Dr Anu Aurora (General Practitioner) has been donning the role of a health consultant in Holy Spirit Hospital, Mumbai, for 12 years. She possesses a 35-year long experience of working as a full-fledged general practitioner. She is considered the go-to doctor, who is efficient in dealing with patients explicitly suffering from different Breast Cancer types. Dr Aurora is also a motivational speaker who has initiated several awareness programs with mainstream discussions on breast and Cervical Cancer.

How to do self-examination for breast cancer?

The first thing the ladies have to see is that they have to be very cautious about the breast examination. Usually, Breast Cancer is seen at the age of 35 or 40, but these days we always ask young girls to start the self-breast examination because we see cancer at an early stage also.

Breast cancer is one of the most common forms of cancer. Every girl above 20 years of age should do a self-breast examination to screen for breast cancer, and even men should learn how to do it so that they can teach it to the women in their house. Even men can be diagnosed with Breast Cancer.

• Stand in front of the mirror (on the seventh day of menses) and see the position of breast, size, shape, and the nipples because you know your body best. Many ladies have one breast bigger than the other, which is normal. If there is any change in the size or shape of the nipple or breast, you should consult your family doctor. This examination is many times life-saving as it could be Breast Cancer.
• When you stand in front of the mirror, see the skin for changes; if the skin color has changed, do you have redness, or if one nipple is pulled up or to the side. Notice if you have nipple crusting, and see the symmetry of the breast too.
• Raise your hands and see if you find any changes in the breast. The breast should rise evenly and watch for dimpling or retraction. You should also see that if there is any swelling on the armpits.
• When you examine the right breast, you should raise your right hand and check it with the left hand; never use the same hand on the same side because you will never be able to examine for Breast Cancer properly. We need to see the armpit too because the lump can come to the armpit also. You have to feel the tissues with the flat hand.
• Use the middle portion of the fingers to examine your breast. Go totally round the breast and try to find out if there is any lump, whether a hard lump or soft lump, which was not there last month.
• Work your way around the breast in a clockwise fashion using small circles of the hand as you go and make sure the entire breast is checked.
• The breast extends till the armpit, called the axillary tail. So, you have to go to the axilla portion, use the same circular motion, and feel for breast lumps and lymph nodes. Normal lymph nodes cannot be felt, but enlarged lymph nodes, which are about the size of a pencil eraser, can be felt easily.
• A nipple- discharge is a significant finding. Strip the duct towards the nipple. Usually, you will see one or two drops of clear milky discharge, but milk will come out only when you are feeding the baby, or if you are pregnant. If you have bloody discharge, you have to consult a histopathologist so that they could test the blood sample to find if it is cancer or not. If the discharge is in large quantity, squirting out or if there is a stain inside of a bra, you should take it seriously.

Every month women should examine for Breast Cancer on the eighth day after the menses, and menopausal women should do it on the first day of the month. If you do it regularly, you will come to know the changes in breast and nipple regularly. If Breast Cancer is detected early, doctors go only for lumpectomy and save the breast, but if the lump becomes big, then they have to remove the breast. So, do self-examination every month, and if there are any findings, please go to your local doctor or a gynaecologist without fail.

You are supposed to examine the breast in three ways:

• Physical examination
• Right hand on the left breast, and left hand on the right breast, around the breast and nipple.
• In lying down position, with the same process.

Don't panic if you find something, because in most cases, it is Fibroadenoma, which is benign. So, the doctor will ask you to go for sonography, mammography and will keep you on annual check-up because those are essential. After the age of 45, we usually advise mammography. If there is no family history of breast cancer, you can do it once every two years, but if there is a family history, then you should go for a check-up every year.

Does wearing tight or black color bra leads to breast cancer?

It is a myth that wearing a black bra leads to cancer. The bra should not be tight; girls should wear a fitted bra. The bra's size should be adequately checked because wearing a tight bra can make girls uncomfortable and give them Pain sensation in the neck.

There is no scientific finding that clothing affects cancer. Still, the wrong material or wrong fitting undergarments can cause skin problems and other issues, so girls should wear materials that give the breast space to breath. Underwire can be worn, but it should be well supported, and the wire should not come out and poke the girl. Cotton bras are better than nylon bras because the latter can cause skin allergies.

How important is early detection, and how can we emphasize it more?

Early detection of Breast Cancer makes a lot of difference in the treatment part. Women have to be aware that if they feel something wrong, then they should go to the doctor and get themselves checked. All the lumps are not cancerous, so they need not get panicked, but they should be aware. They should undergo sonography or mammography. Suppose the lump is small and detected early. In that case, the breast is not removed, and only the lump is removed with the Biopsy. Such cases won't have any physical deformities, and even radiation and chemotherapy may not be needed. Early detection makes treatment short, and the patient can be at peace.

Stigmas and Myths related to breast cancer

Stigmas and myths related to cancer are very popular, especially in villages, since they are not aware of the disease. Villagers still believe that getting cancer means getting a ticket to heaven. They even think that cancer is contagious. We need to provide more awareness by talking to them. Especially, the caregiver and family members can speak to the villagers and provide the right information about the disease.

What do you think is the reason behind young girls getting breast cancer?

The main reasons are lifestyle habits; less body activity, eating junk food, Alcohol consumption, and sometimes family history. Sometimes it's without any reason, and suddenly out of the blue, girls can find a lump but then again, early detection is essential. Early detection can save the patient from a mastectomy. Every time, it need not be a malignant tumor, it can also be a benign tumor, which is removed if it is big or otherwise the patients are kept under observation, and we just ask for regular check-ups. But early detection is only possible if women regularly do self-examination, so self-examination plays a vital role.

What is your advice on the right clothing to wear in connection with breast cancer?

As long as the undergarments are perfect, it doesn't really matter what you wear on top. The clothes you wear doesn't matter much. Bras should be such that the breasts can breathe comfortably. Research hasn't found any link between tight-fitted dress and cancer, but it can cause other problems such as skin rashes and infections. But if they are comfortable, they can wear anything with the perfect undergarments.

Can Breast Cancer patients conceive after the treatment?

Breast cancer patients can generally conceive after the treatment. They are given a specific time limit that after a certain number of years, they can conceive. The oncologist will properly guide them on how it is to be done.