 and medical oncologist in Manipal Hospital's Bangalore. October is breast cancer awareness month and on this occasion, this is a small attempt on my behalf to educate you on some important aspects of this disease. Breast cancer is the most commonly diagnosed cancer among women worldwide and also in urban India. In India, the incidence of breast cancer is 30 to 35 people or 1 lakh population per year. As per statistics, 1 in 8 women have a lifetime risk of developing breast cancer. Now I do understand that the diagnosis of breast cancer has a huge impact on a woman not only on her physical health but also on her emotional health because it is a deeply emotional diagnosis. It has serious repercussions on a woman's body image and self perception. Now breast cancer is basically a cancer arising from the breast tissue which consists of ducts and lobules. It most commonly arises from the epithelial lining of the ducts. Now what are the symptoms of breast cancer? The most common symptom of breast cancer is a lump, is a breast lump newly detected and which is dominated throughout the menstrual cycle. Pain is actually associated with only 2 to 7% of breast cancer and it is mostly in the late stages or only very rare types of breast cancer. So a lump is the most common symptom of breast cancer. Secondly, there will also be some skin changes, reddening of the skin, puckering of the skin, dimpling of the skin, and ulceration on the skin of the breast or in the nipple areolar region. It can also cause retraction of the nipple, nipple discharge. Sometimes a woman may also notice a swelling in her armpit region or in her neck. What are the risk factors for breast cancer and is it hereditary? When 90% of breast cancers are sporadic or random and not related to any hereditary factors, 5 to 10% of breast cancers can be hereditary and most of them are related to a particular mutation called as BRCA mutation. In sporadic breast cancer there are some risk factors associated with the disease. Among them most important is age. Breast cancer mostly occurs in post-monoposal women in 5th and 6th decade and the incidence increases with increasing age. However, no age is immune, younger women can be diagnosed with breast cancer especially those with a hereditary tendency and the breast cancer in younger females can actually be more aggressive and higher grade in nature. Secondly, female gender. Men do get breast cancer but the incidence is much less for every 100 women only one man is diagnosed with breast cancer and it is mostly related to genetic or hormonal factors. Among other factors, early men are at less than 12 years of age, late menopause at more than 55 years of age, first childbirth after 35 years of age lack of breast feeding can be associated with increased risk of breast cancer. Besides this exposure to radiation therapy especially to the chest wall and certain benign breast conditions have also been associated with breast cancer. Hormonal replacement therapy after menopause is a known risk factor for breast cancer. However, oral contraceptive pills which are commonly available are not associated with increased risk of breast cancer. Also obesity and lack of physical exercise are related to increased risk of breast cancer and so is consumption of alcohol. However, no particular food has been established as a risk factor for breast cancer. Breast cancer can be present in 4 stages. In the first and second stage or also known as early breast cancer the cure can approach more than 90%. In the third stage or the locally advanced stage the cure is around 50-60% whereas in the fourth stage or the last stage it is mostly incurable. Now in countries like USA where there are routine screening mammograms most of the cancers more than two thirds are diagnosed in the early stages when it is highly curable. But unfortunately in India due to lack of awareness and lack of screening most of the cancers are diagnosed in the late stages. Now early diagnosis is the single most important factor to achieving cure in breast cancer. A yearly mammogram over the age of 40 can actually reduce the risk of dying from breast cancer by 25%. In women who have a hereditary risk may need screening earlier and with MRI. Also every woman who reaches adulthood needs to learn breast cell examination so that she can approach a doctor the moment she detects a suspicious breast lump. The treatment of breast cancer should be done at a comprehensive cancer center and with a multidisciplinary team. At Manipal comprehensive cancer center we have a team of highly experienced surgeons, medical oncologist experience with chemotherapy, hormonal therapy, targeted or biological therapy as well as immunotherapy which is mostly used in the late stages of breast cancer and also modern techniques of radiotherapy. Now with that we have experienced and trained dedicated breast radiologists and interventional radiologists and also a full-fledged nuclear medicine department.