What Does Overtreatment Of Breast Cancer Mean? Early diagnosis and treatment of breast cancer can improve survival, but overtreatment can put patients at risk of adverse side effects.
Breast cancer is identified as the most common cancer among women and the second leading cause of cancer death in women worldwide. Concerningly, the prevalence of breast cancer is rising. According to WHO, 2.3 million women were diagnosed with breast cancer in 2020. Treatment of breast cancer is highly effective, especially when the disease is detected early. However, overtreatment of breast cancer can put patients at risk of adverse side effects.
What is overtreatment of breast cancer and how one can avoid it? Get to know from Dr. Viswanth Kottakota, Surgical Oncologist, HCG Cancer Hospital, Visakhapatnam. Speaking to The HealthSite, the expert also shed light on the causes of breast cancer in women and the latest innovation in breast cancer management.
Q. Cases of breast cancer in women are reportedly increasing worldwide. What could be the major causes?
Most important cause is the age of the woman. Risk increases with increasing age of the patient. More than 90 per cent of breast cancers occur after the age of 40 years. Other causes include high oestrogen levels in their lifetime which occurs because of early menarche or late menopause. Smoking is another factor. Less than 5 per cent accounts to familial genetic transmission.
Q. What does it mean by overtreatment of breast cancer?
Treatment of breast cancer depends on the stage of the disease. Usually, early breast cancers are treated with surgery followed by chemotherapy and radiotherapy. Chemotherapy for early stage patients is given mainly to prevent the cancer from recurring. However, it also negatively affects physical and mental health, particularly the quality of life of the patient. A thorough understanding of the likelihood of a cancer recurrence will help with optimum treatment, making sure that patients are not overtreated and hence saved from toxic side effects.
Advanced stage cancers are first treated with chemotherapy followed by surgery and then radiotherapy. With recent advances in medical science, breast conservation can be done with decreased side effects. And recently, even chemotherapy can be avoided in early breast cancer depending on various prognostic factors.
One of the ways to avoid overtreatment in early-stage breast cancer is through prognostic tests. Breast cancer prognostic tests analyse certain biomarkers within a patient’s body such as specific genes, patterns of gene expression, or protein biomarkers that can assess the risk of recurrence.
Q. Breast cancer treatment then and now: Shed some light on the key changes.
In particular, over the past several years, we have witnessed a significant improvement in survival of the patients. Today, stage 1 breast cancer patients have a survival percentage that is almost 100 per cent, and stage 2 patients have a survival rate that is greater than 90 per cent. Higher survival rates have been made possible by medical advancements. Furthermore, advances in science have also reduced side effects.
All breast cancers previously were used to be treated with all modalities of treatment i.e., surgery, chemotherapy and radiotherapy which affected the woman both physically and psychologically. In surgery, all patients used to get mastectomy (total breast removal)
Whereas, with new advances, only the affected part of the breast can be removed without any compromise in the aesthetic outcome which is called ‘oncoplastic breast surgery’.
After surgery, if the patient is in early stages of breast cancer, even chemotherapy can be avoided on the basis of the results of prognostic tests.
Q. What is that one latest innovation in breast cancer management that could be called a boon to patients and families?
I would say prognostic tests have been a boon for early-stage breast cancer patients. Earlier, these prognostic tests from the US were costing close to 2.5 to 3 lakhs to get them to India. But now, there’s a similar test in India called ‘CanAssist Breast’ that is validated on Indian patients. It helps identify whether a patient would need chemo or not and it comes at a very affordable pricing. As many as 70 per cent of the breast cancer patients diagnosed in early stages, can avoid chemotherapy with these tests.
