Alarming rise in breast cancer cases in India

Picture this: According to a study by Globocon 2020, In India, every four minutes a woman is diagnosed with breast cancer. With some 1,78,000 new cases being diagnosed every year, the incidence of breast cancer has overtaken cervical cancer to become the most common cancer in Indian women.

What is more alarming is that it is being increasingly diagnosed at a younger age (a decade earlier) in India compared to the West. With 90,000 deaths per annum, tragically, a woman loses her life to breast cancer every eight minutes in the country. For every two women diagnosed with breast cancer, one dies of it.

Dr P Raghuram, director and consultant surgeon, KIMS – Ushalakshmi Centre for Breast Diseases, has been working to create awareness about the importance of early detection through several initiatives in Telangana and Andhra Pradesh. He holds forth on a few myths and facts about the cancer:

Breast Self-Examination (BSE)

It is a regular and repetitive monthly self-examination of the breast performed by a woman at the same time each month to a set method. Here are a few changes to look out for during BSE:

    * A change in size — one breast may have become noticeably larger or smaller

  * A  nipple has become inverted (pulled in) or changed its position or shape

    * A rash on or around the nipple

    * Blood-stained discharge from one or both nipples

    * Puckering or dimpling of the skin

    * A swelling under the armpit or around the collarbone

    *  A lump or thickening in the breast that feels different from the rest of the breast tissue

    * Constant pain in one part of the breast or the armpit.

Myth: Family history of breast cancer is the most important risk factor for getting breast cancer

Fact: The vast majority of women with breast cancer do not have a family history of breast cancer. Strong family history (genetic predisposition) accounts for only 5% to 10% of breast cancers. Those who have abnormalities in BRCA 1 & BRCA 2 genes have a significant lifetime risk of getting breast and ovarian cancer. Not everyone who has BRCA positivity gets breast/ovarian cancer. The Genetic test should only be considered when there is a significant family history of breast cancer (high risk group) and that too only after adequate genetic counselling.  

The high risk group

* One or more close relatives who have had breast cancer before the age of 40.

 * Two or more close relatives who have had breast cancer at any age

 * Close relatives who have had breast cancer and others who have had ovarian cancer

* One close relative who has had breast cancer in both breasts (bilateral) or who has had breast and ovarian cancer

* Male relative who has had breast cancer

Cancer in young people

 Myth: Young women don’t get breast cancer.

Fact: Although the majority of breast cancers occur in women over the age of 50 in the western world, they can occur at any age. A majority of breast cancers in India are diagnosed in younger women — the peak incidence being 40 – 50 years. This is perhaps because we are a young nation (87% of India’s population is under the age of 50)

Childbirth and breastfeeding

Myth: Childbirth and breastfeeding keep breast cancer away

Fact: Any factor that results in uninterrupted exposure to the hormone oestrogen over a prolonged duration can potentially cause breast cancer. Having the first pregnancy after 30 and not breastfeeding can raise the risk of developing breast cancer.

Mammogram risk

Myth: Mammogram can cause breast cancer

Fact: Mammography involves a tiny dose of radiation – the risk to health from this is insignificant. The radiation dose delivered during mammography is the same as receiving a dental X-ray and does not cause breast cancer. The benefits of annual screening mammogram after the age of 40 far outweighs any risks. 

Men and cancer

Myth: Men will not get breast cancer

Fact: Many people are unaware that men can develop breast cancer because they do not think men have breasts. In fact, both men and women have breast tissue. A small proportion of men do get breast cancer each year. Although precise statistics in India are unknown, approximately 350 new cases of breast cancer are diagnosed in men each year in the United Kingdom (approximately 1% of breast cancers).