Breast cancer: 90% mastectomy cases are avoidable, say experts

Prithvijit Mitra | TNN | Nov 6, 2017, KOLKATA: Even as the city observed World Breast Cancer Day on Tuesday, oncologists say the lack of awareness about the disease drives patients for mastectomy (surgical removal of breasts). Doctors maintain that breast conservation is safe and healthy and chances of a recurrence of the disease is less than 1%.

Breast cancer is the most frequent form of cancer among urban women in India and the number is increasing annually. In West Bengal, about 85,000 new cancer cases are diagnosed every year and around 40,000 succumb to the disease. Approximately 13000 new breast cancer patients are diagnosed annually in the state.

"A vast majority of these women could have saved their breasts. But misconceptions drive them to insist on mastectomy which is avoidable in around 90% of the cases. Internationally, it is accepted that if the cancerous lump in the breast is not big enough, surgery could be avoided," said Gautam Mukhopadhyay, secretary of the Bengal oncology foundation which organized a breast cancer walk on Tuesday. Merely 1% of breast cancer patients - who need a surgery - opt for reconstruction.

"A cancerous lump which is less than 4 cm in size can be safely extracted without mastectomy. But strangely, patients insist to have the breast removed. While a surgery is unavoidable in case of bigger lumps, breasts can be reconstructed. This helps a patient to lead a normal life and put the surgery behind. This situation prevails even witn the fact that few are even aware that breasts can be reconstructed," said Diptendra Sarkar, head of the department of breast cancer, Institute of Post-Graduate Medical Education and Research (IPGMER).

Reconstruction techniques are simple and inexpensive, pointed out Sarkar. Muscles from the hips and tissues from the abdomen are used for reconstruction. A silicon implant is not necessary in all cases. "It helps to keep a patient's self-confidence intact. But even though we offer the option to every patient who needs a mastectomy, few go for it," said Sarkar.

The chances of a recurrence were less than 1% in breast cancer, he added. Hereditary factor is often responsible for breast cancer. Other than this, nulliparity, early age at menarche, late age at first pregnancy, obesity, cigarette smoking and alcohol are other known causative factors for this disease. The incidence of breast cancer is much higher in urban than in rural women. This urban/rural difference is mainly due to difference in lifestyle factors. Western dietary influences and the changed lifestyles of urban women are the major cause of rising incidence of breast cancer in the state.