Doctors call for early detection of breast cancer, highlight risk factors

Doctors call for early detection of breast cancer, highlight risk factors

Chennai accounts for the highest crude incidence rate of breast cancer in T.N., reveal data. Women who find a lump in

the breast take 6-8 months to seek medical help. They need to be breast-aware, and meet the right doctors, says expert

Serena Josephine M.

CHENNAI

One in 19 women in Chennai are at risk of being affected by breast cancer in their lifetime — 0 to 74 years*.

Chennai also has the highest Crude Incidence Rate (CIR) of breast cancer in the State, at 51.8 per 1,00,000 population, indicating that more than one factor is driving the rising incidence of the cancer, data from the Tamil Nadu Cancer Registry Project 2019, Cancer Institute (WIA), have revealed.

V. Sridevi, professor, Surgical Oncology, Cancer Institute, said that the significant increase in the incidence of breast cancer was a real concern. “Women who find a lump in the breast take six to eight months to seek medical help, and most often, they do not meet the right doctor. They must be more breast-aware, and meet the right doctors for timely diagnosis,” she said.

Dr. Sridevi said that only about 5% to 10% of breast cancer cases were due to family history. Many factors were at play for the remaining 90% of the cases — one of which is lifestyle changes such as diet, delayed childbearing and nulliparity (having no children), which have increased the risk of breast cancer. R. Swaminathan, professor and head, Department of Epidemiology, Biostatistics and Cancer Registry and Associate Director, Cancer Institute, said, “Factors such as late age of marriage and late age at first childbirth have become natural reasons for the increase of breast cancer in women. Over the past 30 years, the median age of first childbirth has increased by five to 10 years. This is because of many reasons such as education, profession and empowerment of women,” he added. Better awareness levels over the years though have led to early diagnosis of the cancer now. “At the Cancer Institute, nearly 25 years ago, 60% of women came with locally advanced cancer (stage 3). At present, about half of the patients are in the early stages. This is a definite shift,” Dr. Sridevi said.

The State’s Health Department has learnt from the Community-Based Organised Cancer Screening, rolled out in November 2023 at Erode Health Unit District. The initiative was piloted in Erode, Ranipet, Kanniyakumari and Tirupattur, and is all set to be rolled out across the State.

T.S. Selvavinayagam, Director of Public Health and Preventive Medicine, said that an area of concern was hesitancy among those with suspected symptoms to go for higher evaluation for further confirmation.

Arvind Krishnamurthy, professor and head, surgical oncology, Cancer Institute, said the presence of dense breasts as evidenced on mammograms had been shown to carry a higher risk of developing breast cancer. The issue gained interest with the U.S. Food and Drug Administration requiring all mammograms, as of September 10, to include information on breast density. Surgery remains one of the mainstays of breast cancer management.

“It has been traditionally believed that safe surgery had to entail a modified radical mastectomy, or a total removal of breast and axillary nodes. However, evidence over the past several decades has suggested that the option of breast conservation, including conservation of the axilla (sentinel lymph node biopsy), is safe in early-stage breast cancers...,” he added.

The growing popularity of oncoplastic surgeries have additionally resulted in enhanced cosmetic outcomes in women undergoing breast conservation surgeries, Dr. Krishnamurthy said.

It may be noted that October is Breast Cancer Awareness Month.

(*This is the cumulative risk of acquiring breast cancer in a woman’s lifetime from birth to 74 years of age calculated by a formula using summation of 5-year age specific incidence rates up to age 74).