Can I lower my risk of breast cancer?

Can I lower my risk of breast cancer?

In 2020, 2.3 million women were diagnosed with breast cancer and more than 6 lac deaths were reported globally, making it the world’s most prevalent cancer.

India’s National Health Profile predicted that by 2022, breast cancer will overtake cervical cancer as the most common type of cancer among women in India. Breast cancer is the commonest cancer in urban areas in India and accounts for about 25% to 33% of all cancers in women. In Mumbai, it accounts for 28.7% of all cancers.

The life time risk of having breast cancer in women is 1 in 8 in the US, while in India its 1 in 30 in rural & 1 in 60 urban regions. The World Health Organization(WHO) has predicted that by 2022, one in every eight urban Indian women would develop breast cancer in her lifetime.

The rising trend among urban women is due to lifestyle changes and family history among other causes such as environmental factors, delayed pregnancy or never being pregnant, obesity and hormone use, including long-term contraceptive use or postmenopausal hormone therapy.

The objective of the WHO Global Breast Cancer Initiative (GBCI) is to reduce global breast cancer mortality by 2.5% per year, thereby averting 2.5 million breast cancer deaths globally.

The majority of Indian population having breast cancer is young unlike most western countries. At present, I feel younger breast cancer patients aren’t being brought to hospitals for diagnosis or treatment. Because women are shy, they don’t complain when they find a lump in their breast.  This is the reason they mostly get diagnosed very late & in the advanced stage. Combine this with the fact, that over 50% breast cancer patients in India present in stages 3 and 4, which definitely impact the survival. The American Society of Clinical Oncology(ASCO) states that the overall 5-year survival rate of breast cancer patients in the United States, has improved from earlier 75% to 90% presently but in India, the 5-year survival is only 60-65%.

The management of breast cancer requires multimodality treatment such as surgery, chemotherapy, radiation and hormonal therapy which cause a huge cost to the patients. Most of the time, it’s the cost which is the key factor for delay in treatment.

Breast cancer that’s found early, when it’s small and has not spread, is easier to treat successfully.  Regular breast cancer screening by self-examination after age 20, post the 5th day of menses every month is recommended. Guidelines also recommend a mammography after the age of 50 once in 2 years. For a woman of high risk, apart from self-examination, we recommend examination by an expert annually with mammogram or MRI. WHO says there is significant evidence to show that mammography screening among women aged 50-70 years reduces mortality by 15% to 25%.

Currently, the surgery for breast cancer has undergone novel changes from traditional procedure of radical mastectomy to the era of oncoplasty & reconstruction.

The WHO’s Global Breast Cancer Initiative mentions that public health education to improve awareness of the signs and symptoms of breast cancer is an important strategy in reducing deaths globally.