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In India and over the world, Cancer has become a deadly disease that is adversely affecting women from different age groups. According to a survey, one in every 30 women suffers from this deadly disease in their lifetime. This project was first thought of because of the increase in cases of breast cancer and if we can detect it at an early stage then there is an increased chance of it getting cured. This paper lays a foundation in making the detection of cancer automated from histopathological images using deep learning algorithms so that more and more people can get it diagnosed at an early stage and subsequently get cured. To enhance the capability of histopathology image classification, a powerful deep learning algorithm and a sizable, varied dataset are required. In this paper, we have proposed an automatic and precise histopathological image analytical method, to detect breast cancer at an early stage. Deep learning techniques have recently made significant strides and produced outstanding results in the fields of computer vision and image processing, which has encouraged many researchers to use this method for the categorization of histopathology images. [ABSTRACT FROM AUTHOR]

Purpose: Knowledge is a key success factor in achieving competitive advantage. The purpose of this paper is to examine how mobile health technology facilitates knowledge management (KM) practices to enhance a public health service in an emerging economies context. Specifically, the acceptance of a knowledge-resource application by community health workers (CHWs) to deliver breast cancer health care in India, where resources are depleted, is explored. Design/methodology/approach: Fieldwork activity conducted 20 semi-structured interviews with frontline CHWs, which were analysed using an interpretive inductive approach. Findings: The application generates knowledge as a resource that signals quality health care and yields a positive reputation for the public health service. The CHW's acceptance of technology enables knowledge generation and knowledge capture. The design facilitates knowledge codification and knowledge transfer of breast cancer information to standardise quality patient care. Practical implications: KM insights are provided for the implementation of mobile health technology for frontline health-care professionals in an emerging economies context. The knowledge-resource application can deliver breast cancer care, in localised areas with the potential for wider contexts. The outcomes are valuable for policymakers, health service managers and KM practitioners in an emerging economies context. Social implications: The legacy of the mobile heath technology is the normalisation of breast cancer discourse and the technical up-skilling of CHWs. Originality/value: First, this paper contributes three propositions to KM scholarship, in a public health care, emerging economies context. Second, via an interdisciplinary theoretical lens (signalling theory and technology acceptance model), this paper offers a novel conceptualisation to illustrate how a knowledge-resource application can shape an organisation's KM to form a resource-based competitive advantage. [ABSTRACT FROM AUTHOR]

Cancer is the uncontrolled growth of abnormal cells; if not detected and treated at the early stage cancer would become fatal. Breast cancer remains the second leading cause of cancer induced deaths, despite the advances taken place in treatment methods. The incidence of breast cancer in India is on the rise that one in 22 women in India is likely to suffer from breast cancer during her lifetime. One in eight women is affected by this dangerous disease in America. Cancer always a major problem to the world however various methods are available. Some of methods for breast cancer detection are X-ray mammography, MRI and ultrasound. However, they have some limitations to detect the breast cancer but microwave imaging is a safer method as compared to the X-ray. In this Paper cancer tumour in the breast is detected by I-shaped dual C-slotted microstrip patch antenna is designed for 10 GHz. The proposed antenna has a bandwidth of 7.51 dB covering the frequency range 4.9–7.89 GHz, the return loss below − 37 dB and antenna gain of 2.45 dB. The flexible this patch antenna holds good efficiency of 87.1%. [ABSTRACT FROM AUTHOR]

Aims/Objectives: This study was conducted to assess the utilization patterns of anticancer agents in patients with breast cancer and to provide practice recommendations/educational interventions to optimize medication use in patients with breast cancer. Materials and Methods: This was an ambispective study conducted for a period of 3 years at a private, specialty oncology care hospital in South India. In the initial phase, the selection of anticancer agents, dosage of anticancer agents, and management of chemotherapy-induced nausea and vomiting (CINV) were reviewed retrospectively (using paper medical records) with respect to the National Cancer Comprehensive Network guidelines. The administration of anticancer agents and anti-emetics were reviewed with respect to the hospital drug administration policies. The deviations from the standards were reported, and practice recommendations/educational interventions were developed. Treatment patterns were reevaluated prospectively after providing educational interventions. Descriptive statistics were used to report and compare the results from both phases. Results: During retrospective phase, we observed 80% compliance in the selection of anticancer drugs, 74% compliance in drug dosing, and 63.5% compliance in the administration of anti-cancer agents. After the implementation of educational interventions, we observed 85% compliance in the selection of anticancer agents, 82.3% in their dosing, and 86.9% compliance in the administration of anticancer agents. For the management of CINV, we observed 75% compliance in the selection of drugs (vs. 53% during preintervention), 92% compliance in their dosing (vs. 90% during preintervention), 85.1% compliance in the administration of anti-emetics (vs. 50% during preintervention), and 80% compliance in the management of delayed CINV (vs. 60% during preintervention). Conclusions: Treatment patterns of breast cancer were improved with respect to treatment standards after educational interventions to oncology care team. [ABSTRACT FROM AUTHOR]

