Breast Cancer Awareness Month: Fear of test results delays breast cancer diagnoses, say Mumbai doctors

According to World Health Organization (WHO), breast cancer was the most common cancer in women in 157 countries out of 185 in 2022. Around 2.3 million women were diagnosed with breast cancer and it caused 6,70,000 deaths globally. The numbers also paint a worrisome picture closer home. According to data from National Centre for Disease Informatics and Research (NCDIR) - National Cancer Registry Programme, there were 2,21,579 breast cancer cases among females in India in 2023 and an estimated 82,429 deaths due to the condition. While the disease majorly affects females, approximately 0.5-1% of breast cancers occur in men. Despite the severity and mortality rate of breast cancer, timely diagnosis and subsequent treatment remains a key challenge.

Every year, October is observed as Breast Cancer Awareness Month to disseminate accurate information about the condition and raise awareness about the prevention and routine screening for early diagnosis of breast cancer.

WHO states that roughly half of all breast cancers occur in women with no specific risk factors other than sex and age. In such a case, timely diagnosis becomes even more difficult and routine screenings more significant. However, women face several physical, psychological and social hindrances that make it difficult for them to seek professional help. Mid-day.com speaks to Dr. Aditi Agrawal, Breast Onco Surgeon and General Surgeon, Wockhardt Hospitals, Mira Road, and Dr. Pritam Kataria, Medical Oncologist, Sir HN Reliance Foundation Hospital, Mumbai, who shed light on these barriers and bust some common myths about breast cancer screening and treatment.

What are some factors that can lead to a delay in breast cancer screening?

Agrawal: Various factors contribute to delays in breast cancer screening and treatment. Many people still do not have an easy access to healthcare services or expert doctors who can guide them, making it challenging to schedule appointments. People with financial issues like low income or unemployment may hesitate to go for breast cancer screening or treatment due to extreme treatment costs. Some may not be aware of the negative impact of breast cancer on their overall life or the importance of going for regular checks for early detection. These factors altogether can lead to delays in detecting breast cancer and the usual presentation is in the advanced stage.

Kataria: A major factor that can lead to a delay in breast cancer screening is lack of awareness. Also, the lack of proper medical facilities could be another issue. Sometimes, people who have both the knowledge and the facilities may still hesitate to get the screening done due to a fear of malignancy getting detected as it puts one in a difficult situation.

In your professional experience, have you noticed any socio-cultural factors that can prove to be a hurdle in the timely diagnosis and treatment of breast cancer?

Agrawal: Socio-cultural factors can negatively influence the diagnosis and treatment of breast cancer. People often hesitate to discuss breast health which often leads to delayed diagnosis of breast cancer. Factors like cultural beliefs about the illness, the strong fear of cancer and lack of awareness can prevent individuals from seeking timely screenings.

Kataria: There is a social taboo that stops women from undergoing screening. Also, one may be uncomfortable with a self-breast examination or examination by a medical expert. But most importantly, the fear of getting something detected in the scan acts as a barrier.

What are some myths about mammograms that need to be debunked?

(A mammogram is a screening method for breast cancer. It involves an X-ray of the breast that can help in the timely diagnosis of the condition.)

Agrawal: There are various myths or misunderstandings when it comes to breast cancer or screening options like mammograms. Some people believe that undergoing mammogram screening significantly increases the risk of breast cancer. But the fact is mammogram is an effective tool in detecting breast cancer early. Early detection can help make treatment options more effective resulting in positive outcomes.

Kataria: Mammogram is a machine that gives a real-time assessment of the breast tissue. However, people have many false beliefs about the process. One misconception is that this procedure may be painful. Another thing that people believe is that mammogram screening can lead to the spread of cancer, which is untrue.

Also Read: Women less likely to screen for breast cancer over false-positive mammograms

Do you think there's enough awareness to recognise the symptoms of breast cancer? What are some symptoms one must look out for?

Agrawal: Even today, most people are unaware of breast cancer, the risks associated with it, and the importance of early screenings, making it difficult to detect cancer at its early stage. However, over the years, awareness about breast cancer and its symptoms has improved but there is a long way to go.

One should watch out for key symptoms like a lump, visible changes in the shape or size of the breast, white discharge from the nipple and redness of the skin near the breast area. Knowing about these symptoms in advance can help catch breast cancer at its initial stage before it starts to worsen or spreads to another part of the body.

Kataria: We are still far from complete awareness of breast cancer. One must look out for symptoms like breast lump, nipple changes, changes in skin over the breast, or lump in the axilla or supraclavicular area.

What are some challenges that women usually face or must be prepared for in the course of the treatment?

Agrawal: Women who are undergoing treatment options to treat breast cancer can face a range of physical and psychological challenges. Treatment options like chemotherapy or radiation therapy often lead to multiple side effects like fatigue, nausea, weakness, unbearable pain and hair loss. Navigating through these physical side effects can be overwhelming and add up to their mental load. Over time, one can develop mental health conditions like anxiety, stress and depression while continuously thinking about their health and future life. During breast cancer treatment, women also undergo body changes like hair loss in several areas like the head, eyebrows and eyelashes. This can negatively affect their self-confidence about their body image.

While these challenges can occur during treatment, they can be navigated with proper guidance and physical and mental preparation. These should not deter one from seeking treatment.