Dr Srinivas Reddy, Senior Surgical Oncologist, Kamineni Hospitals highlights that there is an exponential increase in breast cancer cases since last few years. The mean age of onset of breast and ovarian cancer has dropped considerably and we are now diagnosing many young women with cancer, which is indeed very alarming!
National cancer registry program report 2020 released by ICMR-NCDIR, estimates a whopping 12 per cent increase in cancer cases by 2025.
Increasing life expectancy combined with increased screening for cancer, and improving access to health care have contributed to the rising numbers. On an average, women live longer than men and that also goes on to increase their chances of getting cancer.
According to latest statistics, gynecological cancers, including breast cancer, account for more than half of all cancers in women. Of these, over a quarter were breast cancers (25.4 per cent) followed by cervix cancer (15.2 per cent). The others to follow are ovarian cancer, uterine cancer, lung, gastro and oral cancer.
There is an exponential increase in breast cancer cases since last few years. The mean age of onset of breast and ovarian cancer has dropped considerably and we are now diagnosing many young women with cancer, which is indeed very alarming!
Adoption of western life style, improper dietary food habits, sedentary life style causing obesity, Smoking, alcohol, delayed marriage, nulliparity, delayed first pregnancy and avoiding breast feeding all have contributed to this rapidly increasing incidence.
Knowledge of risk factors for breast cancer, breast self examination and screening mammograms are essential in early detection of breast cancer.
As compared to the past, we have noted a considerable increase in awareness in general population with a knowledge about breast cancer and adoption of breast self examination. Pink walks and pink talks have indeed helped considerably in spreading awareness and should be continued.
Though still many women report for medical help only with locally advanced breast cancer, we are seeing an uptrend in the detection of early breast cancers including non palpable lumps detected with screening mammograms and wire localisation.
This gives a chance for the women to have a breast conservation surgery when detected in early stage, giving an appealing aesthetic outcome along with cure. Screening mammograms and breast ultrasound are proven imaging methods as part of triple assessment for breast lumps.
Newer imaging modalities are evolving
- Digital breast tomosynthesis produces a 3D breast info and aids in detection of lesions not seen in conventional mammogram.
- High resolution ultrasound, 3 D ultrasound, contrast enhanced ultrasound with microbubbles, and Sonoelastography are other evolving methods.
- MRI is used for screening of high risk groups, with BRCA positive mutations, multicentricity and breasts with implants.
- It is being studied now with diffusion, elastography and spectroscopy also.
- Thermography with microwaves and infra red waves have been studied as an alternative non invasive, painless imaging methods using non ionising rays.
Apart from advances in imaging, BRCA gene testing using Next generation sequencing is increasingly being used in young women with triple negative cancers.
Cervical cancer is the second most common cancer in women. Though the incidence and mortality of cervical cancer has declined over the past 2 decades, it is still a major concern in our country.
The situation is more alarming in rural areas, due to illiteracy, poor hygiene, early marriage and lack of proper screening facilities. A trend of decline in the incidence rates in urban areas, truly represent the life style changes, better access to screening, health care, HPV vaccines, all of which are not reflected in rural areas.
Simple screening with pap smear and visual inspection with acetic acid with magnification and Lugols iodine, at primary health centres have been of immense help to detect cervical pre-cancers and cancer at early stage in rural women.
Improved access to health care facilities for colposcopy and HPV DNA will be even more beneficial. HPV DNA testing has proven to be more effective than pap smear alone and saves more lives..
Myths about HPV vaccine should be busted. Girls and their parents should be educated and encouraged to take HPV vaccine.
Newer cost effective modalities to improve screening under large scale in rural areas have been under research. Single life time screening particularly of high risk women along with analysis of cost effective tumour markers such as Argyrophilic nucleolar organising regions ( AgNOR) pleomorphic counts, to discriminate high risk dysplasia cases appears to be a reliable approach for the vast rural indian population and is being studied. For ovarian and uterine cancers, reporting early to doctor at symptom onset and prompt treatment is the only way, as we don’t have any proven screening tests.
Education and awareness is the key for Early detection of cancer. It is our responsibility to spread this awareness among all our women and protect them.
Woman! You are very precious! Be aware and beware of this menace !
The time to come forward is NOW !