to Sapam Robinhood #2 :: Gallery
  • Lai Khong Chingba @Thangjing #4
  • Manipur Sangai Festival 2016 #5 : Ooba