Detecting Breast Cancer Risk

Detecting Breast Cancer Risk

Subject :Science and Technology

Section: Health

Why in news?

A new study has found how breast tissue density plays a role in detecting breast cancer risk. A study has found that while breast density declines with age, a slower rate of decline in one breast often precedes a cancer diagnosis in that breast.

What is Breast Cancer?

• Breast cancer is a disease in which cells in the breast grow out of control. There are different kinds of breast cancer. The kind of breast cancer depends on which cells in the breast turn into cancer.
• Breast cancer can spread outside the breast through blood vessels and lymph vessels. When breast cancer spreads to other parts of the body, it is said to have metastasized.

The common kinds of breast cancer are—

Invasive ductal carcinoma: The cancer cells begin in the ducts and then grow outside the ducts into other parts of the breast tissue. Invasive cancer cells can also spread, or metastasize, to other parts of the body.

Invasive lobular carcinoma: Cancer cells begin in the lobules and then spread from the lobules to the breast tissues that are close by. These invasive cancer cells can also spread to other parts of the body.

Causes of Breast cancer

• Breast cancer is not a transmissible or infectious disease. Unlike some cancers that have infection-related causes, such as human papillomavirus (HPV) infection and cervical cancer, there are no known viral or bacterial infections linked to the development of breast cancer.
• Certain factors increase the risk of breast cancer including increasing age, obesity, harmful use of alcohol, family history of breast cancer, history of radiation exposure, reproductive history (such as age that menstrual periods began and age at first pregnancy), tobacco use and postmenopausal hormone therapy.

Behavioural choices and related interventions that reduce the risk of breast cancer include:

• Prolonged breastfeeding
• Regular physical activity
• Weight control
• Avoidance of harmful use of alcohol
• Avoidance of exposure to tobacco smoke
• Avoidance of prolonged use of hormones
• Avoidance of excessive radiation exposure.

Unfortunately, even if all of the potentially modifiable risk factors could be controlled, this would only reduce the risk of developing breast cancer by at most 30%.

India Facts

According to a report by the Indian Council for Medical Research on the ‘Burden of cancers in India’, seven cancers accounted for more than 40% of the total disease burden: lung (10.6%), breast (10.5%), esophagus (5.8%), mouth (5.7%), stomach (5.2%), liver (4.6%) and cervix uteri (4.3%).

Policies and schemes in India

• In order to prevent and control major Non-Communicable Diseases (NCD), the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) was launched in 2010 with focus on strengthening infrastructure, human resource development, health promotion, early diagnosis, management and referral.
• Under NPCDCS, NCD Cells are being established at National, State and District levels for programme management, and NCD Clinics are being set up at District and CHC levels, to provide services for early diagnosis, treatment and follow-up for common NCDs
• For the Cancer component, there is the Tertiary Care Cancer Centers (TCCC) scheme, which aims at setting up/strengthening of 20 State Cancer Institutes (SCI) and 50 TCCCs for providing comprehensive cancer care in the country. Under the scheme there is provision for giving a ‘one time grant’ of Rs. 120 crore per SCI and Rs. 45 crore per TCCC, to be used for building construction and procurement of equipment, with the Centre to State share in the ratio of 60:40 (except for North-Eastern and Hilly States, where the share is 90:10).

Treatment – WHO Guidelines

WHO outlines three pillars of action with specific key performance indicators:

• Recommending countries to focus on breast cancer early-detection programmes so that at least 60 per cent of breast cancers are diagnosed and treated as an early-stage disease.
• Diagnosing breast cancer within 60 days of the initial presentation can improve breast cancer outcomes. Treatment should start within three months of the first presentation
• Managing breast cancer so that at least 80 per cent of patients complete their recommended treatment.

World Health Organization (WHO) announced an initiative called the “Global Breast Cancer Initiative”. GBCI employs 3 key strategies to achieve these objectives: health promotion and early detection; timely diagnosis; and comprehensive breast cancer management. Through GBCI, WHO provides guidance to governments across the world on ways to strengthen systems for detecting, diagnosing and treating breast cancer, to further their capacities to manage other types of cancer.

Global Breast Cancer Initiative:

Aim

1. The initiative aims to reduce global breast mortality by 2.5% by 2040.
2. The initiative will particularly focus on reducing deaths in low-income countries. There the progress to tackle the disease is relatively slow.

Key Features of the Initiative:

1. Guidance to Governments: Under the initiative, WHO will work with other UN agencies. They will provide guidance to governments on how to strengthen systems for diagnosing and treating breast cancer. It is expected to improve capacities to manage other types of cancer.
2. Evidence-based Technical Package: An evidence-based technical package will also be provided to countries as part of the initiative. It will incorporate existing WHO cancer tools and products.

Breast Density

1. The study published in JAMA Oncology finds that while breast density declines with age, a slower rate of decline in one breast often precedes a cancer diagnosis in that breast.
2. Breast density is now an acknowledged risk factor for breast cancer, albeit one of many.
3. Dense tissue also makes tumors harder to detect in imaging scans.