Symposium report: breast cancer in India-trends, environmental exposures and clinical implications
Jasmine A McDonald1,2, Roshni Rao3,4, Marley Gibbons5
1Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, 722 West 168th St, New York, NY, 10032, USA. jam2319@cumc.columbia.edu.
Purpose:
Incidence of breast cancer (BC), particularly in young women, are rising in India. Without population-based mammography screening, rising rates cannot be attributed to screening. Investigations are needed to understand the potential drivers of this trend.
Methods:
An international team of experts convened to discuss the trends, environmental exposures, and clinical implications associated with BC in India and outlined recommendations for its management.
Results:
Panels were structured across three major BC themes (n = 10 presentations). The symposium concluded with a semi-structured Think Tank designed to elicit short-term and long-term goals that could address the challenges of BC in India.
Conclusion:
There was consensus that the prevalence of late-stage BC and the high BC mortality rates are associated with the practice of detection, which is primarily through clinical and self-breast exams, as opposed to mammography. Triple-Negative BC (TNBC) was extensively discussed, including TNBC etiology and potential risk factors, the limited treatment options, and if reported TNBC rates are supported by rigorous scientific evidence. The Think Tank session yielded long-term and short-term goals to further BC reduction in India and included more regional etiological studies on environmental exposures using existing India-based cohorts and case-control studies, standardization for molecular subtyping of BC cases, and improving the public's awareness of breast health.
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