How we can stop more deaths from breast cancer by 2030

Francis Okoye, CNS Correspondent, Nigeria
(First published in Nigeria Politics Magazine)
In a webinar organised for the media by Citizen News Service, titled ‘Are we on track to reduce breast cancer deaths by 1/3 by 2030?’ medical experts and breast cancer survivors shared their views on how to reduce deaths from this dreaded cancer.
The panel of experts and cancer survivors included Priya Kanayson, Advocacy Officer, NCD Alliance; Dr Pooja Ramakant, Associate Professor, Department of Endocrine and Breast Surgery, King George Medical University; Prof Anand Mishra, Head of Department of Endocrine and Breast surgery, KGMU; and Bret Miller, Founder, Male Breast Cancer Coalition and a breast cancer survivor himself.

According to Priya Kanayson, “Breast cancer is the most common killer cancer in women. Men can develop breast cancer too, even though only less than 1% of all breast cancers occur in men. Unless urgent measures are taken, an estimated 19.7 million cases of breast cancer will occur and 5.8 million women will die from it in the next decade. However, governments of the world have committed to achieving the sustainable development goals (SDGs) by 2030, and this includes reducing burden of breast cancer by 1/3.

Are we on track on diagnosing breast cancer early enough for better treatment outcomes? Civil society, government, private sector, and all health institutions should do more to reduce the burden of this disease. While advertisements of cola drinks and the use of mobile phones has reached even remote Indian villages, awareness of breast cancer has not, lamented Dr Ramakant. She also dispelled various myths associated with breast cancer, like—only  women can get breast cancer; it is mostly genetic and that it is incurable. The facts given by her included breast cancer is common among urban women; 5%-10% cases are caused by heredity; early stage diagnosis and treatment has 90%-100% cure rate; advanced stage records 50%-70% cure rate; it can happen in men too. 50% of all breast cancer cases in India occur in women in age group of 40– 50 years and usually present for diagnosis in stage 2 and stage 3. 80% of India women with breast cancer are below 65 years of age. Risk factors include hereditary (5-10%); certain types of benign breast disease; early menarche; late menopause; obesity; and alcohol.

Prof Anand explained how to diagnose breast cancer using triple assessment—(i) clinical (age and examination), (ii) imaging (ultra sound and mammography) and (iii) pathology (FNAC and core cut biopsy). This ensures confident diagnosis in 95% of cases. Treatment can entail surgery, hormonal therapy, radiation, and chemotherapy. Experts recommended annual mammogram plus clinical breast examination every 6-12 months (starting at 30 years of age), annual breast MRI; along with risk reduction strategies. Dr Ramakant cited the benefits of breast self examination (BSE). It is easy to perform; does not require any equipment or trained personnel  and so no costs are involved. The diagnostic power of BSE is 80-90% and can result in 50% reduction in mortality, said Dr Ramakant. We need to spread awareness about breast cancer by talking/writing/advertising about it; forming patient support groups; having school/college programmes; collaborating with social workers in order to spread the correct information for prevention, early diagnosis and treatment.

Francis Okoye, Citizen News Service - CNS
January 10, 2017