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Bengaluru, 20th May, 2022: International Finance Corporation (IFC) India Country Head, Wendy Werner, visited a rural health camp organized by health-tech company Niramai that offers non-invasive and radiation-free breast cancer screenings. Wendy showcased IFC’s support towards innovation and opportunities for the underserved in India by engaging with the women participants at the event.

Held at PHC Kodathi, Sarjapur Main Road, (behind Wipro SEZ), the event received an overwhelming response with 180+ women participating, including anganwadi workers and nurses, among others. The camp had 5 booths where women could get screened in a privacy-aware manner with no one else present. 7 technicians from Niramai were present to educate the women about breast health and facilitate a smooth screening experience. Wendy also interacted with the women who had already undergone the screening to learn about their experience. In India, IFC’s focus is on growth and diversification of its country portfolio while supporting inclusive and sustainable development in the region.

Speaking at the camp, Wendy Werner, Country Head-India, IFC, said, “As the largest multilateral investor in healthcare in developing countries, we recognize the power of innovative healthcare solutions.” She added, “Breast cancer, already the most prevalent cancer among Indian women, has become a major health concern in the country. By supporting Niramai’s digital health solution, IFC reiterates its commitment to help improve women’s health and safety in emerging markets. Moving forward, especially in a post-COVID world, new technologies can potentially alter the health-care ecosystem rapidly, increasing access to affordable and quality healthcare across the country and the region.”

Also Read: Breast Cancer in women- Various myths and its management 

Dr. Geetha Manjunath, CEO & Co-founder, Niramai, said, “Niramai has developed this affordable, accessible and accurate breast cancer screening test to bridge the gap in healthcare infrastructure in our country. We are thankful to IFC and World Bank for recognizing our contributions to this field and conferring the Global Women Healthtech Award to Niramai earlier this year. Now, I am so glad that Ms Wendy took her valuable time off to visit the camp site, speak with the beneficiaries and endorse her strong commitment to women’s health. It is a matter of pride for us at Niramai to receive the support of IFC for sponsoring such a large health camp.”

Niramai has so far conducted over 4000 camps for the underprivileged and screened over 55000 women. NIRAMAI Health Analytix is a deep-tech healthcare company offering a novel AI-based, radiation-free, non-touch, highly accurate, breast cancer screening test for women of all age groups. The solution is portable, automated and detects breast cancer at a much earlier stage than traditional screening methods.

Niramai is available in Apollo Clinics, HCG Hospital, Rainbow hospital and 100+ other reputed diagnostic centers and cancer hospitals in 25 Indian cities. They recently partnered with home healthcare providers like Healthians in Delhi/NCR region, Ikigai Services Pvt. Ltd. in Mumbai and AMTZ in Andhra Pradesh to conduct breast health test at home on a large scale. Anyone interested in taking their home test can book an appointment on the Niramai website, www.niramai.com.

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Cancer occurs due to abnormal proliferation of cells in the body. The primary factor driving the formation of cancer cells is the mutation or alteration of the cell’s genetic material. Although cancer can occur in anyone, there are certain differences in the incidence of types of cancer between men and women. It’s important that the cancers are diagnosed when they are in nascent stage so that treatment could yield high cure rate and minimize morbidity associated with cancer.

Common cancers among women include:

1. Breast cancer: Screening in the form of mammogram is recommended to all women, to pick up the disease in nascent stages when the person is asymptomatic. The disease manifests as painless lump in the breast, skin changes, nipple discharge, and lump in the axilla. Diagnosis is made by imaging (diagnostic mammogram) and confirmed by a biopsy.

Also Read: Breast cancer : One in every five women in India carry anomalies in breasts 

2. Cervical cancer: Screening in the form of PAP smear is recommended to diagnose the condition in early stages. The disease manifests as irregular menses, intermenstrual bleeding (i.e., bleeding in between the menses cycle), bleeding after sexual intercourse, foul smelling vaginal discharge. The disease is initially identified by a PAP smear. Positive results are followed with colposcopy and biopsy.

Commonly occurring cancers irrespective of sex include:

1. Oropharyngeal cancer: Common among tobacco chewers. There’s no specific screening test. Disease is usually picked up by a routine dental and oral cavity exam. If symptoms arise, there could be painless ulcer, soreness of mouth, lump in the neck, difficulty swallowing. Diagnosis is confirmed by biopsy of the lesion.

