KOCHI: Breast cancer is the most common malignancy among women worldwide, surpassing lung cancer in 2020. Around 2.3 million breast cancer cases account for 11.7 % of all cancers in the world. In India, breast cancer accounted for 13.5 % of all cancer cases and more than 10% of all deaths in 2020.
Breast cancer was also the fourth most common cancer in the 1990s in the country. But it has risen again.
Kerala is one of India’s hot zones for breast cancer, recording a steady rise in cases since 2015. In fact, cancer cases in the state grew from 5,682 in 2016 to 6,748 in 2018. While this is becoming a state-wide burden, there are indications that not many women are keen on conducting self-examination or mammographic screening for early detection.
Recent studies show lack of awareness is not to blame, but for fear, stigma and rejection the women feel.
With 1 in 28 women in India likely to be diagnosed with breast cancer, oncologists and other health experts have affirmed that early detection and management remain the best way to increase survival rates in the country.
In context, women with breast cancer in the US have a 90% five-year survival rate, while it is only 66% in India. It is because almost 70% of all first visits to the doctor by breast cancer patients in India happen in stages 3 and 4.
A recent study of 3,041 women aged 18-60 years in Kerala showed that 64% of respondents had a history of cancer in their immediate family, but 40% didn’t think heredity was a risk factor. Whereas 66% had knowledge of breast cancer but a number of them were not carrying out self-examination.
The study puts the rate of those who engage in self-examination at 53.6%. Women must understand that the most important step in successful breast cancer treatment is early detection. It doesn’t take more than two minutes to stand before a mirror and check for any unusual signs, patches or lumps.
Though not every abnormality is a sign of breast cancer, it is important to consult a doctor. In a recent focus group conversation, many women admitted to being afraid of the stigma of a diagnosis. There have been cases of spouses abandoning their wives because of breast cancer. Many of them fear that self-examination and mammographic screening may lead to other consequences.
With patient support groups and voluntary healthcare organisations, women know early detection.
Women aged 50 and above need to have a mammogram once every year. Those with higher risks due to a family history of breast cancer and ovarian malignancies, as well as detrimental BRCA ½ mutations, also should have a regular MRI breast scan.
Governments at the state and central levels need to invest in local health centres and provide equipment for screening. So breast cancer detection is brought closer to the people of Kerala, including those in remote locations. More importantly, there should be awareness campaigns to ensure women understand their lives matter.
Covid has caused a lot of disruptions and it was difficult for people to participate in breast cancer screenings and treatment for some time. But things are slowly returning to normal and it must be given priority in Kerala.