Breast cancer will become epidemic in India: oncology pioneer

By Madhusree Chatterjee, IANS,

New Delhi : Breast cancer will become an epidemic in India in another 10 years if the country does not put in place a vigorous mechanism for early detection and an awareness building exercise, says Umberto Veronesi, the father of modern breast cancer surgery.


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“The first priority in the campaign against breast cancer in India is early detection, which is fundamental. It makes the difference between life and death,” Veronesi told IANS in an interview here.

The 83-year-old Italian oncologist is the scientific director of the European Institute of Oncology in Milan in Italy, a non-profit medical organization that spearheads cutting edge researches on cancer and cures.

He was in India to address the Indian Breast Cancer Initiative 2008 at the Artemis Superspeciality Hospital in Gurgaon in Haryana.

“The second most important thing is to convince women – to raise the level of women consciousness – and the third priority is to convince the government to equip hospitals and health facilities across the country with mammography machines for detection and all the allied technology required for a big intervention programme.”

“Then comes the task of convincing doctors that mastectomy is not the only way out. Doctors here in India have a very fatalistic approach to breast cancer.

“I personally conduct one mastectomy in one out of every 10 cases. I advocate maximum breast conservation, along with hormone and chemotherapies.”

Veronesi, who has been researching cancer cures for more than 50 years and has more than 500 papers to his credit, pioneered the breast conservation surgery in breast cancer. He invented a technology called quandrantectomy, which challenged the idea that cancers could only be treated with aggressive surgery.

Breast cancer is the most common form of cancer among women. According to a study by International Agency for Research on Cancer (IARC), there will be approximately 250,000 new cases of breast cancer in India by 2015. At present, India reports around 100,000 new cases annually.

But Veronesi says chances of survival and cures for breast cancer is as high as 90 percent. “I operated on my wife 25 years ago for breast cancer. She is fine now.”

He attributes the rise in the incidence of breast cancer in Indian cities to changing lifestyles.

“Even two generations ago, India was not the high incidence zone. That was because Indian women married early and nursed two to three children each on an average. That kept the hormones flowing and breasts remained healthy.

“But now, women in India are emulating the West, marrying late and the average child bearing age has increased to 30 and sometimes even beyond that. If a woman has her first child at 16, it reduces the risk of breast cancer,” the oncologist said.

“If India continues to follow in the footsteps of the West and women decide not to have children and stop weaning their babies, breast cancer will become an epidemic in five to 10 years’ time,” the medical scientist said.

Veronesi called for a women’s movement. “India needs a change. It is growing richer and the healthcare system must be reconsidered. Women, especially in the semi-urban areas and Tier 2 cities, should be told that they are important to society and efforts must be made to preserve their health,” he said.

In the millions of villages and small towns across India, women afflicted with breast cancer are looked down upon by their spouses, families and friends.

“Italy was like India 20 years ago. But changes have now set in and women are more aware of their bodies and diseases like breast cancer,” Veronesi said.

The average age of the high risk group in India is 43 to 46 years, unlike in the West where women aged 53-57 years are more prone to breast cancers. According to studies, less than three percent of women come for regular screening in India for early detection of the disease. Many Indian women in villages shy away from the doctor fearing social embarrassment.

Globally, every three minutes a woman is diagnosed with breast cancer in the world, amounting to one million cases annually. The incidence could go up by 50 percent to 1.5 million by 2020, said the World Cancer Report.

(Madhusree Chatterjee can be contacted at [email protected])

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