As breast cancer incidence rises, doctors emphasize the importance of early detection and the need for women to be aware of the disease.

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One in 19 women in Chennai between the ages of 0 and 74 are at risk of developing breast cancer in their lifetime*. Compared to other parts of Tamil Nadu, the city has the highest crude incidence rate (CIR) of breast cancer at 51.8 per 100,000 population. Multiple factors are driving the rise in breast cancer incidence, data from the Institute of Cancer Research (WIA)'s Tamil Nadu Cancer Registry Project 2019 shows.

V. Sridevi, professor of surgical oncology at the Cancer Institute, said the significant increase in breast cancer incidence is a real concern. “When a woman finds a lump in her breast, it takes six to eight months before she sees a doctor, and most of the time she doesn't get the right doctor. You have to see the right doctor for that,” she said.

What are the main factors driving the increased incidence? Dr. Sridevi says only about 5-10% is due to a family history of breast cancer, and many factors contribute to the remaining 90%. He said that One of these is lifestyle changes such as diet, delayed childbearing, and nulliparity (no children), which also increase the risk of breast cancer.

R. Swaminathan, professor and director of the Department of Epidemiology, Biostatistics and Cancer Registry and deputy director of the Cancer Research Institute, said, “Factors such as later age at marriage and later age at first birth are natural reasons for the increase in breast cancer. “There is,” he pointed out. For women. The average age at first birth has increased by 5 to 10 years over the past 30 years. This is due to many reasons such as education, profession and women empowerment,” he added.

However, thanks to increased levels of awareness over the years, early diagnosis of cancer is now possible. “At the Cancer Institute, about 25 years ago, 60% of women had locally advanced cancer (stage 3). Today, about half of patients are in the early stages. This is a clear change.” said Dr. Sridevi.

The state health department Community-based organized cancer screening It was rolled out in Erade Health Unit District in November 2023. The initiative is being piloted in four districts – Erode, Ranipet, Kanyakumari and Tirupattur and will be rolled out across the state in future. TS Selvavinayagam, director of public health and preventive medicine, said one area of ​​concern is the reluctance of people with suspected symptoms to undergo higher evaluations for further confirmation.

diagnosis and treatment

Arvind Krishnamurthy, professor and chair of surgical oncology at the Cancer Institute, said the presence of dense breasts, as evidenced by mammograms, has been shown to be associated with a higher risk of developing breast cancer, and that this issue is a major issue for the U.S. Food and Drug Administration. He said the project is attracting the attention of the bureau. As of September 10, all mammograms include information about breast density.

Surgery remains one of the mainstays of breast cancer management. “It has traditionally been believed that safe surgery requires a modified radical mastectomy, or complete removal of the breast and axillary lymph nodes. However, evidence from the past few decades suggests that axillary preservation ( Studies suggest that breast-conserving options, including sentinel lymph node biopsy), are safe in early-stage breast cancer, and some studies even suggest that the results of breast-conserving protocols are actually safe. It is better than protocols that involve removal of the entire breast,” he added.

Dr. Krishnamurthy said the growing popularity of oncoplastic surgery has also improved cosmetic outcomes for women undergoing breast-conserving surgery.

[*This is the cumulative risk of acquiring breast cancer in a woman’s lifetime from birth to 74 years of age calculated by a formula using summation of 5-year age specific incidence rates up to age 74]