Breast cancer cases among women rising alarmingly

First, the bad news. More women in Bangalore than ever are falling prey to breast cancer which forms the largest percentage of all cancers reported - 27 out of every 100. Now, the good news. there are two drugs that are effective in prevention-tamoxifen and raloxifene. But the downside is that very little awareness among city women about these two drugs.

The rise of breast cancers among city women is indeed alarming. Twenty years ago, cancer of the cervix was the most diagnosed, at 28.1%. Breast cancers were 14.7%. By 2004-05, breast cancers had risen to 27.6%, with cancer of the cervix falling behind to 15.7%.

The figures, mentioned by the publication of the PBCR (Population based cancer registry) and the HBCR (Hospital based cancer registry) of the NCRP (National Cancer Registry Programme), indicate the seriousness of the problem. Worse, when a woman is affected with breast cancer, there are 50 to 90 per cent chances that her daughter, niece or sister may fall prey to the same disease. This is where today, the role of preventive medicine comes in.

New guidelines set out by the National Institute for Clinical Excellence (Nice) suggest that all women over 30 at high risk of breast cancer should be offered the drugs tamoxifen or raloxifene. If a woman has a genetic defect, like BRCA1, she has life time chance of 70 to 90% of getting breast cancer. In BRCA2 mutation, the chances are about 40-50%, said Dr Radheshyam, consultant, medical oncologist,

But what about preventive medication in case of breast cancer in the city? “We advise high risk women to undergo blood genetic test to identify the risk factor. The next option is elective tamoxifen therapy and close follow-ups,” said Dr BS Ajaikumar, Chairman, HCG.

The only preventive medicine is tamoxifen or raloxifene. “Tamoxifen reduces the incidence of estrogen receptor positive breast cancer. Thus at least 50 per cent of the incidents can be stopped with intervention of preventive medication,” said Dr Anthony Pais, Professor and HoD, oncoplastic breast surgery, Mazumdar Shaw Cancer Centre.

Indian women can benefit from the discovery that aromatase inhibitors like femara can reduce breast cancer incidence, added Dr Radheshyam. However, while this elective tamoxifen treatment is common among cured breast cancer patients to avoid recurrence of the disease, not many women come forward for a preventive therapy, said Dr Ajaikumar.

“There is lack of awareness about preventive medication available for breast cancer. Less than one per cent of the high risk cases would approach for any preventive medical intervention. High risk women ask for the cause of breast cancer, but not about preventive measures. They wait till they get the disease to be treated,” said Dr Pais.

February 4 is World Cancer Day.