Breast Cancer Awareness and Screening – The role of the Primary Care Physician
Abstract
Breast cancer is one of the commonest cancers in women globally and specially in India. It leads to a considerable health care and economic burden, affecting both morbidity and mortality. October is observed as breast cancer awareness month. Screening is the most beneficial method of early diagnosis which enables timely intervention and treatment. Unfortunately, rate of screening in India is low as compared to western countries. This is due to barriers and challenges including population size, socio-cultural diversity, lower access to specialty care, and economic limitations which need to be overcome. Therefore, a risk based targeted approach by improving awareness and recommending screening at the primary care level with family physicians rather than a mass age/gender-based screening approach may be more relevant in India to help build a firm foundation for breast cancer screening, and improving its efficiency and benefits.
References
2. Sun YS, Zhao Z, Yang ZN, Xu F, Lu HJ, Zhu ZY, Shi W, Jiang J, Yao PP, Zhu HP. Risk Factors and Preventions of Breast Cancer. Int J Biol Sci. 2017 Nov 1;13(11):1387-1397.
3. NIH, National Cancer Institute [Internet]. BRCA gene changes: Cancer Risk and Genetic Testing. Updated July 19, 2024. Available from https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-
sheet#:~:text=Testing%20for%20inherited%20harmful%20changes%20in%20BRCA1%20and%20BRCA2%20may,that%20are%20present%20in%20saliva.
4. Ren W, Chen M, Qiao Y, Zhao F. Global guidelines for breast cancer screening: A systematic review. Breast. 2022 Aug; 64:85-99.
5. Khan M, Chollet A. Breast Cancer Screening: Common Questions and Answers. Am Fam Physician. 2021;103(1):33-41
6. Smith P, Hum S, Kakzanov V, Del Giudice ME, Heisey R. Physicians’ attitudes and behaviour toward screening mammography in women 40 to 49 years of age. Can Fam Physician. 2012 Sep;58(9):e508-13.
7. Radhakrishnan A, Nowak SA, Parker AM, Visvanathan K, Pollack CE. Linking physician attitudes to their breast cancer screening practices: A survey of US primary care providers and gynecologists. Prev Med. 2018 Feb;107:90-102.
8. Gopika MG, Prabhu PR, Thulaseedharan JV. Status of cancer screening in India: An alarm signal from the National Family Health Survey (NFHS-5). J Family Med Prim Care. 2022 Nov;11(11):7303-7307.
9. Sekar P, Ghosh S, Dhillon P, Shridhar K. The dynamics of breast cancer screening approaches in urban India: An ethnographic study from Delhi, SSM - Qualitative Research in Health, 2022; 2:100135. ISSN 2667-3215.
10. Mehrotra R, Yadav K. Breast cancer in India: Present scenario and the challenges ahead. World J Clin Oncol. 2022 Mar 24;13(3):209-218.
11. International Agency for Research on Cancer. World Cancer Report [Internet]. 2020 [cited 4 April 2021]. Available from: https://www.iarc.who.int/cards_page/world-cancer-report/
12. Mittra I, Mishra GA, Dikshit RP, Gupta S, Kulkarni VY, Shaikh HKA, Shastri SS, Hawaldar R, Pramesh CS, Badwe RA. Effect of screening by clinical breast examination on breast cancer incidence and mortality after 20 years: prospective, cluster randomised controlled trial in
Mumbai. BMJ. 2021;372:n256