To
commemorate Breast Cancer Awareness Day on October 22nd, Regional Cancer Centre
has conducted a one day workshop for Doctors from Kerala Government Health
Service. The month of October is being celebrated as Breast Cancer Awareness
Month and October 22nd is Breast Cancer Awareness Day, which is celebrated
worldwide as “Pink Ribbon day”. Pink ribbon is considered as symbol of Breast
Cancer awareness.
Every
year 1.38 million new breast cancers cases (115 000 cases in India) are
diagnosed. Incidence increasing in most countries. Every year world over 458
000 deaths are happening due to breast cancer
Half
of the global burden in low- and medium-resourced countries. In developing
world more than 60% are diagnosed in stages III and IV 5-year survival less
than 50% .Breast cancer is on the increase in India especially in Kerala (17.4
per 100,000 in 1991 increase to 30.5 in 2001).Stage distribution of breast
cancer in India is less favorable because 70-74% of breast cancers present in
locally advanced or metastatic disease (RCC, TVM data). There is a rapid raise
in number of breast cancers in the last decade.
In the year 2008-09, 1559 cases came to RCC for treatment while in
2009-10 it was 1610 cases. The reasons being attributed includes increased
urbanization, change in dietary habits and change in reproductory factors and
other lifestyle factors. Because of social reasons and lack of awareness a
significant percentage of patients seek medical health at very late stage,
which is often beyond cure.
But
breast cancer is better cancer because it has prolonged detectable preclinical
phase, effective treatment available and end result improved by early
diagnosis. Breast cancer can be diagnosed early by screening. Mammography is
the most effective screening programme available. Singapore is the first Asian
country to implement breast cancer screening by mammography. After introduction
of screening mortality is beginning to decline in Singapore. But In India mass
mammography is not feasible because of lack of resources and lack of
cost-effective as the incidence is low.
Studies
have shown that by clinical breast examination by health professionals breast
cancer can be detected early and successfully treated. Department of
health and family welfare in
collaboration with National Rural health mission and RCC plans to start District
Cancer Control Centres in all the Districts of Kerala as part of the programme
to bring cancer control to the doorstep of the patient. This programme also
envisages early detection of breast cancers in the community. RCC conducted a preliminary study in
collaboration with IARC and WHO in Trivandrum district where more than 50,000
women are screened for breast cancer by trained health workers. 133 wards of
Trivandrum districts are randomized to intervention and 144 to control arm. Study was initiated in January 2006. The target
population was healthy women aged 30-69 years. Health education on breast
awareness, clinical breast examination and provide affordable and early access
to diagnostic and treatment service offered in intervention arm. Cancers
detected are treated as per Institute guidelines. The preliminary results
showed that participation was good (90%) Early stage at diagnosis more in
the screened population (58% vs. 39%)
Lymph node negative cases more in the screened population (50% vs. 43%).Rate of
breast conservative surgery more in the screened population (18% vs 5%) . Today’s programme is to train doctors to
health workers for implementing mass screening programme by RCC in
collaboration with department of health and family welfare and NRHM in state of
Kerala. This one day workshop was attended by doctors from health service from
Trivandrum and Kollam. The main faculty were Dr.Paul Sebastian (Director)and
Dr. Ramdas( Superintendent) ,Dr. Romany Wesley ( Head of Community Oncology) and Dr.
Chandramohan (Organizing Secretary) . This programme was attended by doctors
from Trivandrum and Kollam Districts.