When it comes to cancer in Indian women, breast cancer is one of the most common and frequently occurring cancer types. In most of the developing countries like India, the overhead charges for breast cancer are very high which leads to a poor mortality rate when compared to western countries. As of now, large numbers of researches have been carried out based on deep learning and machine learning prediction of Breast cancer. This paper reviews some of the existing machine learning algorithms like Decision Tree (DT), Multi-Layer Perceptron (MLP), Random Forest (RF) and Support Vector Machines (SVMs) in linear (SVML), polynomial (SVM-P), and radial basis function (SVM-RBF) on the Breast Cancer Wisconsin (BCW) data set using Python. An experimental result shows that SVM-L outperforms all the above algorithms with 96.5% accuracy. [ABSTRACT FROM AUTHOR]

Breast cancer detection is a crucial topic in the healthcare sector. Breast cancer is a major reason for the increased mortality rate in recent years among women, specifically in developed and underdeveloped countries around the world. The incidence rate is less in India than in developed countries, but awareness must be increased. This paper focuses on an efficient deep learning-based diagnosis and classification technique to detect breast cancer from mammograms. The model includes preprocessing, segmentation, feature extraction, and classification. At the initial level, Laplacian filtering is applied to identify the portions of edges in mammogram images that are highly sensitive to noise. Subsequently, segmentation is done using modified adaptively regularized kernel-based fuzzy C means (ARKFCM). Feature extraction is accomplished using the morphological, texture, and moment invariants. The corresponding feature values are provided as inputs to a deep neural network (DNN) model that classifies the normal and abnormal portions in the mammogram images. The performance of the proposed model is validated with the Mammographic Image Analysis Society (MIAS) database. The efficiency of the proposed classifier is experimentally proved by comparing the various classifiers with respect to their statistical performances. On an applied database, the proposed model offered a maximum classification with the highest accuracy level of 99.13%. [ABSTRACT FROM AUTHOR]

• An optimize ensemble machine learning model has been proposed for breast cancer classification on the basis of Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) and Crow Search algorithm. • The proposed model improves the overall performance metrics consists of accuracy, recall, precision, AUC, F1 score, Kappa and MCC. • Even with the limited number of samples, the proposed model performs better. In this paper, we propose a novel framework for breast cancer classification using optical coherence tomography (OCT) images. As the incidence of breast cancer in India continues to rise, early detection is essential for increasing survival rates. For precise classification, an efficient classifier model is required. Due to the variety of datasets and performance metrics, a single classifier may not be sufficient. Thus, we propose an efficient ensemble classifier based on Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) integrated with the Crow Search Algorithm (CSA). TOPSIS, a technique for Multi-Criteria Decision Making (MCDM), ranks and selects the ensemble's base classifiers. The CSA fine-tunes the weights of the base classifiers. In addition, we employ SHAP (SHapley Additive exPlanations) values to visualize feature attributions at the observation level, thereby facilitating model interpretation and comprehension. The proposed classifier performs admirably on the experimental testing dataset, with values of 0.921, 0.921, 0.923, 0.921, 0.846 and 0.846 for precision, recall, F1-score, Kappa, and MCC, respectively. This model's ultimate goal is to reduce reliance on skilled pathologists, reduce interobserver variability, and speed up the processing of breast tissue assessments. [ABSTRACT FROM AUTHOR]

