The following are common ways of diagnosis of breast cancer:
- Clinical examination of the breast – like self-examination of the breast, palpitation or physical examination to find any abnormal physical features such as lumps in the breast becomes the first step towards suspecting the growth of a tumour.
- Mammography – is the X-ray scanning of the tissues of the breast. Apart from this, ultrasound, CT and PET scans are sometimes advised depending on the patient.
- Tissue examination in the form of biopsies – are biopsies of the breast taken to check for the status of some hormone receptor proteins and some other molecular factors. Based on the revelations of these tests, further treatment and surgery will be suggested.
Additional tests for general fitness could include a blood test and ECG. For advanced cases, additional bone and chest scanning might be necessary.
These facilities are available in most of the public and private hospitals today. Dr Sridhar, a medical doctor by training and a research scientist by profession, at St John’s hospital in simply put words said that no new technology is necessary for better diagnosis. He says, “We have all we need for diagnosis with significant certainty and very little ambiguity”.
As for the treatments available, the following methods are commonly used
- Surgery – is a straight forward procedure of the removal of the cancer mass in the breast. Depending on how much the cancer has grown or spread, either the cancer mass is removed or mastectomy (partial or complete removal of the breast) is done. Medical science has made enough progress to reduce the aggressiveness of treatment, but much more is needed. The entire breast must not unnecessarily be removed anymore, but the patient must be treated with a targeted treatment.
- Chemotherapy – is injection of usually a combination of drugs into the body to kill cancerous cells.
- Radiation therapy – is exposing the site of tumour to high intensity X-rays to kill cancerous cells and reduce the risk of these cells growing back.
- Hormonal therapy – depending on the type of cancer identified, hormonal therapy is advised or omitted. Estrogen is a hormone which when binds to its receptor on a cell, signals the cell to divide. Thus, through therapy, we can block this interaction in order to not let the cancerous cells divide.
- Targeted therapy – as opposed to chemotherapy where healthy cells also get killed along with cancer cells, these treatments target cancer cells only.
Surgery, chemotherapy and radiation therapy are important ways of treating breast cancer. Some treatments are local, which means that they only target the tumour without affecting the rest of the body. Depending on the nature and type of breast cancer and how aggressive it is, a combination of targeted therapy or treatment may be required either before or after surgery or both. Dr Sridhar, during his interview with us mentioned about the present approaches for treatment in hospitals with what are called Multi-Disciplinary Teams or MDTs in short. It is a core team of people with different specialities mostly comprising a surgeon, radiation expert, medical oncologist, expertise in psycho oncology, nutritional support etc. for the evaluation of a particular patient.
Aparna Dhar, a medical geneticist who works with CORE Diagnostics, one of the major current players in spearheading diagnosis for many diseases including breast cancer spoke to us more about how current technological integration into the healthcare system such as tele-medicine (use of technology to share information over a distance between healthcare providers) and tele-healthcare (use of technology to spread awareness and in follow – up care through routine diagnostic monitoring) is indeed helping people. She also suggests the option of seeking a second opinion if time permits. A second opinion provides the patient with more information and helps them feel more confident about their treatment plans.
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