EPIDEMIOLOGY OF
BREAST CANCER
MUJEEB AHMAD
ROLL NO. 86
MBBS 2020
DEPT. OF COMMUNITY MEDICINE
CONTENTS
• WORLD SCENARIO
• SCENARIO IN INDIA
• SYMPTOMS OF BREAST CANCER
• RISK FACTORS
• PREVENTION
• WHO GBCI
WORLD SCENARIO
Female Breast cancer has now surpassed lung cancer as the leading
cause of global cancer incidence in 2020, with an estimated 2.3
million new cases, representing 11.7 % of all cancer cases
It is the fifth leading cause of cancer mortality worldwide, with
6,85,000 deaths
Incidence rates are 88% higher in transitioned countries then in
transitioning countries(55.9 end 29.7 per 1,00,000 respectively)
However, transitioned countries have 17% higher mortality rates
compared with transitioning countries(15 and 12.8 per 1,00,000
respectively)
SCENARIO IN INDIA
In India breast cancer is the topmost cancer with about 1,78,361
(13.6%) new cases diagnosed in 2020
The incidence rate is about 25.8% per 1,00,000 population
It was estimated to cause 13.3 deaths per 1,00,000 population in the
year 2020
The survival rate decreased by 2.7 times for breast cancer, in case of
detection at stage 4 against stage 1
A total of 90,408 women died of cancer breast in 2020 in India
SYMPTOMS OF BREAST CANCER
A painless lump or thickening in the breast
Alteration in size, shape or appearance of a breast
Dimpling, redness, pitting or other alteration in the skin
Change in nipple appearance or alteration in the skin surrounding the
nipple
Abnormal nipple discharge
90% of breast masses are not cancerous
Non cancerous breast abnormalities include benign masses like
Fibroadenomas and Cysts as well as infections
Breast cancer can present in a wide variety of ways, therefore a
complete medical examination is important
Women with persistent abnormalities should undergo tests like breast
imaging and tissue biopsy to determine if the mass is malignant or
benign
Advanced cancers can erode through the skin to cause ulceration but
are not necessarily painful
Cancerous cells may spread to other organs and cause cancer related
symptoms such as bone pain and headache
The most common first detectable site of spread is to the lymph
nodes under the arm
RISK FACTORS
AGE: High incidence is seen between the ages of 35 and 50. A slight
Bimodal trend has been observed with a dip in incidence at
menopause
POSITIVE FAMILY HISTORY
EARLY MENARCHE AND LATE MENOPAUSE
ELEVATED ESTROGEN AND PROGESTERON
PRIOR BREAST BIOPSY
PARITY: McMahon, et al in their international case-control study
found that risk of breast cancer is directly related to the age at which
women bear the first child. An early first, full-term pregnancy has
protective effect. Unmarried and nulliparous women are at more risk
than married and multiparous women
HIGH FAT DIET AND OBESITY
SOCIO-ECONOMIC STATUS
RADIATION EXPOSURE
PROLONGED USE OF OCPs
PREVENTION
Behavioural choices and related interventions that reduce the risk of
breast cancer include:
Prolonged breastfeeding
Regular physical activity
Weight control
Avoidance of Alcohol, Tobacco and Hormones
Avoidance of excessive radiation exposure
SURGICAL INTERVENTIONS
Earlier all breast cancers were treated surgically by mastectomy
(complete removal of breast)
Today they are treated with a smaller procedure called a lumpectomy
or partial mastectomy, in which only the tumour is removed from the
breast
MEDICAL TREATMENT
It is based on biological subtyping of the cancer
Cancers that express the oestrogen receptor and/or progesterone
receptor respond to Hormone/Endocrine therapies such as
TAMOXIFEN or AROMATASE INHIBITORS
Cancers that do not express ER or PR are hormone receptor negative
and treated with Chemotherapy
HER2 positive cancer are treated with targeted biological agents like
TRASTUZUMAB
RADIOTHERAPY
In early stage breast cancer, radiation can prevent a woman having to
undergo a mastectomy
In later stage breast cancer radiation can reduce recurrence risk
In advanced stage radiation may reduce likelihood of dying of the
disease
WHO GLOBAL BREAST CANCER INITIATIVE
(GBCI)
The objective is to reduce global breast cancer mortality by 2.5% per
year, thereby averting 2.5 million deaths globally between 2020 and
2040
The three pillars towards achieving this objective are :
• Health promotion for early detection
• Timely diagnosis, and
• Comprehensive breast cancer management
BIBLIOGRAPHY
K. PARK, TEXTBOOK OF PREVENTIVE AND SOCIAL
MEDICINE, 27TH EDITION. JABALPUR :M/S BANARSIDAS
BHANOT PUBLICATIONS, 2023
THANK YOU!
