Hereditary Breast Cancer: Need of awareness and screening

Hereditary Breast Cancer

It’s a known fact that of all the known cancers in the world, breast cancer rates are alarming in India, especially among women. No matter what age you are, understanding and being aware about the risk can be considered as the first step to win the fight against breast cancer.


Experts stress upon the need for awareness and early diagnosis which can increase the success rate of its treatment and management, especially among women who have a familial history of breast cancer often termed as Hereditary Breast and Ovarian Cancer(HBOC). Lately, clinicians have been witnessing the rising number of women affected with HBOC and this is rising constantly especially among women between 30 to 50years of age. With the rising breast cancer incidence in India and disproportionately higher mortality when detected in the advanced stages, it is essential to understand the level of cancer literacy. In general, women aged 40 – 45 years onwards are screened annually with bilateral breast mammogram. But with a significant family history as deemed after discussion with their clinician, women need to be screened at least 10years before the onset of diagnosis of the first case in their family. To say, screening detects cases before the onset of symptoms, meaning at a very early stage.

In general, Breast lump has been the most commonly known symptom along with having a history of breast cancer in a close relative as a potential risk factor. The first step to managing HBOC is being aware of your family history. It is very important for every woman to understand and recognize the initial symptoms – some warning signs of breast cancer includes:

  • A lump in the breast or underarm
  • Thickening or swelling of part of breast
  • Irritation, dimpling of breast skin, redness or flaky skin in the nipple area or the breast.
  • Any change in the size or the shape of the breast

In some cases, breast cancer symptoms might be difficult to notice, but your clinician can help identify a possible mutation when you have a family history of breast cancer which will put you in the track of stringent screening programme. It will also give information on other possible cancers that can be implicated by the gene, prophylactic surgeries to prevent such cancers and further probing of other family members for the detected gene. Genetic tests look for inherited BRCA1, BRCA2 mutations and a variety of other inheritable genetic mutations based on the family history. These tests are typically available to the general population; however, an individual’s needs for a specific screening test are based on factors such as age, gender and family history. A Genetic counsellor also helps in making decisions regarding such tests.


It is true that, in India 9.6 million people die from cancer every year and 70 per cent of cancer deaths occur in low-to-middle income countries. The average 5-year survival rate for women with Stage I invasive breast cancer is 90% and as with most cancers, survival for female breast cancer is improving. In rural areas, government agencies, NGOs and charity organizations have put great emphasis on improved breast cancer awareness among masses for promotion of early detection, providing comprehensive treatment module and support for breast cancer management along with screening and targeted treatment.

Hence this World Cancer Day, no woman should ignore a lump in the breast, and they need immediate medical attention.Also, several factors affect an individual’s risk of developing breast cancer, some of which are modifiable and largely related to lifestyle and environmental factors. It is essential for women to know about these factors early in life so they can make the right lifestyle choices concerning these risk factors, since an increase in awareness can change their risk perceptions and behaviours.

(Disclaimer: The writer is Dr Sandhya Appachu, Medical Oncologist, Shankara Cancer Hospital. Views expressed are a personal opinion.)

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