Young mother, 38, beats aggressive breast cancer because she did regular breast self-examination: ‘Know your body like your life depends on it’

Apurva says she is an observant person and noticed the lump in her left breast as she had been aware of breast self-examination techniques. “My husband was out of town. When I told him, his first reaction was denial. But deep down, we both knew,” she says. Their fears were confirmed after a breast ultrasound, mammography and an FNAC (Fine Needle Aspiration Cytology) test, which extracts a small sample of cells or fluid from a tissue mass. She had three tumours, two in her left breast and one in her underarms.

“Many women tell me they had felt a lump long ago but didn’t take it seriously. They say, ‘It didn’t hurt, so I ignored it.’ But breast cancer often doesn’t cause pain. They waited, hoping it would go away on its own. The trauma of the diagnosis is heavy and the fear of what it might lead to is sometimes paralysing. But silence is dangerous,” says Dr Suhani, additional professor in the Department of Surgical Disciplines, All-India Institute of Medical Sciences (AIIMS), Delhi, and the surgeon who did Apurva’s mastectomy.

Why early detection helps

That’s why she emphasizes early detection, advising women over 20 to perform a breast self-examination at least once a month. Apurva gave herself the best chance possible because she did so. “Every woman should make it a habit to examine themselves. It helps you detect changes in your own breasts early, see whether any lump or nipple discharge or breast asymmetry has appeared,” says Dr Suhani.

Mammography, too, plays a vital role in early detection. For women with access to healthcare, she recommends a baseline mammogram at age 40, then annual or biennial screening through the 40s and yearly checks after 50 up to age 70. “Individual risks may vary but consistency is the key,” she adds.

Challenges during treatment

Apurva needed chemotherapy to shrink the cancer before her surgery. But despite the peak of COVID-19, she didn’t miss her sessions. “Yet chemotherapy doesn’t always guarantee a positive response. That’s why follow-ups during treatment are critical. After every two or three cycles, we assess the tumour. Is it shrinking? Has it stopped responding? Should we change the approach? This constant monitoring is crucial for the patient,” says Dr Suhani.

Although Apurva’s cancer was aggressive, it responded well to chemo, shrinking by the eighth cycle. But not without side effects. Dr Haresh KP, professor, radiation oncology, prepared her beforehand, saying the chemo could make her feel like a 90-year-old. “We have a combined clinic where we get patients coming for chemo post-surgery as well. I see many patients from all strata of society presenting themselves at an advanced stage. It shows how important self-examination of the breast is. It can be done by every woman every month regardless of her educational status. That self-check can save lives,” says Dr Haresh.

Apurva with her husband. (Express Photo)

Apurva remembers how detailed the process was. Every chemotherapy drug that was infused into her was calculated according to her weight, height and physical condition. During these sessions, she brought her crochet kit to the chemo ward. “Other patients would be crying, talking to nurses. I would sit and knit. It was my way to calm my mind. I was very slow but I wanted to stay productive. I also kept chanting quietly,” says Apurva.

When the last chemo cycle ended, another lockdown was announced, delaying her surgery by three weeks. “We were scared. If the surgery didn’t happen soon, I would have to undergo chemo again. Thankfully, AIIMS came through with an emergency surgery slot,” she says. She underwent a mastectomy — removal of the left breast — and axillary lymph node dissection, where multiple lymph nodes from under her arm were removed to contain the spread.

Life after surgery

Recovery came with its own life-long adjustments. Apurva now lives with a prosthetic breast, avoids crowded places, wears full sleeves to protect her sensitive arm and cannot wear watches, bangles or rings on her left arm. “Even a mosquito bite or a cut won’t heal easily. I have to be careful,” she says.

She has also made significant lifestyle changes —cutting down sugar, increasing her intake of Vitamin C, including fruits and leafy vegetables in her daily diet and building immunity while on immunosuppressants.

Given that triple negative breast cancers have a tendency to recur, at the same site or another, Apurva remains vigilant through follow-ups. “Catching anything early can change the prognosis entirely. Triple-negative tumors, for instance, tend to recur earlier, though not always,” she says.

The emotional cost of therapy

Family support matters during this stage. Dr Suhani recalls how one woman was abandoned by her husband after diagnosis and left to deal with chemo sessions on her own. But there are others who stand by their loved ones through the worst. “One man cared for his wife for nearly eight years through every appointment, treatment and complication. Same society, same disease but very different responses,” she says.

Then there are stories of emotional wounds that cut deeper than surgery. One woman who underwent reconstructive surgery after mastectomy was still visibly distressed. When asked why, she revealed her husband had told her she was “of no use” anymore. “That is the kind of cruelty we still see. And it’s devastating. Support makes all the difference. Because no matter how strong a treatment plan is, it’s the patient who has to live through it physically, emotionally, every single day,” says Dr Suhani.

Apurva is now in remission. She conducts talks with AIIMS doctors at the community level on regular self-examination, seeking medical advice even for the slightest irregularity and pushing for proper testing. “Don’t wait for symptoms to scream at you. Know your body like your life depends on it because it does,” she says.