Breast cancer is the most frequent cancer among women, impacting over 1.5 million women each year, and also causes the greatest number of cancer-related deaths among women. The incidence of breast cancer is increasing in the developing world due to increase life expectancy, increase urbanization and adoption of western lifestyles. Although some risk reduction might be achieved with prevention, these strategies cannot eliminate the majority of breast cancers that develop in low- and middle-income countries where breast cancer is diagnosed in very late stages. Therefore, early detection in order to improve breast cancer outcome and survival remains the cornerstone of breast cancer control.
Breast cancer is now the most common cancer in Indian women having recently overtaken cervical cancer in this respect. In India, we are now witnessing more and more numbers of patients being diagnosed with breast cancer to be in the younger age groups (in their thirties and forties). There is a significant increase in the incidence and cancer-associated morbidity and mortality in Indian subcontinent as described in global and Indian studies. Earlier cervical cancer was most common cancer in Indian woman but now the incidence of breast cancer has surpassed cervical cancer and is leading cause of cancer death, although cervical cancer still remains most common in rural India. According to study published in Asia-Pacific Journal of Clinical Oncology, breast was found as high as 41 per 100,000 women for Delhi, followed by Chennai (37.9), Bangalore (34.4) and Thiruvananthapuram District (33.7) in 2017. According to this study number of cases of Breast cancer will become almost double (17,97,900) by 2020.
According to health ministry of India breast cancer ranks as the number one cancer among Indian females with rate as high as 25.8 per 100,000 women and mortality of 12.7 per 100,000 women. India continues to have a low survival rate for breast cancer, with only 66.1% women diagnosed with the disease between 2010 and 2014 surviving, a Lancet study found. The US and Australia had survival rates as high as 90%, according to the study.
Globally, about 10% of breast cancer is genetic or due to an inherited DNA mutation. But a recent study suggests that there may be a greater occurrence of genetically-linked breast cancer among Indian women. Most inherited breast cancer cases are because of defective breast cancer genes called BRCA1 and BRCA2, where BRCA stands for breast cancer.
The major reason are Lifestyle changes such as bearing a child late in life, lack of breastfeeding, medical use of hormones, menarche occurring in younger people, lack of awareness of early signs of breast cancer and screening methods, secondly non- availability of diagnostic centres and knowledgeable oncologists. The domains that need attention include primary prevention, secondary prevention (early detection), diagnostic modalities including pathology, treatment, palliative care, and translational research including biomarkers. There need to be systematic efforts at researching, preserving, and promoting those factors that “protect” Indian women from breast cancer.
Source: Epidemiology of breast cancer in Indian women. DOI: 10.1111/ajco.12661, Breast cancer: Indian experience, data, and evidence, doi: 10.4103/2278-330X.187552, WHO, breastcancerindia.net, livemint.com, scroll.in