The breast or mammary gland is composed of glandular and fatty tissues and is a most important part of a woman’s reproductive system.

Breast cancer is the commonest cancer in women. Worldwide, estimated 1.3million women are diagnosed with the disease annually and about one third of that number will die from it.

Cancer of the breast is a malignant tumor and this means there is uncontrolled growth of abnormal tissues which can spread to adjacent organs or by blood or lymph there can be distant spread. It is a life threatening condition.

The month of October has been designated, ‘Breast Cancer Awareness Month”. During this month there is usual public education to enlighten and increase the awareness of this life threatening disease. This is a good idea.

At the same time, however, it is of utmost importance that there remains an awareness of breast cancer among women, their families and medical practitioners at all times and not just in the month of October. A high index of suspicion for the possibility or presence of cancer will ensure early detection and timely intervention.

The prevalence of breast cancer peaks in the age group forty five to fifty five years. It is important to highlight that there have been many instances of women in their thirties and even twenties being diagnosed with the disease.

The exact causes of breast cancer are not known but there have been some well documented risk factors for the disease. There are two broad categories of breast cancer described, cancer in the reproductive years and breast cancer in post-menopausal women.

The following are risks factors for breast cancer.

1. Advancing age 2. Nulliparity(women who have not given birth) 3. Early menarche and late menopause 4. Strong family history. It is more common in women who have a first degree relative with the disease. 5. Diet high in saturated fats.

The commonest presentation of breast cancer is a lump in the breast. At the same time, however, although the majority of breast lumps are not cancerous, its possibility must always be considered in any lump in the breasts until tests are done which prove otherwise.

There are other changes in the breasts which may indicate the presence of cancer. These include blood stained discharge from the nipples, dimpling, discoloration or ulceration of the skin.

Self-breast examination which is recommended monthly for all women has been responsible for the discovery of the majority of lumps in the breasts.

This does not diminish the importance of routine or yearly mammogram starting after age forty five years. It is not recommended before this age, for women who are still in their reproductive years, as this would prove unnecessary exposure to radiation which can have implications for future childbearing. Moreover an ultrasound is a very useful tool which can be used to detect and reveal the nature of lumps.

When a lump is present in the breast it should be removed for biopsy. If malignancy is confirmed then the different options of treatment are evaluated. Treatment options are based on the stages of the disease and the individual preferences of the woman.

The rights of the patient must always be respected. What is important is for her to be enlightened and presented with the optimum options so that informed and enlightened consent to treatment can be given.

A combination of treatment is usually employed for the treatment of breast cancers. Surgery may involve complete removal of the breast, total mastectomy or a partial mastectomy which usually involves sectoral resection of the affected area.

Surgery is usually combined with chemo-therapy and or radiation therapy.

There are always risks and side effects to the different treatment options. This will vary with individual patients. The effects of radiation and chemotherapy generally result in infertility. It is important to inform the patient of side effects of treatment.

The rights of the patient must always be respected. What is important is for her to be enlightened and presented with the optimum options so that informed and enlightened consent can be given to treatment.

Of no less importance is the fact that counseling of women who have been diagnosed with breast cancer forms a very important part of their overall plan of treatment.