From Statistics to Stories: Unveiling the Epidemiology of Breast Carcinoma in Northwestern India

Abstract

After receiving the pathology report for breast cancer, the first question most patients ask their doctor is about their journey ahead. The type of cancer and how it spreads can give us an idea of what to expect during follow-up. Unfortunately, there is a lack of reporting, management, and documentation of breast cancer cases in India, resulting in a shortage of information on the different types of breast cancer. To address this issue, a study was conducted to gain a better understanding of the pattern of breast carcinoma in Northwestern India. A total of 2619 breast cancer pathology reports were gathered from four major diagnostic centres in Northwest India. Out of all breast cancer patients, 97.74% (2560) were women, while men accounted for only 2.25% (59) of the sample. At the time of diagnosis, 72% of patients were in stages III and IV, while only 28% of patients were in the early stages of cancer (stages I and II). The most common type of breast cancer was infiltrating duct carcinoma (IDC), which constituted 80.71% (2114/2619) of all malignant lesions. infiltrating lobular carcinoma was the second most common pathology, accounting for 5.38% (141/2619) of all cases. The rarer pathologies had a presentation rate below 10%. Our study revealed the most common symptom as a painless lump. Significant majority presented in advanced stages. An alarming 20% presented with foul-smelling ulceration or fungation of the skin. Varied presentations of breast cancer subtypes were evident. As the age-old saying goes-the 'most common' is often ignored as a large portion of the researcher's attention is focused on 'rarer stuff'. Similarly, IDC being the commonest deserves most of our attention. Not just the histology but its grades too. The lack of awareness regarding the risk factors and early detection methods of breast cancer is unfortunately even prevalent in 49% of healthcare workers. What India needs are more data reporting, timely diagnostic strategies, standardized reporting for pathology, and guideline-based management strategies. Increasing data collection electronically in the coming years will help India in displaying more data.

Keywords: Breast cancer; Cancer distribution; Case series; Epidemiology; Male breast cancer.