The survival rate of women with breast cancer has increased significantly over the last decade, thanks to the advances in diagnosis and treatment. While early diagnosis and treatment increases survival rate, overtreatment of early-stage breast cancer can lead toxic side effects as well as increase financial burden on the patient's family. Here comes the importance of using a personalized treatment approach.
What does it mean by overtreatment of breast cancer and how personalized treatment approach can help avoid it? We asked Dr Poovamma CU, Surgical Oncologist, Cytecare Cancer Hospital. She has several years of surgical experience including super-specialisation in Breast Oncoplastic Surgery.
Following are experts from the exclusive interaction with Dr Poovamma: -
Q. What are the factors that are contributing to the rise in the prevalence of breast cancer?
Breast cancer has been on the rise across the globe. In India, it is the most diagnosed cancer across regions. Though there is no known cause for breast cancer, change in lifestyles, food habits, environmental changes contribute largely to the cause. Earlier, women used to conceive at a relatively younger age and breast feed for at least a year. The scenario has changed in recent years. Conceiving at a late age, and insufficient breast feeding, obesity and less physical activity are some of the leading causes for breast cancer.
Though there are many advances in the treatment of breast cancer and a lot of awareness being created for early diagnosis, breast cancer incidences are not reducing. The oncologists and researchers have mentioned and proved many times that early diagnosis can lead to better treatment and increase survival rate post treatment. Yet, many patients are being diagnosed at a later stage where treatment becomes challenging and affects the physical, mental, and financial condition of the patient and their family.
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Q. How much is too much treatment for early-stage breast cancer?
Breast cancer, at the time of diagnosis, is categorized mainly into 4 stages. Stage 1 & 2 are considered as early-stage breast cancer where the cancer is contained to the affected breast. Whereas stage 3 & 4 are considered as advance stages where the cancer has either spread to the other breast or other parts of the body; known as metastasis. The treatment for breast cancer changes based on the stage.
Early-stage breast cancer patients have a higher rate of survival compared to the later stages. The treatment mainly includes surgery, radiation therapy and chemotherapy or hormone therapy. In most of the cases, surgery is followed by chemotherapy as a standard protocol. However, it is not necessary that all the early-stage breast cancer patients benefit from chemotherapy. If the treatment is generalized, then it may cause overtreatment and make the patient undergo unnecessary physical and emotional trauma.
Q. How can overtreatment be avoided?
Overtreatment can be avoided by getting a better understanding of the tumor biology. Many tools that were available until the last few years could give insights regarding the cancer up to certain extent, with which personalizing the treatment was a challenge. But now, with the latest advances in diagnosis, it is possible to personalize the treatment. Prognostication is one such tool that allows the study of tumor biology which gives in-depth information about the risk of recurrence. One such prognostic test available in India is CanAssist Breast. In early-stage, hormone receptor-positive breast cancer patients, CanAssist Breast provides information about recurrence risk. It is the only test validated on Indian patients. With the help of such prognostic tests, oncologists can personalize the treatment. As per the recent publications, about 80 per cent of early-stage hormone receptor-positive patients can avoid chemotherapy safely. With accurate diagnosis and specific recurrence risk categorization, administering the right course of treatment is much easier and more effective. This approach will not only help the oncologist but saves the patient from the toxic side effects of chemotherapy and related financial burden.
Q. Fear of breast cancer treatment is also prevalent among many patients? What can be done to reduce their fear?
Being a specialist in breast cancer surgery, I make sure that the patient gets the best possible treatment and help them cope with the trauma by counseling them before starting the treatment and post-surgery. The fear of cancer treatment is reducing drastically with the outcomes being delivered with the help of latest advances. Moreover, cancer is now categorized as a lifestyle disease which is treatable. Being an oncologist, I urge women to practice self-breast examination and opt for regular screenings. This can help them detect the cancer at an early stage when the chances of positive outcomes is high.