Objective: To estimate the catastrophic health expenditure and distress financing of breast cancer treatment in India. Methods: The unit data from a longitudinal survey that followed 500 breast cancer patients treated at Tata Memorial Centre (TMC), Mumbai from June 2019 to March 2022 were used. The catastrophic health expenditure (CHE) was estimated using households' capacity to pay and distress financing as selling assets or borrowing loans to meet cost of treatment. Bivariate and logistic regression models were used for analysis. Findings: The CHE of breast cancer was estimated at 84.2% (95% CI: 80.8,87.9%) and distress financing at 72.4% (95% CI: 67.8,76.6%). Higher prevalence of CHE and distress financing was found among rural, poor, agriculture dependent households and among patients from outside of Maharashtra. About 75% of breast cancer patients had some form of reimbursement but it reduced the incidence of catastrophic health expenditure by only 14%. Nearly 80% of the patients utilised multiple financing sources to meet the cost of treatment. The significant predictors of distress financing were catastrophic health expenditure, type of patient, educational attainment, main income source, health insurance, and state of residence. Conclusion: In India, the CHE and distress financing of breast cancer treatment is very high. Most of the patients who had CHE were more likely to incur distress financing. Inclusion of direct non-medical cost such as accommodation, food and travel of patients and accompanying person in the ambit of reimbursement of breast cancer treatment can reduce the CHE. We suggest that city specific cancer care centre need to be strengthened under the aegis of PM-JAY to cater quality cancer care in their own states of residence. Trial Registration: CTRI/2019/07/020142 on 10/07/2019. [ABSTRACT FROM AUTHOR]

Purpose: We present a methodically devised protocol for conducting a systematic review and meta-analysis aimed at ascertaining the prevalence of BReast CAncer gene (BRCA) mutations in breast and ovarian cancer (BOC) among women in India. The review will include cross-sectional, cohort, case-series, and registry-based studies focusing on females clinically diagnosed with any stage of BOC, tested for BRCA germline mutation and undergone any form of treatment. Methods: A Cochrane literature search will be carried out to identify all the published and unpublished articles available in English from 2010 till date across various electronic databases including PubMed, Psych Info, SCI, Cochrane Central, Embase, Scopus, IND Med and Google Scholar. A step-by-step process will be followed to select all the relevant studies for final inclusion using Rayyan software. The selection process of the review will be reported based on Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA) checklist. The protocol has been registered in PROSPERO (ID: CRD42023463452). Joanna Briggs Institute Critical Appraisal Checklist will be used to evaluate the methodological quality of the included studies. The outcome measure will be the prevalence of BRCA1/2 gene mutation in this population. Meta-analysis will be performed to report the pooled prevalence along with 95% confidence interval. Discussion: The results of this review study will provide valuable insights for clinicians, and policy makers, enabling them to formulate guidelines that underscore the importance of screening for BRCA mutations in cases of BOC. [ABSTRACT FROM AUTHOR]

Introduction Breast cancer is the most frequent cancer among women. In the last few decades, the outcome of breast cancer has improved significantly in terms of survivorship and quality of life. However, it is crucial that alongside managing the disease, breast cancer services address and manage associated or co-occurring psychiatric illnesses such as acute stress reactions, procedural anxieties, adjustment issues, depression, and fear of recurrence, which leads to an overall better experience of the patient. Objective There is a paucity of data on the patterns of psychiatric morbidity in patients with breast cancer who access psycho-oncology services in a naturalistic setup outside research studies from India. The current study focused on exploring this alongside reporting the common treatment methods adopted for this group of patients. Materials and Methods Real-life data from electronic patient records were retrospectively reviewed for all patients with breast cancer accessing integrated psycho-oncology services in a tertiary care hospital in India over three 3 years (2018–2020). The various psychiatric morbidities were reported, along with associated cancer demographic data, disease characteristics, and treatment details. Results Of all the breast cancer patients (n = 338) in the calendar years 2018 to 2020 reviewed by psycho-oncology services, the most common psychiatric diagnosis was depressive illness (n = 100, 29.6%), followed by adjustment disorders (n = 68, 20.1%) and anxiety (n = 66, 19.5%). There was a significant minority with serious enduring mental illnesses such as schizophrenia (n = 11, 3.3%) and bipolar disorders (n = 14, 4.1%). On the other hand, 14.2% (n = 48) of the patients with breast cancer who attended Psycho-oncology outpatient department did not have any psychiatric syndrome. Around 16.3% of patients could be managed without a prescription for any medications and almost half of the patients needed only one psychotropic medicine. Psychological interventions were used for 45.6% of patients. Conclusion Integrated psycho-oncology services in a cancer hospital catering to patients with breast cancer help in psychiatric assessment, diagnosis, and addressing the mental health needs of patients. The treatment offered needs to be nuanced and individualized and may require a combination of psychotropic medications and psychological techniques. [ABSTRACT FROM AUTHOR]

