The most common cancer amongst across all sex is breast cancer. Globally, breast cancer contributed 11.5 % of the total number of new cancer cases. The mean mortality rate in high economies is 15%. In India it is around 50%. It is caused due to delays at pre-diagnostic, diagnostic and treatment phases.

Breast cancer occurs when some breast cells begin to grow abnormally. These cells divide more rapidly than healthy cells do and continue to accumulate, forming a lump or mass. Studies show that breast cancer is mostly diagnosed in adults over the age of 35 but it can occur at any age.

Painless lumping/thickening of the breast, redness or flaky skin in the nipple area, nipple discharge other than breast milk are some of the warning signs of breast cancer.

While the main cause of breast cancer is still unknown, genetic predisposition, sedentary lifestyle, late pregnancy, non-lactation, smoking, excessive alcohol consumption and obesity are some of the risk factors associated with it. With 1 in 28 women in India likely to be diagnosed with breast cancer, early detection and management remain the best way to increase survival rates.

Diagnosis and Treatment

Management of breast cancer depends on the severity/stage of the disease and the patient’s preference. There are several breast cancer treatment options, including surgery, chemotherapy, radiation therapy, hormone therapy, immunotherapy, and targeted drug therapy. Choosing the right treatment depends on many factors, including the location and size of the tumour. 

In breast cancer, information about whether the cancer has spread from primary tumour location to other locations is very critical. Cancer is diagnosed and localised before surgery by imaging devices like Mammography/MRI and minimally invasive biopsy, but during surgery nodes are challenging to be localised with naked eye or conventional tracer. Technological advancements like 4K Fluorescence Imaging (FI) technology help surgeons to precisely map the cancer cells and to selectively remove the lymph nodes, also known as sentinel lymph node dissection, thereby preventing post-op complications such as lymphedema, sensory deficit, pain, impaired arm movement amongst patients.

To map the lymph nodes, the patient is injected with a safe and affordable dye, Indocyanine green (ICG), before or during surgery in the breast area. The dye flows into the lymphatic system and accumulates in the lymph nodes, allowing surgeons to see the nodes which are likely to be affected by cancer. When viewed in overlay fluorescence mode, the affected nodes and tumour illuminates in fluorescent green colour. The nodes are precisely removed and sent for cancer staging to decide further line of treatment. 

FI has also been widely used in breast oncoplasty/ reconstruction post mastectomy and node removal to identify blood flow in the tissues. This information is critical to plan the approach of reconstruction surgery that involves anastomosis (stitching) of these micro-vessels of harvested flap and breast. Real time, clinically significant and actionable information provided by FI technology enables surgeons to improve quality of cancer care, outcomes and lower overall healthcare burden.

This World Cancer Day, it is imperative to address the cancer education/awareness gap and make a combined effort to promote breast cancer prevention and early diagnosis. Every individual above 35 years of age should undergo regular breast screening. An informed and empowered patient or caregiver can go a long way in early and effective management of breast cancer. So, know your options and lead a healthy lifestyle.

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Views expressed above are the author's own.

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