Representative image of a cancer cellBy Dr Anthony Pais, Senior Consultant and Clinical Director Oncoplastic Breast Surgery, Cytecare Hospitals, Yelahanka, Bengaluru

Striving for better prognosis & personalised care for breast cancer In India, there is a confirmed breast cancer diagnosis every four minutes, making it one of the top three types of cancers prevalent in the country. The COVID-19 pandemic has amplified the challenges of detection and treatment by pushing breast health awareness to a low priority.

The prime peril in the current scenario is that cancers are likely to be undetected until they reach stage 3 or 4, drastically cutting down the chances of recovery. While the treatment of breast cancer is covered under government schemes such as A yushman Bharat, the need of the hour is greater awareness and timely action.

New learnings Theres a lot more that we know about breast cancer today than we did a decade ago. Diagnostic scans are more accurate and radiation treatments come with lesser side-effects today. The development of immunotherapy and newer drugs for targeted treatment as well as breakthroughs in stem cell research and gene therapy are paving the way for effective and personalised cancer care in the future.

Recently, researchers at Lund University in Sweden published their findings on developing a computational model that effectively detects and identifies genetic mutations in breast tumours. Based on data gathered over 10 years from over 15,000 patients, the study, published in the scientific journal EMBO Molecular Medicine, aimed to inform patients a week after surgery which personalised treatment was best suited for them.

In terms of therapeutics, theres greater focus on molecular drivers of the cancer with multiple agents being developed for every subtype of breast cancer. Though still new to the immunotherapy space, there is exciting data emerging in breast cancer treatment, particularly with triple-negative breast cancer. There is a steady transitioning towards reduced surgeries and making radiation therapy more comprehensive for high-risk patients. By choosing to combine lumpectomy over mastectomy and fewer axillary surgeries, there is a decrease in the risk of lymphedema.

Studies show that physical activity and healthy diet, along with lifestyle changes, are important factors in influencing the health outcomes for women with breast cancer. Patients with ER-positive breast cancer on certain inhibitors, for instance, tend to gain weight and obese patients have poorer outcomes with therapy. In some cases, a low-fat diet and even as little as five per cent weight loss decreased the risk of recurrence.

Simple solutions A majority of healthcare centres in India lack the basic facilities for early diagnosis of cancer and adequate expertise to treat the disease in the most effective manner. Unless the country invests in cancer care, the statistics for breast cancer will continue to be bleak.

Theres no denying that technological advances in imaging are creating massive improvements in both screening and early detection. For instance, 3-D mammography, also called breast tomosynthesis, takes multiple images or X-rays of breast tissue to recreate a 3-dimensional picture of the breast.

However, as the latest World Cancer Report (2020) rightly states, the best way to tackle the challenge is by early detection through regular breast examination (self-examination as well as mammogram). For women above 40 years of age, regular breast examination with a mammogram is recommended once in two years.

The need of the hour is to spread awareness about the importance of getting breast examinations done. Its essential to design powerful campaigns to drive societal changes. In most parts of India, women are uncomfortable to discuss symptoms and go in for a physical examination. Studies show that most deaths occur among the unscreened population as the cancer is typically detected at a late stage.

The pandemic has forced the world to look at healthcare with renewed emphasis. Now is the time to make lasting changes for a healthier and happier life.

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Unless the country invests in cancer care, the statistics for breast cancer will be bleak: Dr Anthony Pais, .. - ETHealthworld.com