Guwahati,

Health Talk

Early Diagnosis of Breast Cancer

 Breast Cancer Screening and its Importance:

This is a systematic evaluation of a 'normal' individual to see if there is any underlying cancer. Many cancers go through a stage-wise manner. A cancer begins in a single cell, which slowly multiplies to form microscopic 'tumour' which keeps on enlarging, and ultimately produces some symptom, depending on the organ system it involves. It is usually seen that most tumours tend to produce symptoms when they are fairly big. As a 'cancer' grows, its 'invasiveness' increases. So if we were to catch a cancer much before it produces any symptoms, we will be able to treat it with minimum number of modalities, decreasing the trauma, and at the same time, increasing the survival of the patient. By regular check-ups and by being alert, we can catch the cancer in its initial stage. To note here, as the stage of a cancer increases, the survival becomes less and less. So it is essential to detect cancers early. Cancer cannot be prevented but it can be detected early. 
Screening enables us to detect a cancer much before it produces symptoms. 
 
Age at which screening should begin:
Breast Self-Examination: This includes regular and systematic palpation of the breast by a woman herself to assess for any abnormality. After age of 20 years, a woman must regularly do a BSE, and must be evaluated by a clinician, atleast once every few years. Up to the age of 40, this is all that is needed. 
Mammography: Mammography will be advised by a clinician yearly, after a woman crosses 40 years of age. If mammography is normal, screening continues every year.
 
Who should do the screening? 
For screening of breast cancer, a qualified medical personnel, preferably who is well versed and up to date with diseases of the breast and who is involved in the treatment of breast cancer, should be involved in screening. The reason is, all lumps in the breast are not cancerous, and sometimes, there is just nodularity and nothing else, all of which may be 'benign' (non-cancerous) and may not need any treatment. So if the doctor involved in screening is not an expert in breast diseases, it may cause unnecessary apprehension in many normal people if some positive finding turns up.
 
Signs of breast cancer
Initially, breast cancer may not cause any symptoms. A lump may be too small for you to feel or to cause any unusual changes you can notice on your own. Often, an abnormal area turns up on a screening mammogram, which leads to further testing.
In some cases, however, the first sign of breast cancer is a new lump or mass in the breast that you or your doctor can feel. A lump that is painless, hard, and has uneven edges is more likely to be cancer. But sometimes cancers can be tender, soft, and rounded. So it's important to have anything unusual checked by your doctor.
According to the American Cancer Society, any of the following unusual changes in the breast can be a symptom of breast cancer:
* Swelling of all or part of the breast
* Skin irritation or dimpling
* Breast pain
* Nipple pain or the nipple turning inward
* Redness, scaliness, or thickening of the nipple or breast skin
* A nipple discharge other than breast milk
* A lump in the underarm area
These changes also can be signs of less serious conditions that are not cancerous, such as an infection or a cyst. It's important to get any breast changes checked out promptly by a doctor.
Eight out of 10 lumps that women may feel in their breasts are benign (not cancerous). In any event, if you feel a lump and you're worried about it, don't hesitate to see a doctor. By getting a doctor to check the lump you'll ease your fears. And if it's something serious, you can start getting treatment right away.
Breast self-exam (BSE), or regularly examining your breasts on your own, can be an important way to find a breast cancer early, when it's more likely to be treated successfully. Not every cancer can be found this way, but it is a critical step you can and should take for yourself.
(Dr. Juri Bharat Kalita is a Senior Consultant, Microbiology and Health Care Management, and Heads Quality for Ayursundra Healthcare Private limited. She can be reached atjbkalita@gmail.com)
 
MIND OVER MATTER
 
Q. Madam, I am a girl of 18 years and studying in Standard 11. I recently broke up with my boyfriend. I have moved on in my life. But my boyfriend says that he wants me back in his life. I told him that it's not possible but he is forcing me to accept him again. Please advise me what to do. 
(Name withheld) 
Ans: My girl, no one in this world can force them to do something against your will. Unless you allow that to do so! You have moved on with your life and that's that. If someone else is having a problem because of that, it's their problem. Not yours. Stay busy with your studies and other extracurricular activities. Don't allow anyone else to rule over your life.
 
Q. Hello Madam, I am in the 8th standard. There is a boy who disturbs me. If I pass by, he always passes bad comment. I feel scared to pass by them. It is affecting my studies a lot. I keep thinking about it all the time. I never reach my goal. How do I get rid of this? Please help. 
(Name withheld)
Ans: What you state is a serious matter. This should not be taken lightly. Please inform your parents at the earliest. They will deal with it in the appropriate manner. Do not engage in any kind of quarrel with this boy. Let the elders deal with it. If possible for a while do not move around alone. Take care.
 
Q. I am a 28 years old male, I feel extremely possessive about my girlfriend. I want to be with her 24x7. If she doesn't call me, I get angry. If she does not want to go out with me, I get angrier. Because of all this, she is slowly beginning to avoid me. At times I wait outside her house, wait for her to come out. She does not like it very much. But I can't help myself. She is very nice and a patient person. But now she tends to get irritated with me. I really love her and am scared of losing her. What should I do? 
(Name withheld)
 
Ans: Any form of relationship requires a degree of trust and comfort. Giving one another ample space to practice one's own individual interests is of utmost importance. If we tend to step into one another's shoes at all times, definitely it tends to get claustrophobic for the partner. Everyone requires some degree of breathing space!
What is it that makes you behave this way? Do you not trust your girlfriend? You have yourself realized that your possessive behavior is causing discomfort for her. Then stop behaving this way. Visit a psychologist or a counsellor and have a heart to heart chat. It is always beneficial to discuss in person.
 
Ms.Gariasi Dutta, MSW (TISS) is Psychological Counsellor with Down Town Hospital, Guwahati. She can be contacted at 98640-55560 or dutta.gariasi@gmail.com