‘Avg breast tumour size has halved in 25 yrs’

Oncologists claim the size of tumours has reduced owing to early detection and treatment; stress the need to eradicate stigma

The number of breast cancer cases among patients – both male and female – at Tata Memorial Hospital (TMH), Parel, one of the country’s leading specialty medical centres – has increased by 11% in the last five years, internal data shows.

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Despite the rise, oncologists said the average size of the breast tumour has halved in the past 25 years – from approximately 4cm-6cm, to around 2cms – due to growing awareness coupled with early screening and detection.

Breast cancer is caused by malignant tumours that start in the cells of the breast and have the potential to invade other tissues or spread to other parts of the body. Last year, 3,952 patients were diagnosed with breast cancer as against 3,548 in 2014.

It is the most common form of cancer among Indian women.

“Downsizing of tumours has played an important role in increasing the survival rate among women cancer patients who come to the hospital at an earlier stage,” said Dr Sudeep Gupta, professor of medical oncology, TMH.

“This is one reason why the average age of breast cancer patients in India is about 10 years younger [between 45-50 years] compared to western countries.”

Gupta, who is also the director of Advanced Centre for Treatment, Research and Education in Cancer (ACTREC) at Kharghar, added, “As a result, a woman with stages 1or 2 breast cancer has more than 85% chance of being cured. Those at stage 3 of the disease have about 40-50% chance, and there is less than 20% chance of a long-term cure for those with stage 4 [metastatic] cancer.”

Due to early detection, oncologists can diagnose a lump measuring one centimetre – the size of a peanut.

“Awareness has led to regular check-ups, self-breast examinations, higher number of mammography screenings, and as a result, early diagnosis,” said Dr Suresh H Advani, mentor, onco-sciences, Sir HN Reliance Foundation Hospital.

A similar trend of decreasing tumour size was witnessed following the introduction of mammography in the 1980s in the US. It had led to a two-thirds decline in mortality rates, a 2016 study revealed.

The study, published in the New England Journal of Medicine, reported a substantial increase in the detection of small breast tumours from 36% in 1975 to 68% in 2012.

During the same period, the proportion of large tumours diagnosed decreased from 64% to 32%.

Indian oncologists, however, said the country still lags behind the US and UK in early diagnosis due to the cultural stigma attached to a breast examination.

“Women in India present with much larger tumours and more advanced breast cancers because they are typically shy and uncomfortable with examining their breasts or exposing themselves for evaluation. Hence, they may wait for a while before seeing a doctor even if they have a lump in the breast,” said Dr Ian Pinto, consultant, medical oncology, Jaslok Hospital and Research Centre, Cumballa Hill.