2. Lung cancer: Usually arises in long term smokers. Symptoms include long standing cough, coughing up blood, weight loss and fatigue, chest pain, recurrent chest infections. Diagnosis is done by imaging of the chest and confirmed by a biopsy.

Also Read: Lung cancer : A significant risk factor is cigarette smoking

3. Prostate cancer: Usually asymptomatic in initial stages. Symptoms, if present include urinary urgency, urinary frequency, and pain during urination, passing blood in urine. Sometimes disease is diagnosed in advanced stage by which time, metastases would have occurred. The symptoms of metastases (distant spread) include bone pain (especially the back), swelling of legs, weight loss. If the disease is suspected, the doctor will suggest DRE (Digital Rectal Exam) to assess prostate, PSA (Prostate Specific Antigen) test, imaging in the form of MRI, and biopsy of the prostate.

4. Stomach cancer: Usually asymptomatic in initial stages. Symptoms start when the disease has already progressed. Symptoms include vomiting, abdominal pain, indigestion, loss of appetite and weight, passing black coloured stools. Diagnosis is picked up by the endoscopy and is confirmed by biopsy. The patient may be subjected to imaging to stage the disease, so that management is planned accordingly.

5. Blood cancer: Common in men than in women. There are various types of blood cancers of which lymphoma is common. Symptoms include swelling of the lymph nodes, long standing fever, night sweats, bleeding from gums and weight loss. Diagnostic tests include blood film and visualization under microscope, blood counts and imaging studies. This is followed by procedures like biopsy of lymph node and/or bone marrow aspiration and biopsy.

Dr. Sudarshan S

Consultant Physician, Bengaluru

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Ahmedabad-based Cadila Pharmaceuticals Limited has launched Trastuzumab, with the brand name TARZED.  Tarzed is a humanized monoclonal antibody, recommended in HER2 Positive Early Breast cancer and Metastatic Breast Cancer. According the latest audit report of Globocan Incidences of Breast Cancer are highest among all types of Cancers in Indian Population.

In a commitment to further strengthening the oncology portfolio Cadila’s TARZED is available   as       440 mg injection. The pharma giant has always been focused in making sure high quality, affordable and life-saving treatments are within the reach of patients. TARZED is considered safe and more efficacious compared to conventional treatment medicines for breast cancer.

Cadila Pharmaceuticals Ltd. (www.cadilapharma.com) is one of the largest privately-held pharmaceutical companies of India. It has recently concluded and cleared USFDA inspection successfully in February 2020. Over the past six decades, Cadila Pharmaceuticals has been engaged in development and manufacturing of affordable medicines and in making them available for patients across the world. Its innovation-driven drug discovery processes ensure the health and well-being of people around the world.

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Early detection of breast cancer is the only key to reduce mortality from this rapid disease.  The percentage of women between 30-40 years being detected with the disease has more than doubled in the last two decades. In recent times about 50% of women diagnosed with breast cancer each year are below 50 years of age.

Many women tend to ignore symptoms such as presence of lumps, nipple discharge and change in shape of the breast which often leads to delayed diagnosis of breast cancer. It is important that women be aware of such conditions as well as of advanced techniques like Vacuum-Assisted Breast Biopsy which is an advanced and minimally invasive diagnostic technology which helps sample even the smallest of lumps that may not get sampled by core needle biopsy. VABB also supports a minimally invasive and cosmetic friendly removal of non-cancerous lesions Fibroadenomas which occur commonly in young women. This October, let women pledge to take better care of their breast health and be watchful of their well-being.

Women often feel anxious once lumps are detected in the breast even though they may be non-cancerous and benign lesions. In younger women (15-35 years), non-cancerous lumps Fibroadenomas are more common. Fibroadenomas comprise about 50% of all breast biopsies, and this rate rises to 75% for biopsies in women under the age of 20 years. A fibroadenoma might feel firm, smooth, rubbery, or hard and has a well-defined shape. Another extremely common condition, Fibrocystic breast disease also gives breasts a lumpy or rope-like texture and is diagnosed in millions of women worldwide.

Traditionally, these would be removed surgically, causing much distress, leaving scars, or patients would choose to live with them in anxiety. Advanced technology like Vacuum-Assisted Breast Biopsy (VABB) comes to respite in such situations. VABB enables removing smallest of benign lumps without leaving scars or disfigurement of the breast which can be very reassuring for women.

The advantage of VABB is that the suspicious area of any size and depth can be easily targeted using VABB; hence small size lesions are also sampled easily. With this advancement in diagnosing breast cancer & removing small benign lumps, women from across age groups with any abnormality in the breast region would have a sense of relief.

