Cancer Awareness Day: Essential self-awareness guide for women in their 40s

The 40s age group marks a pivotal and highrisk decade for womens breast health Defined by significant hormonal shifts demanding careers and active family lives this decade requires women to navigate confusing bodily changes while maintaining vigilance for subtle cancer signs Medical guidance is moving beyond routine screening emphasising the critical need for women to proactively understand their bodies know their individual risk profiles and advocate for personalised careWhile October is observed as Breast Cancer Awareness Month every year India also observes National Cancer Awareness Day on November 7 and there can never be enough awareness around any type including breast cancerThe World Health Organization WHO underscores the seriousness of this challenge noting that breast cancer remains the most common cancer among women worldwide In 2022 alone an estimated 23 million women were diagnosed globally resulting in approximately 670000 deathsThis highlights the importance of early detection and tailored screening protocols particularly as women enter this highrisk decade This comprehensive guide featuring insights from leading surgical oncologists delves into personal risk assessment modern selfawareness techniques the complexities of breast density and the oftenmissed red flagsmdashempowering women to take charge of their health during this critical phaseAssessing your personal risk profileAn accurate risk assessment is the starting point for personalised breast care Dr Vidhi Shah consultant breast oncology surgeon at Kokilaben Dhirubhai Ambani Hospital Mumbai stresses the importance of evaluating key factors such as1 Family history Especially firstdegree relatives with breast cancer2 Reproductive factors Age at first period and childbirth3 Genetic predisposition The presence of a genetic mutation like BRCA1 or BRCA2Shah notes that while only 5 to 10 per cent of breast cancers are genetic a confirmed mutation significantly impacts screening protocols She explains If someone is BRCApositive screening typically starts earlier and follows a more intensive schedulemdashfor example alternating between a mammogram and an MRI every six monthsEven without a confirmed mutation a strong family history may warrant earlier screening Shah advises If a close relative has tested positive or was diagnosed with breast cancer at an early age screening should begin five years prior to the age at which the relative was diagnosed For most women screening starts at the age of 40 but for those with strong risk factors it may begin at 35 years or earlierThe shift to breast selfawareness BSAThe method for selfchecking has evolved from rigid monthly checks to a continuous state of Breast SelfAwareness BSA Shah clarifies the modern medically recommended approach The modern approach to selfexamination focuses on breast selfawareness rather than rigid scheduled monthly checks The goal is to understand what is normal for your own body so that any new or unusual changes can be detected earlyThese unusual changes include new lumps thickened areas sizeshape changes skin dimpling redness or nipple discharge Rather than a fixed day Shah suggests ldquoRather than adhering to a fixed day each month women are encouraged to check their breasts regularly and intuitively ideally at a consistent time in their menstrual cycle when hormonal fluctuations are minimal During the seven days following your period breast fullness and tenderness are typically reduced making this the most recommended time to perform a selfexaminationHormonal masking and overlooked red flagsThe hormonal fluctuations of perimenopause once you turn 40 years and through the decade can be deceptive Dr Bhavisha Ghugare senior consultant surgical breast oncology at HCG Cancer Centre in Borivali highlights how perimenopausal symptoms like breast tenderness and glandular changes can mask malignancy Women often attribute changes like fullness pain or small nodules to hormonal variations But what we want women to watch for are noncyclic changesmdashthose that persist beyond their menstrual cyclerdquoBeyond the wellknown lump Ghugare stresses several commonly overlooked red flags Often women overlook signs such as skin dimpling puckering redness or an orangepeellike texture which could indicate underlying malignancy Similarly nipple inversion scaling crusting spontaneous discharge especially if bloodstained or persistent localised pain are red flagsrdquoKnowing ones baselinemdashhow the breasts normally look and feelmdashis key to identifying even small deviations earlyThe hidden challenge of breast densityBreast density is a critical yet often underdiscussed factor in detection particularly for women in their 40s Dense breast tissue not only increases cancer risk but can also hide tumours on a standard mammogram because both appear whiteGhugare explains this lsquomasking effectrsquo Many women in their 40s have dense breasts due to ongoing hormonal activity Knowing your breast density is vitalmdashit should be mentioned in your mammogram report If you have dense breasts talk to your doctor about what additional screening you might needrdquoShe emphasises that for women with dense breasts a strong family history or genetic predisposition relying solely on an annual mammogram may not be enough ldquoSupplemental imaging such as breast ultrasound digital breast tomosynthesis 3D mammogram or breast MRI can help detect cancers that a standard mammogram may missrdquo Ghugare advisesNeed for selfadvocacyldquoDuring an annual health checkup after 40 women should be proactive in discussing their breast health to ensure that screening recommendations are tailored to their individual risk profile Personalised screening starts with an open and informed conversation with your doctorrdquo says ShahShe recommends women to be prepared to ask key questions including1 How to do a proper breast selfexam2 Whether genetic testing is appropriate3 If screening should begin earlier due to family history4 What symptoms warrant immediate medical attention5 What should be the recommended frequency of clinical breast examinations or imagingLifestyle modificationsWhile not all breast cancers can be prevented lifestyle plays a major role in lowering overall risk In your 40s adopting sustainable habits can have a lasting protective impact Shah notes that lifestyle plays a major role in lowering overall risk Protective measures include1 Avoiding tobacco use entirely2 Limiting alcohol consumption3 Maintaining a healthy weight and balanced diet4 Engaging in regular physical activity at least 150 minutes of moderateintensity exercise per weekGhugare concludes with an empowering message for women entering this critical decade She says ldquoYour 40s are the decade to be breastaware not breastanxious Listen to your body track whatrsquos normal for you and never hesitate to ask for clarity or additional tests Awareness not fear is your best defencerdquo