Somita Pal, Senior Correspondent, DNA
Dr. Jyoti Bajpai, Associate Professor & Medical Oncologist, Tata Memorial Hospital
Dr. R. K. Deshpande, Executive Vice Chairman, Asian Institute of Oncology
Dr. Asha Kapadia, Chief of Medicine & Head, Department of Oncology, M.D. (USA), DABP, P.D. Hinduja Hospital
Dr. B. K. Smruti, Medical Oncologist, Bombay Hospital & Medical Research Centre
Dhrubajyoti Roy [ph]: Welcome to all on behalf of DNA. My name is Dhrubajyoti Roy [ph]. I take care of health category. DNA conversation is a initiative to put in the public domain concerns and issues which matters to day-to-day life, especially in important event like health and on. This is the registered property of us and we have been doing for the last years, we have the privilege of getting extremely well-known panelist like you in the past.
Dr. Jyoti Bajpai: So, thanks a lot and this is a very important question which you have asked. And the incidents in all of the areas, not only in Mumbai and India, it's increasing and largely the responsible factors are urbanization of the lifestyle.
So, in majority of registries, urban registries, now breast cancer has superseded the cervical cancer which was – which used to the predominant cause previously. And apart from Chennai in urban areas all of the urban registries like Mumbai, Bangalore, Bhopal, et cetera. So now breast cancer has become the predominant disease. In rural areas, like [indiscernible] [0:01:49] still, we are seeing cervical simply is the predominant cause, so it is essentially a lifestyle driven factors which responsible for these deaths.
Somita Pal: Dr. Deshpande, breast cancer what are the symptoms and like – how to catch it early.
Dr. R. K. Deshpande: Yeah. Okay. I’ll just add one more thing to that.
Somita Pal: Yeah.
Dr. R. K. Deshpande: If you take the sheer incidence this year 2015, it’s expected that 1,55,000 women will get breast cancer in our country. Okay? This is definitely less than 2,50,000 or 3,00,000 which will happen in the United States. But if you actually adjust it to the population, because we are practically four times as much in population, then the incidence is not very different.
But what is more different is, one in five women in the U.S. will die of breast cancer. So if you have 200,000 then one in five, 40,000 will die. One in four will die in China, whereas one in two will die in India, so the mortality is really high, which mean that there is something more at the presentation. And that’s why – answer to your question comes.
Many of these patients who present in India will present locally advance stage, where no matter what you do the results are not going to be the same, because the stage itself is advanced.
Most common presentation is a painless lump in the breast, sometimes discharge from the nipple, lump in the armpit, or in the neck, or in the tummy. These are common symptoms what you actually see.
A small percentage of people particularly are aware of who undergo regular check up, it can show up as a calcified kind of a small nodule in the breast, where the lady feels nothing or even the doctor has not really identified any mass, but it’s a very, very small, clinically non-palpable, but confirmed kind of breast cancer. So, but these are very small anecdotal numbers as of today even now. And the best results actually are in those kind of patients.
A non-palpable breast lump but no spread will have probably a cure rate of almost about 97%. What do you mean by cure, which mean that you treat the patient and the patient is all right for the rest of her life for their expectancy.
For example, today the life expectancy at the age of five is practically around 71 for a lady and 69 for a man. So if at the age of 45, if a lady presents with a non-palpable incidental diagnosis of a lump and if you treat it, she has a 97% of chance that she can achieve that 71 years of age. That's called a cure.
We normally talk in terms of five-year survivals, not because of cancer patient is going to survive only for five years, but because most recurrences don't talk of generally after five years that's a presumption. But in breast cancer that is not really true. You normally take now at least 10 years in sort of these things.
So would I got, you asked, lump in breast, lump in armpit, discharge from a nipple…
Dr. Jyoti Bajpai: These are the cases…..
Dr. R. K. Deshpande: These are the common symptoms.
Dr. Jyoti Bajpai: Common symptoms.
Dr. R. K. Deshpande: Uncommon symptoms is a lady may not even be aware that there is a lump, but she could develop pain from a bone spread in the form of a backache, or she could develop, kind of, convulsions or loss of vision or something because of brain spread, loss of appetite or something like that because of the liver spread, but these are all rare kind of symptoms.