At the moment, according to the Indian Breast cancer Registry, one in every 20 women is likely to have Breast cancer. But very soon by 2020, it is likely to meet the western statistics and the occurrence could be one in 10 women!
The dictum is that Unless otherwise proved treat any breast lump as cancer and go the reverse way till it is proved to be benign or otherwise. The first investigation is USG and a Mammogram (if the patient is above 35 years of age) to define whether it is a cyst or a solid lump. If it is a cyst a simple aspiration may suffice unless it recurs and then you need to excise it surgically. If it is a solid lump-fibroadenoma, excision is the treatment of choice with a cosmetic scar. If the USG/Mammography shows a doubtful lump, suspicious of malignancy, then a biopsy is advisable before further treatment.
FNAC-Fine needle aspiration cytology
Trust/Core biopsy-from four different quadrants and center give tissue diagnosis
Vacuum-Assisted Biopsy (VAB)-gives more tissue, done under USG/Mammography guidance
Stereotactic Biopsy-done under Mammography guidance in lesions which are only mammographically visible and not palpable
Frozen section Biopsy-in doubtful cases
Nipple discharge cytology
Ductoscopiclavage cytology and biopsy
The exact cause is yet unknown. But there are a number of risk factors like-Early menarche, Latemenopause, Late first pregnancy, No breast feeding, Oral contraceptives or hormonal pills for Hormonal replacement therapy (HRT), Alcohol, Fatty die but most importantly it is the stress which leads to hormonal changes which eventually leads to some changes in the response of these hormones on the breast tissue. There is also a role of genetic factor or family history and previous occurrence of the disease.