Based on breast cancer research data obtained from Scopus multidisciplinary database, it is seen that with 6696 (1.82% global share) articles from India on breast cancer during 1975-2014, India ranks 12th in the world in terms of research paper output. About 80% of the Indian publications appeared during the period 2004-14. Hospitals are more productive with Tata Memorial Hospital publishing the highest number of papers during the period. About 30.35% Indian publications are a result of international collaboration with 94 countries. [ABSTRACT FROM AUTHOR]

Despite substantial strides to improve cancer control in India, challenges to deliver oncology services persist. One major challenge is the provision and accessibility of adequate infrastructure. This paper offers ethnographic insight on the conceptual and material conditions that are currently shaping the delivery of oncology in Mumbai, focusing specifically on the way India's socio-economic context necessitates non-biomedical acts of voluntarism or 'seva' (selfless service). Developing the premise that hospitals are not identical clones of a biomedical model, detailed attention is paid to the way 'care' emerges through 'praxis of place' (Casey, 2003) within the cancer hospital as a multi-scalar 'heterotopic' (Street and Coleman, 2012) site. Such a perspective enables global/local tensions to come into view, together with the heterogeneous confluence of juxtaposing materialities, imaginations, social practices and values that both propels and constrains the everyday delivery of care. The paper reflects on the theoretical implications of hospital seva in Mumbai in light of social science studies of hospital ethnography and health activism and contributes important ethnographic insight into the current global health debates regarding effective implementation of cancer services in India. [ABSTRACT FROM AUTHOR]

Aim: This study aims to evaluate the long-term treatment outcome of conventional and hypofractionation radiotherapy in postmastectomy cancer breast patients. Material and Methods: A total of 140 postmastectomy breast cancer patients were included in this retrospective study, who were treated from 2012 to 2014 with chemotherapy and various fractionation radiotherapy schedules. Radiotherapy treatment records for study group-I received radiotherapy 4256 cGy in 16 fractions over 31/2 weeks, group-II patients received 4005 cGy in 15 fractions over 3 weeks, and conventional radiotherapy group-III received 5000 cGy in 25 fractions over 5 weeks. Results: The median follow-up of patients from all groups was 60 months (range 9 to 111 months). There were 39 cases with disease failure, 13 (26%) in group I (42.56 Gy), 16 (40%) in group II (40.05 Gy), and 10 (20%) in group III (50 Gy). There were 4 locoregional recurrences (LRRs), two isolated, and 11 distant failures in group I, 3 LRRs (1 isolated LRR) and 15 distant failures in group II, and only one LRR and 9 distant failures in group III. The disease-free survival (DFS) were 74%, 60%, and 80%, respectively, in groups I, II, and III (P =0.044). Conclusion: The long-term results of this study show that hypofractionation radiotherapy in postmastectomy cases is well tolerated and acute and late side effects are also comparable to conventional fractionation. In our study, locoregional and distant failure seems slightly higher with hypofractionation schedules than in other studies, highlighting the need for more studies with long-term follow-up in postmastectomy patients. [ABSTRACT FROM AUTHOR]