About VABB

VABB is a pioneering tissue sampling technique by which breast abnormalities (benign and malignant lumps) can easily be accessed through a small and single incision. It is performed with the help of either a mammogram or ultrasound, or MRI, to precisely identify the lesions. The ability of VABB to collect multiple samples with a single needle has the potential to reduce procedure times for patients and may reduce discomfort during breast biopsy in a minimally invasive manner. In addition, it ensures that tissue samples are taken from all parts of the lesion. The samples are then sent to laboratory for detailed analysis, to identify if the lump is malignant or benign.

VABB has been approved by FDA (USA) and NICE (UK) for complete removal of fibroadenoma. This advanced technology is widely used abroad and is now available in India and is helping women take charge of their health and outsmart breast cancer. The Vacuum-Assisted Breast Biopsy technology increases the efficiency, accuracy, and ease of targeting such small breast lesions and therefore is practiced as a gold standard across the globe.

Dr Rupa Renganathan

Lead Consultant – Breast Imaging and Interventions

Kovai Medical Centre & Hospital, Coimbatore

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The most common cancer amongs’t women, breast cancer covers 25% of all cancer burden, globally as well as in India. With alarming rise in its incidence in the country, predominantly in urban India, estimates suggest every four minutes an Indian woman is diagnosed with breast cancer and every 13 mins a woman dies due to the condition. According to a recent report by WHO and International Agency for Research on Cancer (IARC), India saw 162,468 women newly detected with breast cancer and 87,090 losing their lives to the disease in 2018.

While genetic predisposition, sedentary lifestyle, longer working hours, late pregnancy, smoking, excessive alcohol consumption, stress and obesity are some of the risk factors associated with breast cancer. Medical experts believe delayed diagnosis and lack of awareness are major reasons for its high mortality rates. Most women do not know enough about breast cancer to get themselves diagnosed early.

Various myths related to Breast cancer and its management:

Myth 1: Breast cancer usually happens in older women and those with family history

It is true that elderly women may be at a higher risk for developing breast cancer,but it can occur in younger population as well. We have been witnessing a surge in breast cancer cases amongs’t women in the age group of 25-49 years in India.While genetic predisposition is a prominent risk factor, it is not the only one. Lifestyle and environment factors too could be at play. Hence, it is important for women for all ages to pay attention to their breasts and regularly examine them. Timely diagnosis and treatment at early stages of breast cancer can go a long way in improving the survival rates.

Myth 2: Leading an active and healthy lifestyle will keep breast cancer at bay

Yes, staying active and eating nutritious food is helpful to keep the body healthy and to lower risk of various disease conditions including breast cancer but it can’t eliminate it. It is critical to watch out for warning signs such as lump in the breast or underarm, thickening or swelling in the breast, pain and redness in the nipple areas, dimples or bulges on the breast skin and nipple discharge. If you notice any unusual changes, it is recommended to consult a doctor. A self-examination of the breast, regular screening with mammography, ultrasound is beneficial for early detection of the cancer.

Myth 3: Lumps around breast indicates breast cancer

No, a lump or lumps in the breast area doesn’t necessarily mean its cancer. Lumps can be formed due to various reasons including infection, inflammation, hormonal changes, trauma, tumor, etc. Breast cancer might or might not cause a lump. So, if you discover a new breast lump do not ignore the change or panic, instead get it checked by a doctor. Annual clinical breast exam and mammography is recommended for those above 30 years of age.

Myth 4: Treatment for breast cancer is same for all

Management of breast cancer depends on the severity/stage of the disease and the patient’s preference.In breast cancer, information about whether the cancer has spread from primary tumor location to other locations is very critical. During the minimally invasive biopsy, technological advancements like fluorescence imaging enables surgeons to selectively remove the lymph nodes and improve clinical accuracy of cancer staging. Enhanced precision and selected removal help avoid post-op complications like lymphedema, sensory deficit, pain, and impaired arm movement. Treating breast cancer may involve surgery, chemotherapy, radiation, and hormone therapy.

Myth 5:Breast cancer means removal of the entire breast

A radical mastectomy or surgical removal of the entire breast is suggested only when the cancer has spread extensively to the chest muscles. For each patient, the course of treatment varies per the cancer stage and his/her condition. With surgical advances breast conservation surgeries are a norm today. During a skin/nipple sparring surgery, surgeons remove only the cancer-affected breast tissues/tumour and re-construct the breast. Fluorescence Imaging helps surgeons to assess the vascularity of the skin flaps during surgery allowing them to ensure that the skin or the nipple areolar flap that are left behind after nipple sparring mastectomy are safe enough for reconstruction.

