Insufficient Breast Cancer Diagnosis in India: Causes, Tests, and Treatment Options You Should Know

All bras in this installation belong to the visitor. The Cardrona Bra Fence in Cardrona, New Zealand is part of a social campaign by the New Zealand Breast Cancer Foundation near Queenstown. Image: Pablo Heimplatz / Unsplash

Breast cancer is the number one cancer among women in India and accounts for 14 percent of all cancers in women. Overall, 1 in 28 women in India (1 in 22 in urban areas and 1 in 60 in rural areas) can develop breast cancer during their lifetime in urban areas. The number of breast cancer cases reported each year is increasing at an alarming rate. Breast cancer is according to data from Globacan 2018 27 percent Of all new cancer cases. According to 2018 ICMR data, more than 15,000 rupees of new breast cancer cases have been recorded in India. The trend for new cancer patients is increasing, and the age group of new patients coming each year is gradually declining from under 55 to under 40.

The overall number of India is superior to that of developed countries such as the United States / United Kingdom, with one in eight women being diagnosed each year. However, the level of awareness of illness in developed countries is so high and there is plenty of government funding to promote timely detection, so most cases are detected and treated early, leading to better survival.

The yellow box shows where the cancer was found in the mammogram by the AI ​​that the radiologist could not detect.Image: Northwestern University

On the other hand, in India, the survival rate is considerably low due to the large population and low awareness rate. One in two women diagnosed with breast cancer will die within the next five years. This is due to a 50% mortality rate. One of the main reasons for high mortality is delays in diagnosis, primarily due to lack of awareness and lack of appropriate breast cancer screening programs, advanced diagnosis, and lack of appropriate medical facilities. Most breast cancers are diagnosed at a relatively advanced stage. Many patients in urban areas are diagnosed in stage 2, where the lesions become palpable lumps, but most often these lesions from rural areas are diagnosed only after they have transformed into metastatic tumors.

Causes of Breast Cancer

The exact cause of breast cancer is not yet known, but years of medical research have identified several risk factors. It is still unclear why some women at very high risk are unaffected, while some women without risk factors may develop breast cancer. It is best to be aware of and pay attention to warning signs, risk factors and precautions. Risk factors for breast cancer include genetics and heritage, sedentary lifestyle, delayed or no pregnancy, use of oral contraceptives, early onset of menstruation, delayed menopause, alcohol overdose, smoking, and increased obesity in young people. , Stress, lack of food intake, etc. These factors are due to the increased incidence of breast cancer in young Indian women.

Unfortunately, there is still no way to completely eliminate the risk of breast cancer. Risk factors such as genetic alterations of specific genes (BRCA1 and BRCA2), family history, etc. are beyond our control. If you have a family history of breast cancer – Mothers or sisters get cancer tumor markers on a regular basis or as advised by their doctor. However, you can minimize its impact by detecting it as soon as possible. Early detection provides the best protection against breast cancer.

Recommended screening protocol

Many studies have shown that regular screening of women without breast cancer symptoms has reduced the number of women who die of breast cancer. The purpose of breast screening is to detect breast cancer earliest when treatment is known to give the best results.

Self-breast examination

> Performed monthly according to the 20-year menstrual cycle

Clinical breast examination

20 to 30 years every year

30-60 years old every 6 months

Over 60 years a year

Mammogram screening *

<40-year ultrasound for assessment of suspicious findings on clinical breast examination

Annual mammogram for 40-55 years

Mammogram 55-70 years old every 2 years

*Perform only after evaluation of breast cancer by baseline mammogram

If breast cancer is detected early, breast-conserving surgery can be performed (rather than removing the entire breast) and, more importantly, avoiding chemotherapy in a selected group of patients with early-stage breast cancer. I can do it.

When should I consult a doctor?

Ideally, consult your doctor as soon as you see any changes in your breasts. This can extend to lumps, indelible abnormal pain, or even secretions of any kind. The following signs indicate changes in the breast and possible symptoms of breast cancer that require immediate attention.

• Changes in breast size, shape, or appearance
• Breast lump or just below the armpit
• Changes in the skin above the breast, such as dents
• Inverted nipple
• Scaling, exfoliation, or crusting of the skin around the nipple
• Redness of the skin of the breast
• Blood or abnormal secretions from the nipple

Treatment options

There are four treatment options for breast cancer

1. Surgery
2. chemical treatment
3. Radiation therapy
4. Hormone therapy

The treatment protocol is based on the stage of diagnosis. Not all patients may need all four treatment options. The advantage of early detection of breast cancer is that breast-conserving surgery can be performed (rather than removing the entire breast) and, more importantly, avoiding chemotherapy in a selected group of patients with early-stage breast cancer. You can do it.

So keep checking for abnormalities / abnormal changes in your chest from time to time. Keep in mind that early detection is key to proper treatment of breast cancer. Early detection is important for better treatment results and higher survival rates.

The author is a breast oncologist and heads the Breast Center at CK Birla Hospital.