In India, the incidence of breast cancer is significantly lower than western countries. Breast cancer in India varies from as low as 5 per 100,000 female population per year in rural areas to 30 per 100,000 female population per year in urban areas11. There is an impression of the higher incidence of breast cancer in younger women in India as most hospital-based series report median age of breast cancer patients a decade younger than western series. However, this may be due to a combination of the population structure and inherent bias against referral, treatment, and ascertainment of breast cancer in the elderly in India rather than a true reflection. The incidence of breast cancer increases with age and this is true in India like rest of the world. With the exception of 5-10% breast cancers where the main risk factor is the genetic predisposition, in the remaining 90% of sporadic breast cancers, the identified risk factors are either reproductive, lifestyle or environmental factors, primarily through their influence on the hormonal milieu. No breast cancer risk factor, unique to the Indian population has been widely reported. Breast cancer screening using various approaches has been the subject of several large randomized trials in USA, Canada, and Europe. Population-based mammographic screening of asymptomatic postmenopausal women has shown a modest reduction in breast cancer deaths in high incidence affluent western countries but with associated overdiagnosis and overtreatment.
In India, we are now witnessing more and more numbers of patients being diagnosed with breast cancer to be in the younger age groups (in their thirties and forties). The overall 5-year survival for breast cancer has increased from 75% in 1970’s to almost 89% presently. This means that, out of every 100 women with breast cancer in the US, 89 women are likely to survive for at least 5 years. There are barely any similar statistics for India available, but a rough estimate from the PBCR and HBCCR reports is that this figure is not even more than 60%. The most important reason being lack of awareness about breast cancer and screening of the same; more than 50% patients of breast cancer present in stages 3 and 4, and an outcome is not as good as earlier stages, however aggressive the treatment may be. The western nations have achieved a steadily improving and good survival mainly because of screening for breast cancer.
When we conducted our session over a month in Narela at the ESIC Dispensary, we got an overwhelming response from the women there. It is a sub-city is a tehsil, located in the North West Delhi district of NCT of Delhi, and forms the border of the Delhi state with Haryana. Narela Tehsil of North West district has a total population of 809,913 as per the Census 2011. Out of which 439,576 are males while 370,337 are females
As per Census 2011 out of a total population, 79.2% people live in Urban areas while 20.8% lives in the Rural areas. The average literacy rate in urban areas is 81.8% while that in the rural areas is 79.6%.
We had run the awareness sessions during my rural posting at Narela during my Internship. To my surprise, men themselves got their mothers and wives for the discussions when it turned into a great actively engaging scenario.Younger Girls Are in Danger In India Unlike the West – Higher Triple Negative Incidence
Cancers in the young, tend to be more aggressive (Most, but not all). Many of these cancers are HER2 positive and ER/PR negative, or HER2/ER/PR all three negative, and they have a worse prognosis than those who have ER/PR positive tumors.
Your pathology report may say that the breast cancer cells tested negative for estrogen receptors (ER-), progesterone receptors (PR-), and HER2 (HER2-). Testing negative for all three means the cancer is triple-negative.
These negative results mean that the growth of the cancer is not supported by the hormones estrogen and progesterone, nor by the presence of too many HER2 receptors. Therefore, triple-negative breast cancer does not respond to hormonal therapy (such as tamoxifen or aromatase inhibitors) or therapies that target HER2 receptors, such as Herceptin. However, other medicines can be used to treat triple-negative breast cancer.
Triple-negative breast cancer: Tends to be more aggressive than other types of breast cancer.Studies have shown that triple-negative breast cancer is more likely to spread beyond the breast and more likely to recur (come back) after treatment. These risks appear to be greatest in the first few years after treatment.