Of the total carcinoma of breast global burden 45% percentage. Earlier the only treatment option was radical mastectomy but since last years there has been great advancements. The women now have options which are breast sparing to choose from.
Breast Cancer incidence in Indian women is on the rise and in the urban locales of India it is the most common cancer and 2nd highest in rural settings. Even though the incidence is low as compared to other countries, it is on the rise in India. The numbers clearly indicate that breast cancer has in India overtaken cervical cancer. Causing factor is aggressive modulation of our life patterns towards industrialization vis a vis urbanization.
India although has availability of modern and excellent treatment regimes for breast cancer, the treatment quality given to the patient depends largely on the place of treatment. Protocol-based combined therapy treatment inspite of being available; a large number of breast cancer patients are subjected to inadequate and inappropriate treatment due to many a times lack of proper finances, lack of access to quality healthcare infrastructure and resources. The sad state of breast cancer in India is because of general indifferent attitude towards female health, unavailability of breast cancer screening programs in rural areas specially, combined with social stigma and shortage of finances, the delayed diagnosis results in poor outcome. The treatment received by the patient in such a scenario where the disease is advanced and there is lack of quality therapy is compromised. Dismal overall survival of Indian breast cancer patients and higher locoregional recurrences need immediate attention.
As a percentage cumulative of all cancers, breast cancer forms a major 33% alone, thus giving a direct picture of how huge the actual numbers would be. This means that one – fourth of all presented female cancer patients, are breast cancer patients.
The recent trend in India has shown an age shift in the affected age group - increasingly the younger age group is being affected by the disease. The younger (below menopause) the affected age more aggressive is the cancer. It is now more common in the 30’s and the 40’s.
Over 50% of breast cancer cases are presented to a clinical settings in stages 3 & 4. Thus adversely affecting the morbidity and the mortality statistics. The late presentation is a clear indication of lack of awareness among the population, affecting the sustenance of life unfavorably. Statistical reports clearly show that only 60% of affected female population is able to survive the disease. The impending need for spreading breast cancer awareness cannot be emphasized more, and also the need for breast cancer screening. These two will significantly contribute in actual decrease of morbidity and mortality numbers. The primary reason of lack of breast cancer awareness causes delayed presentation and thus even with the best combined therapy (however aggressive) the result is not favorable. With mass awareness of breast cancer screening we can have better survival percentage.
The important thing to understand is that there are more chances and better options if the disease is diagnosed at an early stage. Also all lumps in the breast are not malignant or cancerous. If a woman feels that there is alteration in breast shape, may be indentation of nipple or of skin over the breast then she needs to go in for a check-up. Also mostly the lumps are painless so the screening of breast cancer for early detection is important. It is not clear what causes the cells to become cancerous but once they become malignant they spread infecting other cells in the vicinity, they may infect the lymph nodes and other cells. 5 – 10% of cancers are genetically passed, then there may be history of exposure to radiation or cancer causing chemicals resulting in the mutation of cells.
Retinoids, flaxseeds is the way forward in breast cancer. Retiniods have natural compounds which destroy cancerous growth and flaxseeds lowers estrogen in the body. Both help in controlling of the disease.
Treatment for all stages and all types of cancer is available. Mostly it is surgery in combination with radiation, chemo or hormonal therapy. In some cancer treatment hospitals even experimental treatments are available which make a part of clinical research and involve advanced and new technologies.
With low awareness standards mostly “symptomatic” cancers are brought to forefront and that too at later stages. The way out is uncompromising promotion of awareness, urgent screening and proper treatment. Going forward, we need to emphasize on health education focusing on breast cancer, breast cancer screening for early diagnosis and detection of breast cancer, and requirement of increased number and better access to public healthcare facilities for cancer treatment.