Dr Balaji Ramani, Director – Gleneagles Institute of Oncology, Gleneagles Hospital, Chennai
Culturally and historically the Breast has been the representation of Motherhood and Femininity. The source of Mother’s Milk and of her infallible love for her children and the very embodiment of the female form through the ages, today we know the value of Breastfeeding for the Child in Immunity, Oral Development, Holistic nutrition and for the mother in Bonding, Emotional Attachment and its role in Preventing Breast Cancer.
We are in an era where Breast Cancer is the Leading Cancer in Women and the major cancer in the teeming billions in Earth.
“All Cancers are Genetic … but they are not Hereditary” By that we mean that all tumors originate as a result of changes in our genes – the cancer promoting Oncogenes or the cancer preventive Tumor Suppressor gene. Hormonal factors like early age of onset of periods in girls, delayed menopause, decreasing fertility, reduction in breastfeeding and use of hormone replacement therapy-all of these play a major role in breast cancer. More worrisome is the fact there is a rising trend in smoking and alcohol use in the GenZ, women that are directly linked to breast cancer.
There is silver lining is too in these dark clouds. The *general* increase in awareness about breast cancer, better utilisation of screening, mammograms from the age of 40, *newer* modalities of treatments that increase the cure in breast cancer-even in select cases of *Stage 4 *breast Cancer – all these are indeed good news.
Enormous advances have been made in the management of breast cancer-molecular therapies that are even available in tablet form, usage of *Chemo-Port* to avoid infusion *related* complications of chemotherapy, hair fall reducing therapies like scalp cooling, advanced and newer targeted therapy agents-all these signify the latest in systemic therapy in breast Cancer.
Today, Radiation Oncology has progressed to an extent where the skin reactions and darkening usually associated with radiation are minuscule. With this, we also have recent trials that enable us to deliver the same effective dose of radiation. in a much shorter time frame ranging from one week to 3 weeks *as compared to the 5 weeks that was the standard.* The use of *breath-hold *and assisted ventilation during radiation helps in avoiding cardiac toxicity.
Surgery in breast cancer has undergone sea change from the era of total Breast removal for nearly all patients to the current era where Breast conservation surgery along with Onco-plastic reconstruction techniques and breast implants *that* have nearly taken breast removal out of the equation while showing equal-in fact, better survival outcomes. The use of fluorescent green dyes to identify the Sentinel nodes has made arm edema a thing of the past.
Next Generation Sequencing NGS technology has simplified Hereditary and Genetic Testing in all cancers, and this now enables us to perform Preventive Risk Reducing Surgeries in Hereditary Syndromes and also enables us to tailor the therapy according to the patient’s molecular type of breast cancer.
In conclusion, in this pink, October, the future for patients afflicted with breast cancer is Rosy and colourful and portends a long life.