• To diagnose the breast cancer at the earliest to reduce the mortality rate. • Computational method on fuzzy based logistic regression to predict the breast cancer. • Inefficiency of feature selection of gene data is solved by LASSO Logistic Regression (LLR). • Computational Tractable is performed by Maximum Likelihood Estimation (MLE). • Missing Parameters issues are solved by Expectation Maximization (EM) algorithm. Computational based classification of gene expression data for analyzing the genetic pattern provides better clinical prediction for breast cancer. Breast cancer is one of the leading cancers among women all over India. This type of cancer leads to malignant tumor developed in the breast. Recent methodologies have undergone many classification methods to analyze the characteristics of gene expression. This paper focuses on computational method such as fuzzy based logistic regression to predict the expression of the gene data. In order to bring accuracy and to solve the inefficiency in feature selection of gene expression data, LASSO Logistic Regression (LLR), a novel methodology is implemented. For computational tractable, Maximum Likelihood Estimation (MLE) is implied with regression model. Diagnosis and prognosis of breast cancer becomes a great challenge in the medical era. This research work explores the mining technology based algorithm to classify the cancer data using fuzzy methodology by evaluating few samples of gene expression data of breast cancer as a training set and the resultant test data are validated to predict the cancer at the earlier stage. For feasible analysis, Expectation Maximization (EM) algorithm is deployed for unknown or missing parameters of gene data expression. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the commonest cancer among women in India, yet the uptake of early detection programs is poor. This leads to late presentation, advanced stage at the time of diagnosis, and high mortality. Poor accessibility and affordability are the most commonly cited barriers to screening: we analyse socio-cultural factors influencing the uptake of early detection programmes in a Universal Health Coverage (UHC) setting in India, where geographical and financial barriers were mitigated. Methods: Two hundred seventy-two women engaging in an awareness-based early detection program were recruited by randomization as the participant (P) group. A further 272 women who did not participate in the early detection programme were recruited as non-participants (NP). None of the groups were previously screened for breast cancer. Interviews were conducted using a 19-point questionnaire, consisting of closed-ended questions regarding demographics and social, cultural, spiritual and trust-related barriers. Results: The overall awareness about breast cancer was high among both groups. None of the groups reported accessibility-related barriers. Participants were more educated (58.09% vs 47.43%, p = 0.02) and belonged to nuclear families (83.59% vs 76.75%, p = 0.05). Although they reported more fear of isolation due to stigma (25% vs 14%, p = 0.001), they had greater knowledge about breast cancer and trust in the health system compared to non-participants. Conclusions: The major socio-cultural barriers identified were joint family setups, lower education and awareness, and lack of trust in healthcare professionals. As more countries progress towards UHC, recognising socio-cultural barriers to seeking breast health services is essential in order to formulate context-specific solutions to increase the uptake of early detection and screening services. [ABSTRACT FROM AUTHOR]

Breast cancer (luminal and triple‐negative breast cancer [TNBC]) is the most common cancer among women in India and worldwide. Altered sphingolipid levels have emerged as a common phenomenon during cancer progression. However, these alterations are yet to be translated into robust diagnostic and prognostic markers for cancer. Here, we present the quantified sphingolipids of tumor and adjacent‐normal tissues from patients of luminal (n = 70) and TNBC (n = 42) subtype from an Indian cohort using targeted liquid chromatography mass spectrometry. We recorded unique sphingolipid profiles that distinguished luminal and TNBC tumors in comparison to adjacent normal tissue by six‐sphingolipid signatures. Moreover, systematic comparison of the profiles of luminal and TNBC tumors provided a unique five‐sphingolipid signature distinguishing the two subtypes. We further identified key sphingolipids that can stratify grade II and grade III tumors of luminal and TNBC subtype as well as their lymphovascular invasion status. Therefore, we provide the right evidence to develop these candidate sphingolipids as widely acceptable marker/s capable of diagnosing luminal vs TNBC subtype of breast cancer, and predicting the disease severity by identifying the tumor grade. [ABSTRACT FROM AUTHOR]

The research interest in this field is that females are not aware of their health conditions until they develop tumour, especially when breast cancer is concerned. The breast cancer risk factors include genetics, heredity, and sedentary lifestyle. The prime concern for the mortality rate among females is breast cancer, and breast cancer is on the rise, both in rural and urban India. Women aged 45 or above are more vulnerable to this disease. Images are more effective at depicting information as compared to text. With the advancement in technology, several computerized techniques have come up to extract hidden information from the images. The processed images have found their application in several sectors and medical science is one of them. Disease-like breast cancer affects most women universally and it happens due to the existence of breast masses in the breast region for the development of breast cancer in women. Timely breast cancer detection can also increase the rate of effective treatment and the survival of women suffering from breast cancer. This work elaborates the method of performing hybrid segmentation techniques using CLAHE, morphological operations on mammogram images, and classified images using deep learning. Images from the MIAS database have been used to obtain readings for parameters: threshold, accuracy, sensitivity, specificity rate, biopsy rate, or a combination of all the parameters and many others under study. [ABSTRACT FROM AUTHOR]

