Despite controversies—and several studies—in the West over the efficacy of screening for breast cancer via mammograms, especially in younger women, for India, mammograms remain the “best” form of screening method. The argument against mammograms for screening breast cancer in younger women is that because of the denser breast tissue, it is difficult to differentiate between healthy tissue and the malignant one because of the similarity in the way they both are present on the picture created by a mammogram.
However, doctors in India are dealing with the issue by using a "digital mammogram", combining it with ultrasound and MRI in high risk cases, Dr Harit Chaturvedi, chairman, Max Institute of Cancer Care, told THE WEEK. Chaturvedi also said a section of studies have also indicated that screening reduced mortality levels among women with breast cancer by 40 per cent, although there were several other factors that needed to be considered to determine the exact cause that brought the death rate down among those women.
While in the West, breast cancer was being seen in the later years (50-60 years), in India, the incidence was higher among women between 40-50 years of age, he said. According to recent WHO data, breast cancer impacted over 2.1 million women each year, and also leads to the highest number of cancer-related deaths among women, he added. In India, incidence of breast cancer is the highest among cancers in women, and each year, about 1.6 lakh new cases are being reported in the country.
“There are various factors that might increase the risk of breast cancer in women such as obesity, late or no children, lack of breast-feeding, alcohol, and smoking,” he said. Women need to be wary of the key symptoms of the disease such as lump in the breast, nipple discharge, skin changes over breast, pain in the breast and pay attention to their lifestyle, too, said Chaturvedi.
“Among the current image modalities, we have digital mammography, which is better than conventional mammography. The mammography machine that we have uses the advanced technique of tomosynthesis, which is basically like a CT scan where thinner sections of the breast are analysed. Besides, we also use ultrasound and MRI in case of high-risk cases,” said Dr Bharat Aggarwal, director, radiology services, Max Super Specialty Hospital, Saket.
Owing to a "scarcity" of radiologists and limited expertise in breast cancer diagnostics across Asia, Max Healthcare is partnering with Fujifilm to train doctors in early detection of cancer. Spokespersons from Fujifilm recently announced that the company would be sponsoring an advanced fellowship in breast imaging with Max Healthcare, under the “guidance” of Chaturvedi and Aggarwal. Doctors would be trained in breast mammography, breast MR, and breast ultrasound techniques for six months through the Max-Fujifilm collaboration fellowship. Each year, the programme will train two select radiologists in early detection of breast cancer.
While screening was important, the country also needs to have trained radiologists to read the images accurately, said Chander Shekhar Sibal, executive vice president and head of medical division at Fujifilm India.
