Breast cancer is the leading cause of cancer deaths among women in India. Eight women die of the disease every hour. About 50% of women diagnosed with breast cancer in India die within five years of their diagnosis. High fatality rates are partly because of delayed diagnosis. And, delayed diagnosis is a result of lack of awareness of signs and symptoms, acknowledgement of the importance of seeking medical advice for signs and symptoms as well as barriers to accessing medical care.
Research in India is showing that community education followed by provision of clinical breast examinations by nurses and other community health workers can significantly improve early detection of breast cancer. The power of information and education cannot be emphasized enough. In a study involving nearly 150,000 women in Mumbai trial, researchers found that provision of just a single session of health education led women to seek out medical advice and resulted in the detection of a substantial number of confirmed breast cancers.
In countries with greater resources, mammography is being used routinely for breast cancer screening. Women who can afford mammography should consult their physician on the optimal age at which to initiate screening. Global and national experts have concluded that in India, the most feasible public health approach is to ensure that women between the ages of 40 and 60 undergo a clinical breast examination at least once in three years. That said, all women should be aware of breast health: changes in breast health such as appearances of lumps, changes in the skin or nipple should prompt immediate medical care-seeking.
Research in Bangalore is showing how awareness about breast cancer among young men and women can help to improve the breast cancer scenario in the country. Here is an illustrative case. A 48 year old woman was diagnosed with early stage breast cancer at a private teaching hospital. She had waited six months before she told her 22 year old daughter (a commerce graduate) about the lump that had developed in her breast. She had delayed saying anything because her elder daughter’s marriage was being arranged. She was worried that if people got to know that she has cancer it would be difficult for her daughter to get married. Moreover, she did not take the lump seriously because it was not painful. Although her younger daughter pleaded with her to see a doctor, she remained adamant. It was nothing serious. Finally, her younger daughter fasted for a day, and she had to give in. Luckily, the cancer was detected at an early stage, and the prognosis was excellent.
In conclusion, the key to addressing the growing number of deaths due to breast cancer among women in India is raising public awareness of the disease, combatting fear and stigma, and increasing access to affordable diagnosis and treatment. Over 90% of women diagnosed with breast cancer live beyond five years of their diagnosis in the United States. Timely care-seeking, detection and treatment can improve Indian women’s chances of survival.
Suneeta Krishnan, PhD
Research Triangle Institute Global India Private Limited
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