This study presents a bibliometric analysis of the scholastic output on breast cancer in India. The purpose is to provide an overview of the research activities in the country on the subject during the last ten years, exploring different aspects of scientific literature. Data on 3529 items, including 2945 articles and 584 reviews published during 1 January 2005 to 31 December 2014 were collected using Scopus. An advanced search was conducted in the database. The search results were filtered for English language, journals, India and the period under study. Lotka's law was applied to assess the author productivity and Bradford's law of scattering was used to ascertain the distribution pattern of articles in journals. Most (about 96%) contributions were found to be an outcome of collaborative authorship. Around 19.05% of the papers had collaboration of four authors and 16.53% appeared due to collective efforts of three authors each. Trend of an increasing number of articles published over the period has been observed. Author productivity did not fit the Lotka's law with a value of n = 2. The distribution of articles in journals was found acceptable to the Bradford's law of scattering. [ABSTRACT FROM AUTHOR]

Several international and national consensus guidelines from professional bodies and expert panels are available for the management of breast cancers. The widely used international guidelines are from the National Comprehensive Cancer Network (NCCN), St. Gallen International Expert Consensus, and the European Society of Medical Oncology (ESMO) and the National Institute for Health and Care Excellence (NICE) of the UK. This article is an update from the Association of Breast Surgeons of India (ABSI) regarding the guidelines to manage breast cancer in India. The earlier version of the same was published in 2016. This article has been updated with the latest research work in the management of breast cancer to date and necessary changes made to the earlier version. [ABSTRACT FROM AUTHOR]

Background and Purpose: Breast cancer survivors are known to develop upper torso pain and stiffness including shoulder elevation and ipsilateral inclination of the trunk within a short period of time as a result of cancer adjuvant therapies correlating with the type and side of surgery. Hence, the study. Methods: Twenty‐two breast cancer survivors at a tertiary care hospital, Belgaum, Karnataka, have participated in this pre‐post experimental study which included myofascial release (MFR), stretching, and strengthening for four sessions per week for 3 weeks that is, a total of 12 sessions. The participants were assessed at baseline and post‐intervention using photogrammetry for Posture and shoulder range of motion (ROM), flexicurve for spinal curvatures, digital inclinometer for cervical ROM, manual muscle testing and hand dynamometer for strength of the upper back, shoulder muscles and hand grip, Shoulder Pain and Disability Index (SPADI) for shoulder impairment and Functional Assessment of Cancer Therapy‐Breast (FACT‐B) for quality of life. Results: The outcomes were analyzed with a p‐value set at ≤0.05. The results of the study demonstrated a substantial improvement in the posture alignment (p = 0.001), shoulder and cervical ROM (p = 0.001), upper back and shoulder muscle and hand grip strength (p = 0.001), SPADI (p = 0.001), and FACT‐B (p = 0.001) values. Discussion: The upper torso malalignment and muscular imbalance is seen in patients who has undergone surgeries involving the chest wall and early physiotherapy intervention can benefit the patients overall physical performance and quality of life. Hence, MFR, stretching and strengthening has shown to be beneficial in improving upper torso malalignment in breast cancer survivors. Implications of Physiotherapy Practice: The suggested techniques can be applied at a larger scale which can involve patients with head and neck cancer since the areas of intervention are identical. CTRI (Clinical Trial Registry‐ India) Registration No.: CTRI/2021/01/030453. [ABSTRACT FROM AUTHOR]

