Breast Cancer Panel Triggers Important Conversations

On World Cancer Day, Healthcare Thinktank Voice of Healthcare hosted a LIVE virtual Panel Discussion, inviting distinguished leaders under one roof on the theme - Conquering Breast Cancer: Early Detection for Better Protection.

04 FEBRUARY 2022 / 2:00 PM - 3:00 PM

On the occasion of World Cancer Day, Voice of Healthcare – in association with AstraZeneca - hosted a BREAST CANCER PANEL Discussion, “Conquering Breast Cancer: early detection for better protection”. The Panel featured a rich cross-section of leading minds from the healthcare space. 

THE BIG GOAL 

The overarching objective of the program was to sensitize the audience regarding the importance of early detection and methods for early detection. Other parallel goals were to gain insights on strengthening the awareness initiatives so that every woman in the country may be reached. The organizers also wanted to deep-dive into the challenges in early detection, and possible interventions to overcome them.

URGENCIES DRIVING THE INTERVENTION

According to the WHO, 7.8 million living women were diagnosed with breast cancer in the past 5 years, making it the world’s most prevalent cancer. The incidence of breast cancer is low in India, but it is rising. Indeed, it is the commonest form of cancer in urban Indian women and the second commonest one for rural women. The vast majority of breast cancer patients undergo inadequate treatment due to lack of high-quality infrastructure, skilled manpower and financial constraints. While early detection and treatment is associated with a higher survival, most cases are diagnosed at a relatively advanced stage owing to the lack of awareness. We wanted to trigger a narrative that addresses this lacuna in awareness and alertness. 

PERSONAS WHO RAISED THEIR VOICE 

Dr. Vijay Agarwal - Lead & Sr. Consultant - Medical Oncology & Haematology, Aster CMI

Dr. Shalini Singh - Director, National Institute of Cancer Prevention and Research

Dr. Geetha Manjunath - Founder and Chief Executive Officer, Naima Health Analytix

Neerja Malik - Author, "I Inspire", Global Cancer Counselor, Inspirational Speaker and Breast Cancer Conqueror

Dr. Sneha Bhuyar - Chairperson - Breast Cancer Committee, FOGSI, Managing Director- Sukhkarta Hospital

Dr. Vani Parmar - Professor, Surgical Oncology, Tata Memorial Centre Advanced Centre for Treatment, Research and Education in Cancer

Devieka Bhojwani - Vice President, Women's Cancer Initiative (Tata Memorial Hospital)  

HIGHLIGHTS: POINTS TOUCHED UPON BY THE SPEAKERS 

Below is a quick summary of the points raised and angles discussed by our eminent line-up of speakers. 

Dr. Vani Parmar

Early detection is of utmost importance- If detected at 1st stage the 5 year survival can be as high as 95-98%. In contrast, if it is detected at advanced stage, the survival could be less than 5%. There is a gradual downshift from locally advanced cancers towards early cancers, mostly stage 2, which is now more common in India. The shift is seen over a period of years, primarily due to increased awareness. 

Dr. Devieka Bhojwani

If women are aware of normal breast, any abnormality would be picked up much earlier via self breast examination, but unfortunately in India, women come at much later stage. Not only women, the men of the society also need to be made aware about self breast examination.

As it is free of cost, breast self-examination should be widely taught, to women and even young girls at school.

Dr. Vani Parmar

It is important to create awareness regarding breast self-examination. However, as a screening tool clinical breast examination has been scientifically proven in randomized trials to be effective in saving lives, rather than self- breast examination for early detection.

Mammography- not really served as a good screening tool for women below 50, not widely available and is very expensive, but effective for symptomatic women. 

Dr. Shalini Singh

Self-breast examination is good for awareness generation, and all women should carry out breast self-examination every month including the ones treated for breast cancer.  Clinical examination is definitely the way to go and is currently being promoted by the government sector for all women aged 30 -65 years, once every 5 years. A study in Mumbai conducted in 20 clusters, showed that Clinical breast examination improves early detection as well as decreases the breast cancer related mortality.

If larger numbers are subjected to Clinical breast examination, then we should be seeing better results and the opportunity of clinical breast examination should not be missed whenever a woman comes in contact with the health system including during pregnancy and lactation.  People with high risk of breast cancer should be doing self-examination every month and can get a clinical exam annually.

