Breast Cancer:

Myths and Facts

Why do we need to
know about it?
Prof Anand Mishra
Dr Pooja Ramakant
Endocrine (and Breast Surgery)
Department
King Georges Medical University

How to reach to
remote areas?
Pepsi coke ads
gone in villages
Mobiles phones
even used well
in villages

Why cant knowledge

about
cancer prevention and
detection reach to all?

Myths
BC next most common to
Cervical cancer
Mostly genetic
All patients invariably die of
the disease
Happens only in women

Facts
BC- now most common in urban women
5-10% only hereditary
Early stage- 90-100% cure rate
Locally advanced stage-50-70% cure rate
Happens in men too but less frequent

Step ladder approach

1. What is current level of awareness?
2. What are barriers in society that prevent
patients from coming to doctor?
3. How can we break those barriers?
4. How can we spread more knowledge to
all?
5. How can we fight preventing and
treating Cancer?

2 types of people
Ignorant and then present
late
Who know well but still
present late

What is Cancer?
Disease that
causes cells to
changemutation and
grow out of
control

Breast Cancer incidence

Most of the people we know
have some relative / friend
with
Breast Cancer
80,000 new cases diagnosed
in India annually
Incidence rising alarmingly

Proportion of Breast and Cervical

Cancer Among All Cancers in
Indian Women

Age wise Distribution of

Women With Breast Cancer

Stages of Breast Cancer at

presentation

How can we pick early

breast ca. ?
Breast Self Examination
Awareness
Clinical Breast Examinationuseful in developing
countries- where
mammography restricted

Problems
No organized breast cancer
screening program in India
Late stage of disease
presentation
Increased cost of treatment
Alternate pathies
Heterogeneous treatment
facilities
Low survival rates
More treatment related
complications

Risk factors
Nonmodifiable
Hereditary-510%
Benign breast
disease-certain
type
Early menarche
Late menopause

Modifiable
Nulliparity
Breast feeding
Obesity
Alcohol

High Risk Population

Annual mammogram + Clinical Breast
Exam every 6-12 months (starting at 30
years)
Breast awareness
Risk reduction strategies
Recommend annual breast MRI

How to we Diagnose Breast

Cancer??

65 yrs with a small lump in

the right breast for 2 months
RCC

RML
O

Rt Breast: Well defined

spiculated mass lesion,
2.3x1.3cm, in UOQ,
BIRADS 5

Treatment

Breast Cancer Screening

Assess Risk: Breast Cancer Risk

Assessment Tool (Modified Gail
Model)
http://www.cancer.gov/bcrisktool/Def
ault.aspx
NCCN guidelines
2014

'Angelina Jolie effect'

Criteria for genetic

testing
(Personal or family
history)
Both breast and ovarian

Deleterious BRCA
mutation in the family

cancer

Breast cancer < 50

years

> 2 members with breast

cancer, one <50 years

Multiple breast cancers

> 3 members with breast

cancer, any age

TNBC
Pancreatic with breast
or ovarian cancer in
the family

Male breast cancer

Ashkenazi Jewish descent

BSE Benefits

Easy to do
No cost
No equipments
No trained personnel needed

The diagnostic power of BSE is 8090% and can result in 50% reduction
in mortality(Shiraly et al., 2010)

Opportunistic screening
Mammogram who can afford it

What can we do to spread

awareness about BC?

Talk about it
Write about it
Role plays, patient support groups
Awareness walks
Bill boards , Advertise everywhere
School/college programs
Collaborate with social workers,
Anganwadi workers

Take home message

A-Awareness of disease
( it is treatable)
B- Breast self examination
C-Clinical examination

Thank you