Understand the Shift in Breast Cancer Demographics in India: Expert Insights into the Challenges

Why Are Breast Cancer Demographics Changing In India? Know The Challenges From Expert
Why Are Breast Cancer Demographics Changing In India? Know The Challenges From Expert

As times evolve, so do the patterns of illness. Non-communicable diseases like cancer and cardiovascular issues are now predominant health concerns, with cancer alone contributing to nearly 10% of all fatalities. Among women, breast cancer stands out as the most prevalent form, constituting almost 30% of the total cancer burden. Shockingly, a woman is diagnosed with breast cancer every 4 minutes, with one succumbing to it every 13 minutes.

Breast Cancer Awareness Month, observed globally in October, aims to shed light on the impact of breast cancer. In commemoration of this significant month, the editorial team at Onlymyhealth interviewed Dr. Bhuvan Chugh, Consultant-Medical Oncology at Max Hospital, Gurugram, to delve into the shifting demographics of breast cancer and the challenges it poses in India.

What are the demographic shifts observed in breast cancer incidence within the Indian population

There has been a notable shift in the demographics of breast cancer patients in India over the past 25 years. While in the 1980s and 1990s, breast cancer predominantly affected women over the age of 50, there has been a significant change in recent years. Currently, approximately 50% of breast cancer patients are aged between 25 and 50 years.

How have the demographics of breast cancer changes in India

Various factors contribute to this shift, although they are not precisely understood. Possible reasons include inherited faulty genes from parents or a family history of breast or ovarian cancers. Additionally, the onset of breast cancer is more common in women who experience early menstruation (before the age of 11 or 12) or undergo menopause after the age of 55, which is often associated with prolonged exposure to estrogen and progesterone.

Younger women face unique challenges that increase their susceptibility to breast cancer, including:

1. Certain lifestyle choices

Indeed, certain lifestyle factors play a significant role in influencing the risk of developing breast cancer in young women. These factors include delayed or no pregnancies, insufficient physical activity leading to increased obesity rates, and smoking habits. Additionally, excessive alcohol consumption and the use of oral contraceptives have been subjects of debate regarding their association with an elevated risk of breast cancer among younger women.

2. Lack of awareness

Overall, breast cancer in Indian women is often diagnosed at advanced stages compared to Western countries, primarily due to a lack of awareness. Up to 50% of patients are diagnosed with stage 3 and 4 cancer, leading to poorer overall survival rates. This challenge is compounded in younger women due to various factors.

3. Ignoring warning signs

Younger women often have dense breasts, making it challenging to detect lumps through self-examination. Additionally, paradoxically, many younger women tend to overlook warning signs such as breast lumps or nipple discharge, assuming they are too young to develop breast cancer. They may dismiss the lump as a harmless cyst or growth, contributing to delayed diagnosis and treatment.

4. Furthermore, the absence of routine screening programs exacerbates the issue, as regular screening could aid in the early detection of breast cancer among younger women

4. Lack of routine screening programs

Additionally, breast cancers diagnosed in younger women tend to be more aggressive and less responsive to therapy. This issue is exacerbated by the absence of routine screening programs for this demographic, as mammography is less sensitive in women under 40 years of age due to dense breast tissue. Consequently, the evaluation of suspicious lumps often relies on ultrasound or contrast MRI breast scans, which may not be readily available due to limited resources and expertise. This prolonged and inaccurate diagnostic process adds further complexity and stress.

Moreover, the treatment of breast cancer in younger women is complicated by societal norms and medical considerations rarely encountered in older patients. Concerns about future marriage prospects, infertility, and pregnancy-associated breast cancer weigh heavily on unmarried or childless women. Additionally, younger patients are often more socially active and may have dependents to care for, which can impact treatment decisions and recovery. The psychological toll of radical surgeries on body image and the financial and emotional implications of the disease further compound the challenges faced by young women with breast cancer.

Recognizing these unique challenges, breast cancer in young women has emerged as a distinct area of focus for healthcare providers. Addressing these concerns requires comprehensive efforts, including raising awareness, improving diagnosis and management, and addressing the psychosocial impact of the disease.

Why do we have more advanced cancers

Why do we have more advanced cancers

Breast cancer grades and stages among Indian patients tend to be higher compared to those in other countries. Even among the educated population, who may seek curative treatments, misconceptions and a lack of awareness about chemotherapy or mastectomy surgeries often deter them from seeking timely medical intervention. Instead, they may turn to alternative treatment options initially, which may seem appealing but ultimately prove ineffective as the cancer progresses beyond their control. This delay in seeking allopathic treatment prevents timely intervention.

1. Breast Conserving Surgery

In such cases, the surgery aims to remove only the cancerous lump, known as the tumor. Depending on factors like type, size, and extent of the tumor, the surgery may involve procedures such as lumpectomy (removal of the tumor along with minimal surrounding tissues) or partial mastectomy. When followed by post-surgery radiotherapy, these procedures can be as effective as total mastectomy in treating early-stage breast cancer.

2. Mastectomy

With advancements in technology, mastectomy can be followed by reconstructive surgery to restore the shape of the breast. Reconstruction can be performed simultaneously with mastectomy (immediate reconstruction) or at a later stage (delayed reconstruction). It can involve the use of breast implants or tissue from other parts of the body to create a new breast.

Promoting breast cancer screening is crucial to raise awareness among the public. Early detection through screening enables the diagnosis of cancer at its initial stages, increasing the likelihood of successful treatment with minimal intervention. In cases of metastatic or advanced cancer, achieving complete cure becomes challenging, and treatment aims to control further disease progression and achieve remission, where the tumor either shrinks or disappears.