It was out of the blue that Kamala Krishnan* noticed a lump on her right breast a year ago. "I ignored it. The thought of cancer did not even occur to me -- after all I was only 26 years old," she says.

It was only a month later, when the lump had still not gone away and after much urging from her husband, that she decided to visit the doctor. Her nipples were also inverted -- a symptom the significance of which she realised only when the oncologist at Manipal Hospital berated her for not coming in earlier.

"Waiting for the biopsy results was the worst period of my life. I was filled with anxiety -- for my family, for my 3-year-old child, for myself. I remember thinking, 'This is not possible,' " she reminisces.

Kamala's results confirmed her most dreaded fear -- she was diagnosed with Stage III cancer, which had spread to a few lymph nodes as well. She opted for a second opinion, but the answer stayed the same.

An aggressive round of treatments began. Three months of chemotherapy to shrink the large tumour were followed by a radical mastectomy and immediate breast reconstruction.

Post surgery, Kamala's life was in turmoil. "There were so many questions running through my mind," she recalls. "Will my husband find me attractive with these scars? What if I want to have another child -- will I be able to?"

The surgery was followed by four weeks of radiation therapy. Kamala tolerated the treatment well, with only a few side effects like vomiting and fatigue. "Thank God there was no hair loss!" she exclaims. "I remember asking my husband to question the doctor why I was not suffering from acute side-effects. I feared that maybe the treatment was not really working!"

Twelve months later, Kamala's life is slowly returning to normal. She continues to take anti-oestrogen medication and has to go for regular medical checkups every three months, to guard against the return of the cancer.

The chemotherapy did affect her life in that she has stopped menstruating. She does not know whether this effect is temporary or permanent -- only time will tell. Also, the doctors have told her that she must not try to conceive while on anti-oestrogen medication.

At the 1st Asian Breast Cancer Conference held in New Delhi [Images] earlier this year, it was revealed that the incidence of breast cancer is rising among young women, especially in Asia (for more information, click here). Like Kamala, most cases of breast cancer in the young are unfortunately diagnosed in the advanced stages, since younger women often ignore the symptoms as passing blemishes on a perfect body.

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Why and how did Kamala get breast cancer?

The following factors are associated with an increased risk:

But none of the above applied to Kamala.

All she knows is that a distant aunt from her mother's side of the family probably died of cancer. Did she inherit altered BRCA1 and BRCA2 genes, which heighten the risk of developing breast cancer?

Only a gene test can give one the answer. So Kamala strongly advises young women whose close relatives have died of such an illness to find out more. "Be curious," she says, "It could save your life. Talk to a doctor about your risk of developing breast cancer. Don't be fearful of getting the disease -- be fearful of not finding out early enough. Get yourself tested."

In fact, after her recovery, the first thing Kamala did was get her 22-year-old younger sister Sunita* tested for breast cancer, but she was fortunately in the clear.

A breast self-examination is one of the best screening tests for all females older than 15 and especially for those who are at higher risk (due to a family history of breast cancer). It is important to get familiar with the shape and size of your breasts and talk to the doctor if you notice anything unusual.

Here's how you can conduct a self-examination at home:

• Remove all clothing from the waist up and stand before a mirror, so you can see your breasts clearly.
• Place your hands on your hips and look for any signs of breast abnormalcy in the mirror -- dimpled skin, swelling, soreness, redness or inverted nipples.
• Raise your hands above your head and look once more for any unnatural signs.
• Next, you need to feel for any lumps. Using your right hand to check your left breast, mentally visualise the breast as divided into four equal parts and using your fingers, run them in small circular motions over one part at a time. Don't poke the breast with your fingertips; keep your fingers flat and feel with with gentle prodding for any unnatural lumps. You need to cover the entire area of the breast. Repeat the same for the right breast.
• Next, lie down flat on your back and re-check both breasts in the same manner described above.
• Finally, gently squeeze both nipples to check for any abnormal discharge.

While health professionals usually recommend that you conduct a breast self-examination at home, it is not a foolproof method. It may be possible that you miss out on a lump or unnatural characteristic. That is why a mammography is usually advised for women who are more than 40 years of age, though sometimes it may be used for high-risk younger women as well.

Here are a few tips on how to prevent breast cancer:

"There is no need for women to worry," says Kamala. "Just remain aware that these things do happen." Adds her sister Sunita, "Be inquisitive when it comes to your health and take necessary steps, so that you can look forward to a full life as a daughter and sister and someday as a wife and mother. I have."

*Names changed to protect identity.

Meenakshi Hejmadi, RD (IDA, ADA) is a dietitician with NutritionVista.com.