References:

• https://www.forbesindia.com/article/weschool/why-breast-cancer-awareness-needs-better-marketing-in-india/63939/1
• https://www.breastcancerindia.net/statistics/latest_statistics_breast_cancer_india.html
• https://www.who.int/cancer/PRGlobocanFinal.pdf

Dr. CB Koppiker
Breast Onco-surgeon and Medical Director
Orchids Breast Health Center, Pune

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Various treatments are available to cure breast cancer include surgery, chemotherapy, radiation and hormonal therapy. Now a days in many cases breast preservation surgery is performed instead of breast removal. Breast preservation helps to keep morale and up rightness is needed about all the treatment available about breast cancer as in combination they add to cure for the particular.

Increase in the Incidence of Breast Cancer 

Breast Cancer incidence is rising in India. It is a common cancer in women of urban India and accounts for 25% to 32% of all cancer in women. There is an age shift for breast cancer incidence in Asian countries with peak rise in 40’s. In India, 1 in 28 women will likely develop breast cancer and is expected to rise by 26% by 2025. There is an increased incidence in younger women with aggressive nature of breast cancer. This requires proper measures to be taken, to increase its awareness, screening programmes with early detection, making treatment available to all parts of the country and we should aim to decrease death from breast cancer.

Breast Awareness and Breast Self-Examination

Breast self-examination (BSE) is a systematic and regular examination of breast to assess any abnormality. It is the performed every month starting from age 20 years any changes in breast can occur because of aging, mensural cycle, pregnancy or menopause. By doing regular BSE on regular basis, you get to know how your breast normally feels so that you can notice early changes like lump, thickening, dimpling, nipple changes, redness or discharge from nipple. BSE helps to detect early signs of breast cancer early to help in better cure and probably decrease in deaths from breast cancer.

Dr. Sanjay Dudhat
Head Oncosurgeon
Nanavati Super Speciality Hospital, Mumbai

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Bangalore, 05 November 2020: Aster RV Hospital, a multi-specialty quaternary care hospital in Bengaluru, launched the Aster RV Breast Clinic in the city ahead of National Cancer Awareness Day. A dedicated center for women, the exclusive Breast Clinic will be led by a team of specialized doctors with vast experience in breast disorders and breast cancer treatment.

Dr. Vijay Agarwal, Lead & Senior Consultant, Medical Oncology, Aster RV Hospital, said, “Breast cancer is the leading cancer that affects women in India with an increasing number of cases being reported each year. India has a high mortality rate for breast cancer patients and the primary reason for this is the late diagnosis of the condition although it is treatable when found in the early stages. With the launch of the Breast Clinic, we aim to raise awareness among women on identifying breast cancer symptoms early and also help them with screening tools which will aid in the early detection and treatment.”

According to reports, one out of every 22 women in urban India is likely to develop a breast cancer during their lifetime. The clinic will offer personalized care in a supportive and caring environment. Patients will be able to utilize advanced diagnostic tests in order to accurately diagnose and treat all breast-related issues with advanced X-ray, 2D combined with 3D mammograms, breast ultrasounds, biopsy and breast MRI. The clinic also has a Da Vinci Robotic surgical system for minimally invasive breast cancer surgeries and reconstructions.

Dr. Nawab Jan, Consultant – Breast Surgeon, Aster RV Hospital said “The clinic is designed to address any breast-related concerns such as breast pain, tenderness, any lumps or cysts, or infections in the breast area, in a safe and sensitive environment. Also, cosmetic procedures like breast implants/reduction, reconstruction will be offered here.  Patients will be counseled on the most effective diagnostics and treatment approach across a multi-disciplinary team.”

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• Four out of ten people have heard of breast cancer but don’t know much about the disease.
• Poor awareness about Clinical Breast Examination, 52% think it’s done through mammography.
• 80% of population said they will not ignore the symptoms of breast cancer and seek medical help.

Nanavati Super Speciality Hospital Mumbai has released the findings of its Breast Cancer Awareness Survey themed ‘Learn, Educate, Change’. Breast cancer is the most common type of cancers among Indian women with the likelihood of almost one in 28 women under the threat of developing it. The survey comprised of 464 participants, with 85 percent of them being women.

