Wednesday, November 25, 2020

Over 60% breast cancer patients still diagnosed in late stages; Alarming rise of disease incidence in under 50 women

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Advanced treatment protocols and new age prognostic tests are helping breast cancer patients live longer with a better quality of life. However, over 60% of breast cancer cases in India are still diagnosed in late stages resulting in a large burden of preventable deaths.

As we observe Breast Cancer Awareness Month, Oncologists are underlining the need to increase early-stage diagnosis and make prognostic tests such as CanAssist Breast available to a larger number of patients. Doctors are also concerned by an alarming increase in disease incidence among women under 50 years of age.

“Diagnostic and treatment tools are highly advanced today and have given us the ability to save the lives of a majority of breast cancer patients. For example, prognostic tests such as CanAssist Breast can help early-stage patients identify their risk of disease relapse and avoid chemotherapy and over-treatment. Unfortunately, delayed diagnosis prevents a majority of patients from being able to access the benefits of such advanced prognostic tools. Over 60-70% of patients in India are still diagnosed in stages 3 and 4 when the disease has reached an advanced stage,” said Dr. Ashwin Rajagopal, Consultant, Surgical Oncology, Manipal Hospitals, Bengaluru.

While stage 3 is the stage of locally advanced cancer, by stage 4 the disease spread to other parts of the body and is impossible to cure.

Dr. Ashwin points to an alarming trend of an increasing surge of diseases among women under 50 years of age due to lifestyle changes including unhealthy diet, lack of physical activity, increasing incidence of smoking and drinking as well as delayed childbirths.

“Traditionally, breast cancer largely affected women above 55 years of age. However, this pattern has changed alarmingly over the past two decades. With lifestyle changes and urbanization, breast cancer is now afflicting an increasing number of women in their 40s. We see around 20 new patients of breast cancer every month in our hospital alone. The disease surge is particularly worrying in urban areas where unhealthy diet, sedentary lifestyles, smoking, and drinking are common. Higher age of childbirth and reduced breastfeeding are also contributory factors,” added Dr. Ashwin.

Early detection of breast cancer has many benefits. Patients diagnosed with stage 1 or 2 breast cancer can undergo breast-conserving surgery (BCS) rather than mastectomy, enabling them to save their breast. Another major benefit is the possibility of avoiding aggressive treatment and chemotherapy.

“Early stage breast cancer patients are recommended the use of prognostic tests to direct the use of chemotherapy. A recurrence prediction or prognostic test may help some women diagnose early-stage disease and enable their doctors to decide whether the cancer is likely to return and whether chemotherapy will benefit the patient. Based on these test results, low-risk patients have the opportunity to avoid chemotherapy, based on very small chances of the cancer returning. Indigenously developed CanAssist Breast is one such prognostic test that gives low or high-risk stratification with a high degree of accuracy. Avoiding chemotherapy and aggressive treatment not only improves the quality of life but also saves the cost of treatment,” pointed Dr. Ashwin.

Lack of awareness means that many women fail to report suspicious lymph because it is not painful. Similarly, the practice of annual disease screening is very low in India. Educating women about early detection and establishing the practice of annual screenings is the need of the hour. Regular annual screenings can help us detect at least 30% of the breast cancer cases in the early stages.

“We also urge women not to delay reporting their symptoms or avoid their screenings for fear of the coronavirus pandemic. After hitting their 40s, women should go for annual disease screening. Obesity, smoking, hormone replacement therapy after menopause also increase breast cancer risk,” added Dr. Ashwin.

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