A cancer is an uncontrolled growth of abnormal cells. It can start in any part of human body.
Normally human cells grow and divide as and when the body needs them. The old and damaged cells
die giving way to new cells. These new cells are formed by cell division, also called as replication,
as daughter cells are supposed to be perfect copies of the mother cells. But sometimes there may
be some errors in the cell division process called mutation. The resultant daughter cells from
such division are abnormal and are called as cancerous cells. There is a built-in error control
process in our bodies which lead to self-destruction of these cancerous cells. It is when this error
control process of programmed cell death fails, the mutated abnormal cells survive and multiply.
These cancer cells are also able to ignore the signals that normally tell them to stop replicating and
hence may form growth called tumours. As these tumours grow, some cells can break free and
travel through the bloodstream to distant parts of the body forming new tumours.
Breast cancer occurs when cells in the breast begin to grow uncontrollably. A tumour formed
from such growth can often be felt as a lump or detected through x-ray. Breast cancer can start
from any part of the breast. Some breast cancers originate from the milk ducts and don’t develop
the ability to spread outside the breast. Such breast cancers are non-invasive called as carcinoma
(DCIS). This form of cancer rarely shows as a lump and is usually found on a
mammogram. Invasive ductal cancer develops in the cell lining of the ducts and accounts for about
80% of all breast cancers. There are also other types of breast cancers that are less common. It is
possible for breast cancer to spread to other parts of the body through the bloodstream or lymph
nodes. It is known as metastatic cancer.
Breast cancer is the second most common type of cancer in women. Approximately 12.3 % of
women develop breast cancer at some point during their lifetime. Women from developed
countries show more chances of getting cancer but incidences in developing countries are also
According to Globocan Project in the year 2012 in India:
* 144,937 women were newly detected with breast cancer
* 70,218 women died of the disease
This means that for every 2 women newly diagnosed with breast cancer in India one is dying of it
whereas in the US for every 6 women newly diagnosed one will die of it. On comparing the above
data, we can easily make out that mortality rate in India is very high. Persistent efforts in raising
awareness and early diagnosis has helped the US to decrease the mortality rate. So India also needs to
put an effort along the same lines.
Since most patients in India find out about cancer later stages of the disease, they do not survive
in spite of receiving the best treatment. There are lots of reasons for late presentations like lack of
awareness, shyness, social stigma or doctor’s ignorance and wrong diagnosis. Early detection and
adequate treatment can achieve longer survival. Mammography helps in early detection of cancer.
Mammography is a medical procedure that uses a low-energy X-ray to take an image of the human breast.
This X-ray image is called a mammogram. Mammography is of two types:
*Screening Mammography: This procedure is used to check for breast cancer in women who
show no symptoms of the disease. It usually involves taking two x-ray pictures of each
breast. The X-ray image can show tumours that cannot be felt. Screening mammograms
can also find microcalcification (small deposits of calcium) which may be an indication of
*Diagnostic Mammography: This mammography is done on patients to check for breast
cancer after a lump or other sign or symptom of breast cancer is found. Symptoms include
pain in the breast, change in shape or size of the breast, thickening or pigmentation of the skin
of the breast or nipple discharge. A diagnostic mammogram can also be done to evaluates
the abnormality seen in screening mammogram. It is also done on patients with breast
implants, breast reductions or with a family history of breast cancer. Diagnostic
mammography takes longer than screening mammography as more x-rays are needed from
different angles to ascertain the disease. A magnified picture of suspicious area is taken for
the doctor to make an accurate diagnosis.
During Mammography, the technician positions the breast in a mammography unit and then
compress it with a paddle. Although a little uncomfortable, the compression is essential for a good
mammogram. Usually, two views are taken for each breast hence four x-rays are obtained.
Additional images may be taken if specified by the doctor.
A few precautions should be taken before going in for Mammography:
*Inform your doctor if you are or likely to be pregnant as radiation can be harmful to the
* It is best to undergo mammography within a week of your periods
* Inform your doctor if you are taking hormone replacement therapy
* Do not wear deodorant, talcum powder or body lotion on your breast or under your arms
on the day of the exam. The mammogram will be difficult to interpret and can give false
positive for calcium deposits.
* Prior mammograms should be carried along so that doctor can compare with the present
* Women from age 40 to 54 should get screening mammogram done annually. After 54 years
of age, it can be done every 2 years
* Women with a family history of breast or ovarian cancer should have annual mammogram
from 35 years of age.
* Women who have received chest radiation therapy should also start getting annual
mammography done as early as 30 years of age.
* Women who show the symptoms of breast cancer and their healthcare provider
recommends a mammogram.
* Women who have a known BRCA1 or BRCA2 gene mutation
In higher risk categories, an annual breast MRI is recommended along with a mammogram.
Ultrasound imaging of the breast uses sound waves to take pictures of the internal structures of the
breast while Mammogram uses X-rays. Although ultrasound is less painful and does not use
radiation, it is the second line of diagnostic procedure. Ultrasound is recommended when the doctor
has found some abnormalities in mammogram or breast MRI. It may also be useful in women with
dense breast tissue. Ultrasound results in more false positive as compared to Mammograms,
therefore, doctors do not recommend it for regular screening.
Although breast screening or mammography should be a routine annual procedure for women with
age over 45, in some women with symptoms, an early test may be required. These symptoms are:
* A lump or thickened skin in either breast
* Change in size or shape of one or both breasts
* Discharge from either of nipples or nipples sinking in.
* Dimpling of the skin of the breasts
* A lump in either of armpits
* A mammogram helps in early detection of cancer. Early stage cancers are 99% curable.
* A mammogram is able to detect microcalcification, which are tiny deposits of calcium seen
in early stages of breast cancer.
* Mammogram uses a low dose of x-ray so is not harmful. The benefit of early detection far
outweighs the small amount of radiation.
* Each time you have a mammogram, your breasts are exposed to a very small amount of
radiation. Modern mammography machines use the smallest amount of radiation possible
while still getting a high-quality X-ray picture.
* The radiation from screening (which involves two X-rays of each breast) is about the
same as 18 weeks of exposure to natural radiation in the environment.