A Screening Test Could Save Your Life — Cervical & Breast Cancer Explained
Two of the most common cancers affecting women — cervical cancer and breast cancer — share a powerful truth: when detected early, both are highly treatable, and many lives are saved simply through regular screening. Yet in India, a significant number of women with these cancers are diagnosed at advanced stages, when treatment is far more complex and outcomes less certain. This does not have to be the case. Early detection, through accessible and well-established screening tools, can change everything.
Cervical Cancer — What Every Woman Should Know
What Is Cervical Cancer?
Cervical cancer develops in the cells of the cervix — the lower part of the uterus that connects to the vagina. It is the second most common cancer in Indian women. The overwhelming majority of cervical cancers — over 99% — are caused by persistent infection with high-risk strains of the Human Papillomavirus (HPV), a very common sexually transmitted infection.
Crucially, cervical cancer does not develop overnight. It passes through a detectable pre-cancerous stage — cervical intraepithelial neoplasia (CIN) — that may take 10 to 15 years to become invasive cancer. This slow progression is what makes screening so powerful.
Risk Factors for Cervical Cancer
• particularly with high-risk strains 16 and 18 HPV infection
• Multiple sexual partners
• Early onset of sexual activity
• HIV infection or immunosuppressive medications
• Long-term use of oral contraceptive pills
• Non-participation in cervical screening
Symptoms of Cervical Cancer
Early-stage cervical cancer often causes no symptoms — which is why screening is essential. When symptoms appear, they may include:
• Abnormal vaginal bleeding —between periods, after intercourse, or after menopause
• Unusual vaginal discharge —watery, bloody, or foul-smelling
• Pelvic pain or pain during sexual intercourse
• Advanced disease may cause back or leg pain, swelling in one leg, or urinary/bowel symptoms
Cervical Cancer Screening
• Pap smear (Pap test / cervical cytology) — a simple outpatient test in which cells are gently collected from the cervix and examined for abnormalities. Recommended every 3 years for women aged 21–65, or every 5 years when combined with HPV testing.
• HPV DNA test — detects the presence of high-risk HPV strains; highly sensitive; can be done alongside or instead of a Pap smear.
• Colposcopy —a detailed examination of the cervix using a magnifying instrument; performed when Pap or HPV results are abnormal.
• Biopsy —tissue sample taken during colposcopy to confirm or exclude cancer or pre-cancerous changes.
HPV Vaccination — Prevention Is Possible
The HPV vaccine is one of the most significant cancer prevention tools available. It is most effective when given before the onset of sexual activity — recommended for girls aged 9–14 as the primary target group, with catch-up vaccination up to age 26. Two-dose or three-dose schedules are used depending on age. The vaccine protects against the most common cancer-causing HPV strains and is now available for both girls and boys.
Treatment of Cervical Cancer
• Pre-cancerous lesions (CIN) — treated with LEEP (Loop Electrosurgical Excision Procedure), cryotherapy, or laser ablation; these outpatient procedures are highly effective.
• Stage I (confined to cervix) —surgery (radical hysterectomy with lymph node dissection) or radiation therapy with excellent cure rates.
• Stages II–III — concurrent chemoradiation (chemotherapy combined with radiation therapy) is the standard of care.
• Stage IV — palliative chemoradiation and targeted therapy; systemic chemotherapy.
Breast Cancer — Early Detection Saves Lives
What Is Breast Cancer?
Breast cancer is the most common cancer in women worldwide and in India. It arises from the cells of the breast — most commonly from the milk ducts (ductal carcinoma) or the lobules (lobular carcinoma). With advances in screening and treatment, the survival rates for early-stage breast cancer are now excellent — greater than 90% five-year survival for Stage I disease.
Risk Factors for Breast Cancer
• Female sex and increasing age (the greatest risk factors)
• Family history of breast or ovarian cancer
• BRCA1 and BRCA2 gene mutations — significantly elevated lifetime risk of breast and ovarian cancer
• Personal history of breast cancer or atypical ductal hyperplasia
• Early menarche or late menopause — prolonged oestrogen exposure
• Having no children or first pregnancy after age 30
• Not breastfeeding
• Postmenopausal hormone replacement therapy — particularly combined oestrogen-progestogen preparations
• Alcohol consumption — even moderate amounts increase risk
• Obesity, particularly after menopause
• Radiation exposure to the chest in early life
Symptoms of Breast Cancer
Breast cancer can be present without any symptoms — which is why mammographic screening is so important. When symptoms occur, they may include:
• A new lump or thickening in the breast or armpit
• Change in the size, shape, or appearance of the breast
• Nipple changes — inversion, discharge (particularly blood-stained), or crusting
• Skin changes —dimpling, puckering, redness, or an orange-peel texture (peau d'orange)
• Persistent breast pain (less commonly associated with cancer, but should be evaluated)
Any of these changes should be evaluated by a doctor promptly. Do not wait and watch.
Breast Cancer Screening
• Breast self-examination (BSE) —monthly self-examination increases awareness of normal breast texture and helps detect new changes; women should be familiar with how their breasts normally feel.
• Clinical breast examination —by a trained healthcare professional, annually for women over 40.
• Mammography — the gold standard screening test; a low-dose X-ray of the breast that can detect tumours before they are palpable. Recommended annually or biennially for women aged 40–74, or earlier and more frequently for high-risk women.
• Breast ultrasound — used as an adjunct to mammography, particularly in women with dense breast tissue or as the first-line tool in younger women.
• MRI of the breast — recommended for high-risk women, including BRCA mutation carriers.
Treatment of Breast Cancer
Treatment is individualised based on cancer stage, type, receptor status (ER, PR, HER2), and the patient's general health and preferences:
• Surgery — breast-conserving surgery (lumpectomy with radiotherapy) or mastectomy (with or without reconstruction); sentinel lymph node biopsy or axillary dissection.
• Radiotherapy — typically given after breast-conserving surgery; may also follow mastectomy in high-risk cases.
• Chemotherapy — given before surgery (neoadjuvant) to shrink tumours or after surgery (adjuvant) to reduce recurrence risk.
• Hormone therapy —for oestrogen receptor-positive breast cancers; tamoxifen for premenopausal women; aromatase inhibitors (anastrozole, letrozole) for postmenopausal women.
• Targeted therapy — trastuzumab (Herceptin) for HER2-positive cancers; CDK4/6 inhibitors for hormone receptor-positive metastatic disease.
• Genetic counselling and BRCA testing — recommended for women with a significant family history, to guide preventive options.
Cancer Screening & Treatment at Believers Hospital, Thiruvalla
At Believers Hospital Thiruvalla, women's cancer care spans early detection through specialist treatment. Our Department of Obstetrics & Gynaecology offers Pap smear testing, colposcopy, HPV vaccination, and management of cervical pre-cancer. The Believers Institute of Cancer Care brings together Medical Oncology, Surgical Oncology, Radiation Oncology, and a dedicated multidisciplinary tumour board for comprehensive breast and gynaecological cancer management. Mammography, breast ultrasound, and MRI-guided assessment are available, alongside the full range of surgical, medical, and targeted treatments. Regular screening is not optional — it is life-saving. Please do not delay yours.