Breast Cancer in India
Rising incidence of breast cancer in India
Breast cancer is now the most common cancer in most cities in India, and 2nd most common in the rural areas. Breast cancer accounts for 25% to 32% of all female cancers in India
Age shift: Breast cancer now more common in 30's and 40's
In India, the average age of developing a breast cancer has undergone a significant shift over last few decades.
25 years back, out of every 100 breast cancer patients, 2% were in 20 to 30 years age group, 7% were in 30 to 40 and so on. 69% of the patients were above 50 years of age. Presently, 4% are in 20 to 30 yrs age group, 16% are in 30 to 40, 28% are in 40 to 50 age group. So, almost 48% patients are below 50. An increasing numbers of patients are in the 25 to 40 years of age.
Late presentation and decreased survival
In India more than 50% patients of breast cancer present in stages 3 and 4, and outcome of the treatment is not as good as earlier stages, however aggressive the treatment may be. The western nations have achieved a steadily improving and good survival mainly because of screening of breast cancer.
Lack of awareness of breast cancer, lack of screening
In India, healthcare is low on priority, even in major cities Screening is also an 'alien' word for most people. So naturally, this results in most people presenting only when symptomatic, and on an average, most 'symptomatic' cancers are stage 2B and beyond (significant numbers in stages 3 and 4). So the breast cancer patients do not tend to survive for a longer time, as their western counterparts.
In the West, majority of breast cancers (more than 75%) present in stages 1 and 2, resulting in good survival; and there is an ever increasing numbers of patients presenting with mammography detected cancer, with no symptoms. India needs to reach this achievement, and it is only withaggressive promotion of screening and awareness and proper treatment that India will achieve this
Aggressive cancers in the young
Cancers in the young, tend to be more aggressive. Many of these cancers are HER2 positive and ER/PR negative, or HER2/ER/PR all three negative, and they have a worse prognosis than those who have ER/PR positive tumors. Hence we need to catch these cancers early. The chances of long survival decrease fast with increasing stage of these tumors.
For the United States, for the year 2012:
- 232,714 women were newly detected with breast cancer
- 43,909 women died of breast cancer
- 232714 / 43909 = 5.29 = round it off to 5 or 6. So roughly, in the US, for every 5 or 6 women newly diagnosed with breast cancer, one lady is dying of it.
For India, for the year 2012:
- 144,937 women were newly detected with breast cancer
- 70,218 women died of breast cancer
- 144937 / 70218 = 2.06 = round it off to 2. So roughly, in India, for every 2 women newly diagnosed with breast cancer, one lady is dying of it.
Incidence of breast cancer in Bengaluru
- Breast cancer is the commonest cancer in women in Bengaluru
- Breast cancer accounts for 27.3% of all cancers in women in Bengaluru.
- We are witnessing breast cancer in much younger ages than earlier
- The numbers of breast cancer cases in all age groups is rising rapidly
- More than half the patients still present to doctors in advanced stages
- Breast cancers in the young tend to be more aggressive than cancers in the older population, and survival in younger patients, especially in advanced stages, is lesser.
So the NEED OF THE HOUR is awareness, beginning from 20 years of age, and regular screening from a qualified doctor, Mammogram for patients above 40 years of age once a year, so that we can detect the cancer early and treat it in earlier stages thereby giving a chance of longer life for the patient as also decreasing the chance of a recurrence.