Breast cancer awareness should begin during adolescence

Non-communicable diseases (NCDs) are responsible for almost 70 per cent of all deaths worldwide, over 85 per cent of these "premature" deaths occur in low- and middle-income countries. NCDs contribute to around 5.87 million (60 per cent) of all deaths in India. Given our sedentary lifestyle, we are prone to many killer diseases, one of them being breast cancer. While men can also suffer from breast cancer, its incidence among women is significantly high. Breast cancer is the most common cancer among women globally as well as in India. According to the Global Burden of Disease Study, 2016, in India, the rate of breast cancer has increased to 39.1 per cent from 1990 to 2016. There were an estimated 5.26 Lakh patients with breast cancer in 2016. Inputs by Dr Muzammil Shaikh, Consultant, Medical Oncology at Hinduja Hospital, Khar highlights that breast awareness should begin at adolescence and how our contemporary unhealthy lifestyle is wreaking havoc.

Several factors are known to raise the risk of developing breast cancer; some of these are beyond human control. However, there are numerous factors that can be monitored such as overeating, lack of exercise and balanced as well as a nutritional food. Among the controllable factors, obesity has been considered as one of the most critical ones that greatly affects the risk of breast cancer.

The increasing rate of obesity among Indian women raises an alarm. The Global Nutrition Report 2018 pointed out that obesity among the adult population is at record levels with nearly 39 per cent of adults overweight, globally. The World Health Organization defines overweight and obesity as “abnormal or excessive fat accumulation that may impair health”.

Recent studies across different settings in the world have demonstrated that obesity is related with higher risks of cancers of various organs counting oesophagus, gastric cardia, thyroid, pancreas, colon, rectum, endometrium, prostate, gallbladder, ovary, and breast.

Obesity is significantly associated with an upsurge in the risk of breast cancer among women and the risk of breast cancer among obese women is believed to be12 per cent higher than the women of normal weight.

It is important to note that maintaining a healthy weight becomes more important but it becomes difficult as we age. For women, menopause is a typical point of challenge that causes many to gain weight. Thus, awareness about breast cancer and maintaining a healthy lifestyle must be targeted from the adolescent age. Also, a comprehensive approach of addressing lifestyle-related risk factors such as maintaining ideal body weight, regular physical exercise, quitting smoking and excessive alcohol consumption, breastfeeding, along with promoting regular breast cancer screening are some of the very effective and low-cost preventable strategies.

Even the efficacy of cancer treatments is significantly lower in obese breast cancer survivors, posing bigger challenges in patient care and disease management in this patient population. Further investigations are necessary to assess the effects on treatment outcomes and optimise therapeutic mechanisms in order to successfully target breast cancer associated with obesity. Obese women with breast cancer represent a unique patient population. They are at increased risk for the development of breast cancer and may experience more complications related to surgery and radiation.