World Cancer Day 2023: More middle-aged Indian women prone to breast cancer

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Instances of women below 35 years falling prey to breast cancer are on a steady rise in India, say experts who attribute the trend to obesity and sedentary lifestyle. The medical fraternity across the country has undertaken a campaign to create awareness about the deadly disease as part of the Breast Cancer Awareness observed every October.

Dr Niti Raizada, Director - Medical Oncology and Hemato-Oncology, Fortis Group of Hospitals, Bangalore told IANS that according to data from GloboCan 2020, a total of 1.78 lakh women in India are diagnosed with breast cancer annually from GloboCan 2020.

"However, unlike the west, where cancer is more frequently observed in women over the 55 years, our country also has women in the age range of 35 to 50 years who are the extremely prevalent age group of breast cancer," she added.

Dr Vipin Goel, Senior Consultant and Laparoscopic Surgeon, Surgical Oncology, CARE Hospitals Group, explained that women developing breast cancer at a much younger age compared to others is because of these genes. On the other hand, an important cause of breast cancer is a sedentary lifestyle, mainly a lack of exercise and poor diet (obesity).

Underlining that breast cancer can be prevented, he said the primary measure is to remove the risk factors by improving the lifestyle. This includes enough physical exercise, avoiding smoking and drinking, and a balanced diet.

A few years ago, cervical cancer was the number one cancer among the female population in India. This was due to poor hygiene and human papillomavirus. The incidence of cervical cancer is decreasing. Now, breast cancer has replaced cervical cancer as the number one cancer in females in India.

"The incidence of Breast cancer in young people is showing an increasing trend. Ten years ago, we saw one to three cases in 100 breast cancer cases below the age of 35 years. Now we see around eight to ten in 100 cases below the age of 35 years," Dr Goel stated.

He further explained that the cause for the increase can be both hereditary and non-hereditary. Around 10-20 per cent of breast cancer cases in the world are hereditary because of the BRCA1 and BRCA2 genes present in people.

The secondary measure for preventing 'Breast cancer' is going for screening and tests. A mammogram is one of the simplest tests to determine lumps in the breasts. It is advised to get a screening done once a year after the age of 40 years. If the cancer is caught in an early stage as stage I, the chances of survival and cure are almost 95 per cent, he explained.

It is critical to address these issues in order to effectively treat younger women with the life threatening disease. Although breast cancer is a risk for all women, certain factors can raise the likelihood that a woman will get the disease before age 45. The first step in determining your risk is to determine what factors increase the likelihood of developing breast cancer.

"Knowing the symptoms of breast cancer might also help you determine when to consult a doctor," he underlines.

On a similar note, Dr Amit Rauthan, HOD and Consultant - Medical Oncology, Manipal Hospital Old Airport Road stated that the rising incidence of breast cancer in younger women is because they are in their prime and busy juggling both work and the home front.

While some are young unmarried females, some have small children, and others have families to take care of. Their diagnosis affects them and their family life tremendously! he added.

Though the exact cause is not known, it is possibly a mix of environmental, dietary and lifestyle factors. About 15 per cent of young females have hereditary breast cancer, Dr Rauthan stated.

The biology of breast cancer in younger females is more aggressive, and they tend to have a higher stage at diagnosis, and a higher incidence of the aggressive triple negative subtype, he explained.

Management of breast cancer requires a multi-modality approach using surgery, chemotherapy, radiotherapy and hormonal therapy. Special issues which need to be considered in young females relate to fertility, marriage, sex, nursing and long term implications, he says.

"Special consideration is required as fertility preservation needs to be planned during their treatment. Chemotherapy is known to affect fertility, and so special techniques are used for fertility preservation."

This may be in the form of embryo or ovary cryopreservation before starting chemotherapy, or in the form of special hormonal injections given during chemotherapy to preserve the ovarian function. During surgery, emphasis is given to breast conservation surgery, which not only improves cosmesis, but gives a lot of psychological advantage for females," Dr Rauthan explained.

Better understanding of breast cancer biology in younger women is leading to improved outcomes with a good quality of life. Integration of newer modalities like immunotherapy and targeted therapies are also paving a way for better long term survival, he added.

Dr Niti Raizada explains that breast cancer in young could also have some hereditary factors related, and triple-negative and HER2-positive breast cancer are frequently found in younger women.

Additionally, these variants are a very aggressive variety that needs more intensive monitoring and treatment. These women also have fertility issues because the majority of them either want to complete their families or are undergoing IVF treatment, she said.

It is critical to address these issues in order to effectively treat younger women with breast cancer. Although breast cancer is a risk for all women, certain factors can raise the likelihood that a woman will get the disease before age 45, as per Dr Raizada.

"Knowing the symptoms of breast cancer might also help one determine when to consult a doctor," she said.

Also read: Real cancer cases estimated to be 3 times higher than reported in India: Report

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