Dr. Sneha Bhuyar

FOGSI has formed a breast cancer committee with an objective of increasing awareness among gynecologists regarding screening, early detection and timely referral. They are continuously sensitized about breast examination not just to the patients coming with breast complaints but to every patient. Training the paramedics and ASHA workers for detection of breast cancer would make a big difference, as they reach the grassroot levels. Teaching them what is normal and what is abnormal and how early to report to the clinician, would really make a difference. 

Dr. Geetha Manjunath

Self breast examination, clinical examination and mammography, all are good methods when feasible but we in India need more. 

NIRAMAI uses AI and Thermolytics to measure the temperature variations using thermal sensors and automatically analyses to detect changes in the breast, points out the area of abnormality and type of abnormality which can then be confirmed by other imaging methods. It aims to provide a highly sensitive alternative, which after clinical validation may prove as an option with the accuracy close to that of mammography but at a much better cost, and at a very large scale. Till date, it has been tested in close to 50,000 women worldwide.

Automation is the way to go. The results produced are less subjective, scalable & follow up tests are sufficient to give confirmation. 

Dr. Vani Parmar

When it comes to generating awareness, thermoscan, self-examination, clinical examination, health education are all tools equally helping to create cancer awareness, and there is no tool that supersedes the other.

Neerja Malik

Self-awareness is very important as the breast lump is first detected by the woman herself. 

Every school and institute should be approached for creating awareness about self breast examination, so that we can talk more freely about aspects of feminine form and remove the stigma around breast cancer. 

We need to not only spread awareness on different kinds of breast examinations but also on the cancer disease itself, as many people still believe cancer to be a contagious or infectious disease. 

We need more and more people to talk about it at various camps, clubs and institutions so that the fear of cancer doesn't kill the person before the disease ever does. 

Devieka Bhojwani

Cancer education and self-breast examination should be a part of the school curriculum as an educational programme, so that people take it more seriously and without stigma or shame. We need to set up a forum and involve the government to address this issue at national level. 

Neerja Malik

If you’ve been detected with breast cancer, don't get agitated, don't get hassled, don't get traumatized. Go with the flow and get your treatments done. Women should be also be sensitized regarding genetic testing, its familial and therapeutic implications. 

Dr. Vijay Agarwal

Genetic testing should be done after a thorough genetic counselling as it can have significant implication socially, economically and emotionally. If detected with breast cancer, follow the advice of professionals rather than taking random decisions on which tests to get. 

Dr Vani Parmar

5-10 % breast cancers are associated with genetic abnormality. Younger age, first- or second-degree relatives with breast and ovarian cancer, males with breast cancer, are few pointers for a genetic involvement. In addition to prevention, genetic testing also helps in deciding the treatment approach. It is also not necessary to lose your breast just because you have a genetic risk. Breast conservation is safe in BRCA mutated patients too.

Neerja Malik

Ask the doctor if there is a scope for removing the breast lump without undergoing mastectomy (lumpectomy). If so, you have a choice in your hands on which treatment to go for. A lot has to do with your mind-with love, courage, hope and faith. Do not let ‘cancer’ be more than a word.  

HONORABLE MENTIONS 

1. Dr. Geetha Manjunath - Please do not shy away from technology, cancer detection has to be a marriage of technology and clinicians. 

2. Devieka Bhojwani - We need more health programmes by the government and policies focused on screening done by trained health professionals in India. 

3. Dr. Sneha Bhuyar - Working on a 3-tire system with gynecologists, paramedics and even family physicians working on this should be the way to move forward. Focus should be on the grassroot level. 

4. Dr. Shalini Singh - Apart from different methods of examination, the Indian population should also be made aware of the risk factors causing breast cancer, such as obesity, physical inactivity, diabetes, tobacco and alcohol use, etc. A combined approach for prevention and treatment of cardiometabolic risks will ameliorate a number of non-communicable diseases including cancer. This approach is particularly helpful in improving outcomes of cancer survivors.  

5. Neerja Malik - Breast cancer is not a stigma. Don’t fight cancer, face it. You need to believe in surgery and doctors and believe you're cured. 
                      “A surgery is a gift, chemotherapy is the packing and radiation is the ribbon” 

6. Dr. Vani Parmar - The earlier the tumor is detected, and the smaller it is, higher is the chance of survival. It also helps to save the breast and mastectomy may not be necessary at all. Whichever method you may use for detection, detecting breast cancer early is the most important. 

*This press release is published by VOH team.*