Breast Cancer Care in India: The Current Scenario and the Challenges for the Future

Abstract

The incidence of breast cancer is low in India, but rising. Breast cancer is the commonest cancer of urban Indian women and the second commonest in the rural women. Owing to the lack of awareness of this disease and in absence of a breast cancer screening program, the majority of breast cancers are diagnosed at a relatively advanced stage. The quality of care available for breast cancer patients varies widely according to where the patient is treated. Although there are some centers of excellence providing multimodality protocol-based treatment at par with the best anywhere in the world, the vast majority of breast cancer patients undergo inadequate and inappropriate treatment due to lack of high-quality infrastructure and sometimes skills, and above all financial resources. The recent emphasis on health education, early diagnosis of cancers, and more public facilities for cancer treatment are expected to bring about the much needed improvement in breast cancer care in India.

Analysis of Clinico-Pathological Characteristics of Indian Breast Cancers Shows Conservation of Specific Features in the Hormone Receptor Sub-Types

“…Half of the tumors were between 2-5cm (pT2) in size and a quarter of them involved either the overlying skin or underlying muscle (pT4), and thus were locally advanced. Invasive ductal carcinoma was the predominant histological sub-type in this series at >97%, confirming the rarity of the lobular sub-type that has been noted in other Indian series in the past [10,13]. A majority of the tumors (80%) were grade 3.…”

“…Over the years reports from Indian centres, that are too numerous to cite have spoken of the varying proportion of these sub-types at their centres [6][7][8][9][10][11][12]. Only three incontestable facts emerge from the detailed examination of these reports.…”

Knowledge, beliefs and practices about breast cancer and its self-examination procedure among urban and rural women of district Gurdaspur, Punjab, India: a cross sectional study

“…The burden of breast cancer in India has almost reached about two-third of US figures and this number/ratio is steadily rising. 5 The late marriage, birth of the first child at a later age, fewer children, and shorter periods of breast feeding etc., are most common reasons of breast cancer, particularly among urban educated women.…”

Screening of 185DelAG, 1014DelGT and 3889DelAG BRCA1 Mutations in Breast Cancer Patients from North-East India

“…It has been speculated that in 2020, around 1·7 million women will be diagnosed with breast cancer, which is an increased of about 26% in the developing world from current levels (Wong et al, 2009). In India, almost 100,000 women are diagnosed every year with breast cancer, and a rise to 131 000 cases is predicted by 2020 (Agarwal et al, 2008;Mangtani et al, 2010). And in North-East India breast cancer has always been a hotspot in comparison to rest part of the India because of genotoxic stress from tobacco exposure (Sunita et al, 2010).…”