The objective was to understand the level of awareness in symptoms, screening, diagnosis and treatment options for breast cancer. As a key highlight of the survey; just 42 percent participants lacked adequate knowledge about the disease, testing options and available treatments. However, most participants (80%) said they won’t ignore the symptoms of breast cancer and immediately seek medical help.

Commenting on the results of the survey, Dr Sanjay Dudhat, Head of Oncosurgery, Nanavati Super Speciality Hospital said, “Though the awareness about breast cancer is low among masses, it’s welcoming that majority of them were certain to seek medical help in case of primary symptoms. Incidence of breast cancer is shifting towards younger population (below 40’s). Through optimized screening program for early detection and decentralization of treatment resources, we can reduce mortality of breast cancer.”

As per the Ministry of Health and Family Welfare, the incidence of breast cancer is expected to rise to 35 per 100,000 women by 2026. From the total of 464 people (men and women) who participated in the survey, 76 percent were in the age group of 26-60 years. 45 percent of those surveyed had either not heard about breast cancer, or had limited knowledge. 60 percent of respondents were aware of the Self Breast Examination and 80 percent mentioned that they would seek medical help in case of symptoms of breast cancer. The survey pointed to a poor awareness of the Clinical Breast Examination with 52 percent respondents thinking it is done through mammography. Most importantly, over 10% of the participants reported a family history of breast cancer.

“Between 5%-10% of breast cancers are linked to genetic mutation (BRCA1 and BRCA2 genes). Women with these genes have an 80% chance of getting breast cancer. Thus the role of genetic counselling along with frequent screening, mammography and in selected cases MRI mammography, becomes important for early detection of cancer among such high risk individuals,” Dr Dudhat added.

Proper healthy lifestyle, avoiding tobacco alcohol, balanced and nutritious diet, continuous physical activity, yoga and meditation are known ways to keep cancer at bay. ON the backdrop of World Breast Cancer Awareness month, experts hoped for cancer awareness & treatment opportunities to reach all rural and urban parts of India, to strengthen the fight against cancer.

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Bangalore:  In order to spread awareness about breast cancer and salute the spirit of breast cancer survivors, the medical staff at Aster CMI Hospital donned pink masks, formed a pink-ribbon human chain, and educated the patients on early detection of breast cancer at the hospital by holding pink placards. Due to the COVID-19 pandemic, many patients started avoiding regular physical check-ups, including essential health screenings, like mammograms. This has put a huge burden on the medical and preventive care progress of breast cancer patients.

As per a recent WHO report, there has been a sharp rise in the incidences of cancer in the country due to the increase in sedentary lifestyles. The report further highlights that one in 10 Indians will develop cancer in their lifetime. With the cases of breast cancer rising each year, the age group of cancer patients also seems to be getting younger, with many women now being diagnosed in their 30s. This has made preventive measures like regular mammograms all the more essential. Therefore, by undertaking this initiative, the medical staff at Aster CMI Hospital has aimed at encouraging more women to get screened for cancer as early detection can increase survival chances and can aid in better managing the disease.

Speaking on the initiative undertaken by the hospital, Dr. Vijay Agarwal, Lead & Sr. Consultant – Medical Oncology & Haematology, Aster CMI Hospital, said: “Breast Cancer is currently very prevalent among the women of the age group 40-55. Due to the lifestyle changes, this disease has now started creeping up among younger women also. Even though many of us are aware of this disease, however, we still fail to undertake the necessary precautions and measures. A simple measure such as Breast Self-Examination can play a vital role in the early detection of the disease and can aid the doctors in successfully diagnosing it. Therefore, the sole motive of our hospital behind undertaking this initiative is to spread awareness about breast cancer. Even while managing between work and life, women should take out some time to take care of themselves and should be proactive to visit a doctor if they spot any unusual signs and symptoms of breast cancer like a lump in the breast and nipple retraction. This can help in reducing the incidences of breast cancer in the country and provide early diagnosis of the disease to the women.”

Sharing his views, Dr. G Girish, Consultant, Surgical Oncology, Aster CMI Hospital, said: “Currently there are a lot of myths surrounding breast cancer. Due to which many women often feel anxious while undergoing breast cancer screening tests and many more choose to avoid these tests due to the fear of cancer diagnosis. One must understand the early detection can save lives. Hence, with this initiative, we not only want to break the several myths surrounding breast cancer but also want to make women feel more confident while undergoing these tests and help them lead a happy life.”

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