Breast Cancer in India: Where do we stand ?? 1

Breast cancer is the most common cancer in American women, except for skin cancers. There are over 3.5 million breast cancer survivors in the United States. On average, every 2 minutes a woman is diagnosed with breast cancer in the United States. Female breast cancer represents 15.2% of all new cancer cases in the U.S.

India scenario: Breast cancer is the most common cancer in most cities and the second most common in rural IndiaBreast cancer accounts for 25% to 32% of female cancers in all cities across India. In India, one woman is diagnosed with breast cancer every 4 minutes. One woman dies of breast cancer, every 13 minutes in India.

Increasing incidence of BC in younger age groups (30’s and 40’s)

Breast Cancer in India: Where do we stand ?? 2

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). Please consider the adjoining graph (This is only a rough representation of the data):
The horizontal line lower down represents the age groups: 20 to 30 years, 30 to 40 yrs and so on. And the vertical line represents the percentage of cases. The blue colour represents the incidence 25 years back, and maroon colour represents the situation today. 25 years back, out of every 100 breast cancer patients, 2% were in 20 to 30 years age group, 7% were in 30 to 40 and so on. 69% of the patients were above 50 years of age. Presently, 4% are in 20 to 30 yrs age group, 16% are in 30 to 40, 28% are in 40 to 50 age group. So, almost 48% patients are below 50. An increasing numbers of patients are in the 25 to 40 years of age, and this definitely is a very disturbing trend.
Of course, one particular reason for higher numbers of younger patients is our population pyramid, which is broad at the base and middle and narrow at top, which means that we have a huge population in the younger age group and much lesser in older age group.


Rising incidence of breast cancer in India

Breast Cancer in India: Where do we stand ?? 3
Breast Cancer in India: Where do we stand ?? 4
Breast Cancer in India: Where do we stand ?? 5

Breast cancer is now the most common cancer in most cities in India, and 2nd most common in the rural areas. Please have a look at the following bar graph about percentage distribution of top ten cancers in females in Mumbai. After going through all the graphs, the point worth noting is that, breast cancer accounts for 25% to 32% of all female cancers in all these cities. This implies, practically, one fourth (or even approaching one thirds) of all female cancer cases are breast cancers.

Late presentation and decreased survival

Breast Cancer in India: Where do we stand ?? 6

Consider the adjoining image. This was published by ASCO (American Society of Clinical Oncology) in 2009, and shows the improvements in the overall five year survival for various cancers in the United States.
If you see, the over all 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 atleast 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 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 of breast cancer.


Lack of awareness of breast cancer, lack of screening

Breast cancer is a non existent entity for a majority of population till a near and dear one suffers from it. Healthcare is low on priority and even in major cities, screening is also an ‘alien’ word for most people. So naturally, this results in most people presenting only when symptomatic, and on an average, most ‘symtomatic’ cancers are stage 2B and beyond (significant numbers in stages 3 and 4). So the breast cancer patients do not tend to survive for a longer time, as their western counterparts.
In the West, majority of breast cancers (read more than 75%) present in stages 1 and 2, resulting in good survival; and there is an ever increasing numbers of patients presenting wih mammography detected cancer, with no symptoms. India needs to reach this achievement, and it is only with aggressive promotion of screening and awareness and proper treatment that India will achieve this; and will take atleast a few decades to reproduce similar results.

Which state in India has highest cancer rate?

The highest number of cancer cases recorded from Indian states were from Haryana at 39.6 % followed by Delhi at 27.3 % and Uttar Pradesh at 12.7%, are the key findings across India as per the FMRI Cancer Registry.

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