Breast cancer is the most common form of cancer affecting females in India. 1 in 29 females are projected to develop breast cancer during their lifetime, with a total of 1.78 lakhs women suffering from breast cancer in India in 2020. Of these, more than 40% of Indian women are diagnosed with advanced (stage 3 or 4) breast cancer in the country. The ongoing pandemic posed various obstacles contributing to late diagnosis and poor treatment adherence, exacerbating challenges of limited screenings across rural and urban areas and poor health-seeking behaviors. Other challenges include social stigma, fear of cancer diagnosis or discussing the same with family members, shame over having a breast examination, and alternative priorities, which result in women neglecting their health and delaying screenings and care, resulting in lowered patient survival rates at advanced disease stages.
Dr. Shyam Aggarwal, Senior Consultant Medical Oncologist, Sir Ganga Ram Hospital Delhi said, “Today, breast cancer has emerged as the most common form of cancer in women, in Delhi and across the country, surpassing cervical cancer. Breast cancer accounts for nearly 30% of all women cancer cases today. In India, 40 women of every 100,000 are diagnosed with breast cancer, with over 50% of patients coming in advanced stages of the disease. This trend of delayed diagnosis is particularly pronounced in more remote, rural areas of the country, owing to illiteracy, limited facilities, and social stigma. To facilitate early disease detection, after 40 years of age, monthly self-breast examination, particularly during menstruation, and clinical check-ups, along with mammograms aid diagnosis. Biopsy is mandatory to confirm diagnosis. Once diagnosed, a number of tests, including X-rays, bone scan, ultrasound and various receptor tests can be performed to understand how far the disease has spread.”
Many patients and families believe that advanced breast cancer represents the end of life. A pattern observed across Indian women and their caregivers that, instead of spending on treatment to attain an improved standard of care, they save money for the family’s future.
Dr. Aggarwal added, even with locally advanced cases, particularly where metastasis has not occurred, eradication of the disease can be possible. Treatment include chemotherapy, surgery, radiation procedures or hormonal/targeted therapies. In early stages cure rates exceed 90%. Treatment modalities differ based on individual cases, such as if the disease has spread to different parts of the body and is deemed inoperable. Particularly to patients who are estrogen receptor positive, newer targeted hormonal therapies are offered. As high as 80 to 90% of patients respond positively to such treatments, enabling them to lead normal lives with an enhanced quality, for many years . Similarly for her2 neu positive advanced cases, targeted drugs with chemotherapy yield similar results these days in most cases.. With such innovations, cancer can be viewed as a chronic disease that can be cured and controlled.”
Awareness of risk factors can prompt more self-breast examinations as well as screening, which can enable timely disease detection. There are a variety of treatment options available for breast cancer based on the individual’s specific case, including surgery, or chemotherapy, or advanced targeted therapies and hormonal therapies, which can be adopted for advanced breast cancer cases as well, particularly to shrink the cancer or attack abnormal breast cancer cells without causing harm to normally functioning cells. Newer targeted therapy advancements have also limited adverse side effects compared to more traditional forms of treatment, such as chemotherapy, which can result in significant daily life compromises.
This October, which marks Breast Cancer Awareness Month, there is a dire need to raise awareness amongst patients and caregivers about the availability of treatment options even at advanced stages of the disease.
If you’re an advanced-stage breast cancer patient – discuss your treatment options with your oncologist to manage your disease, alleviate troubling symptoms and live with an enhanced quality of life and care.