Breast cancer is the most common cancer among Indian women, with the cases steadily increasing. Breast cancer accounts for 27% of all female cancers in India, with cases projected to rise 170% by 2050. Mortality rates may increase 200%, and the five-year survival rate is 66.4%. In 2024, India recorded approximately 2,60,000 new breast cancer cases.  In Karnataka, the total number of new cancer cases was 87,855, with breast cancer being the most prevalent among women.

With this alarming increase in number of cases, let us understand the possible risks, nature and types of breast cancer and the possible treatments available and preventive measures.

Risk Factors

• Family history of cancers who could be possible carriers of various pathogenic mutations. A recent indigene study shows about 40% cases of breast cancers could be hereditary in nature.
• Hormonal and reproductive factor: Early menstruation (before 12), late menopause (after 55), Late or no pregnancies, Hormone replacement therapy.
• Lifestyle and environmental factors including obesity, excessive alcohol consumption, smoking, radiation exposure, sedentary lifestyle, lack of proper diet, exposure to heavy metals, pesticides etc.
• Aging (higher risk after 50)
• Dense breast tissue (more glandular tissue than fatty tissue) 
• Other breast conditions such as ADH, ALH, fibroadenomas with complex features, papillomas (small wart-like growths in milk ducts), Radial scars (star-shaped breast tissue formation) etc.
•  LCIS, which is abnormal cell growth in the milk producing glands (lobules). Women with LCIS have a 7-12 times higher risk of invasive breast cancer.

Types of Breast Cancer

There are many types of breast cancer, and many different ways to describe them. It’s easy to get confused. A breast cancer’s type is determined by the specific cells in the breast that become cancer.

• Non-Invasive (In-situ) Breast Cancer – DCIS: Cancer cells in milk ducts but haven’t spread.

• Invasive Breast Cancer: 

• Invasive Ductal Carcinoma – IDC – Most common type; spreads beyond milk ducts
• Invasive Lobular Carcinoma – ILC – starts in lobules, may spread. 

• Triple Negative Breast Cancer (TNBC) – Lacks estrogen, progesterone, and HER2 receptors; aggressive and harder to treat.
• HER2-Positive Breast Cancer – Has high levels of HER2 protein, often aggressive but treatable.
• Inflammatory Breast Cancer (IBC) – Rare and aggressive, causes red, swollen breast.
• Paget’s Disease of the Breast – Affects the nipple and surrounding area.

Treatment Options:

Treatment depends on the type, stage, and patient’s overall health.

1. Surgery

– Lumpectomy (removes tumor, keeps most of the breast)

– Mastectomy (removes one or both breasts)

2. Radiation Therapy

– Uses high-energy rays to kill cancer cells, often after surgery.

3. Chemotherapy

– Uses drugs to destroy cancer cells, often before or after surgery.

4. Hormone Therapy

– Blocks hormones like estrogen/progesterone that fuel cancer growth.

5. Targeted Therapy

– Attacks specific cancer cell markers like HER2 (e.g., Herceptin).

6. Immunotherapy

– Boosts immune system to fight cancer, mainly for TNBC.

Prevention Strategies

– Healthy Lifestyle: Exercise regularly, maintain a healthy weight, avoid smoking and limit alcohol.

– Breastfeeding: May lower risk.

– Regular Screening: Mammograms help detect early signs.

– Genetic Testing & Risk-Reducing Measures: Consider if high risk (e.g., BRCA mutations).

– Limit Hormone Therapy: Use the lowest effective dose for the shortest time if needed.