Objectives: The study aims to investigate the efficacy of screening by low-cost technology in down-staging and reduction of mortality due to breast and cervix cancer. Methods: The present trial is a community-based, cluster randomised controlled cohort study on screening for breast and cervix cancers (clinical breast examination and visual inspection of the cervix after application of 4% acetic acid). Univariate and multivariate logistic regression analyses are conducted to identify the predictors of compliance to referral among screen-positive women and to treatment among cancer cases. Results: The compliance to diagnostic investigations is 73% among screen-positive women referred for breast cancer and 79% among women referred for cervix cancer. Younger women, women working in service or being self-employed, school level-educated women, mother tongue Marathi, participation in screening in all 3 rounds and women referred as screen positive for cervix cancer had higher compliance to diagnostic investigations. The compliance to treatment completion is higher in women diagnosed with breast cancer, at 95%, compared to 86% for cervix cancers and 81% for cervix pre-cancers. Conclusions: Good compliance rates along with a proper system of referral, further investigations, confirmation of diagnosis and treatment as demonstrated in this trial are crucial for successful screening programmes. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: To identify and describe the breast cancer-specific health-related quality of life (HRQoL) instruments with evidence of validation in the breast cancer population for potential use in patients treated for breast cancer (excluding surgery).Methods: We conducted a systematic literature review using PubMed, Embase, and PsycINFO databases to identify articles that contain psychometric properties of HRQoL instruments used in patients with breast cancer. Relevant literature from January 1, 2009, to August 19, 2019, was searched. Articles published in English that reported psychometric properties (reliability, validity) of HRQoL instruments were identified.Results: The database search yielded 613 unique records; 131 full-text articles were reviewed; 80 articles presented psychometric data for instruments used in breast cancer (including generic measures). This article reviews the 33 full articles describing psychometric properties of breast cancer-specific HRQoL instruments: EORTC QLQ-C30, EORTC QLQ-BR23, FACT-B, FBSI, NFBSI-16, YW-BCI36, BCSS, QuEST-Br, QLICP-BR, INA-BCHRQoL, and two newly developed unnamed measures, one by Deshpande and colleagues (for use in India) and one by Vanlemmens and colleagues (for use among young women and their partners). The articles that described the EORTC QLQ-C30, QLQ-BR23, and FACT-B centered on validating translations, providing additional support for content validity, and demonstrating acceptability of electronic patient-reported outcome administration. Psychometric properties of the measures were acceptable. Several new measures have been developed in Asia with an emphasis on development on cultural relevance/sensitivity. Others focused on specific populations (i.e., young women with breast cancer).Conclusions: Historically, there have been limited options for validated measures to assess HRQoL of patients with breast cancer. A number of new measures have been developed and validated, offering promising options for assessing HRQoL in this patient population. This review supports the reliability and validity of the EORTC QLQ-C30 and FACT-B; new translations and electronic versions of these measures further support their use for this population. [ABSTRACT FROM AUTHOR]

Background: Breast cancer incidence rates are increasing in developing countries including India. With 1.3 million new cases of cancer been diagnosed annually, breast cancer is the most common women's cancer in India. India's National Family Health Survey (NFHS-4) data 2015-2016 shows that only 9.8% of women between the ages of 15 and 49 had ever undergone breast examination (BE). Further, access to screening and treatment is unequally distributed, with inequalities by socio-economic status. It is unclear, however, if socio-economic inequalities in breast examination are similar across population subgroups.Methods: We compared BE coverage in population sub-groups categorised by place of residence, religion, caste/tribal groups, education levels, age, marital status, and employment status in their intersection with economic status in India. We analysed data for 699,686 women aged 15-49 using the NFHS-4 data set conducted during 2015-2016. Descriptive (mean, standard errors, and confidence intervals) of women undergoing BE disaggregated by dimensions of inequality (education, caste/tribal groups, religion, place of residence) and their intersections with wealth were computed with national weights using STATA 12. Chi-square tests were performed to assess the association between socio-demographic factors and breast screening. Additionally, the World Health Organisation's Health Equity Assessment Toolkit Plus was used to compute summary measures of inequality: Slope index for inequality (SII) and Relative Concentration Indices (RCI) for each intersecting dimension.Results: BE coverage was concentrated among wealthier groups regardless of other intersecting population subgroups. Wealth-related inequalities in BE coverage were most pronounced among Christians (SII; 20.6, 95% CI: 18.5-22.7), married (SII; 14.1, 95% CI: 13.8-14.4), employed (SII: 14.6, 95%CI: 13.9, 15.3), and rural women (SII; 10.8, 95% CI: 10.5-11.1). Overall, relative summary measures (RCI) were consistent with our absolute summary measures (SII).Conclusions: Breast examination coverage in India is concentrated among wealthier populations across population groups defined by place of residence, religion, age, employment, and marital status. Apart from this national analysis, subnational analyses may also help identify strategies for programme rollout and ensure equity in women's cancer screening. [ABSTRACT FROM AUTHOR]

One of the major global health crises in the contemporary scenario is the rapid increase in the incidence of the disease of cancer in general with breast cancer in particular affecting millions of women worldwide. The diagnosis of breast cancer provokes a series of changes in patient's lives with social support seen as critical in facilitating women cope with the illness as well as the stress associated with it. Although breast cancer has emerged as the focus of clinical research and intervention in Kashmir, the experiences of support dynamics characterising post-diagnosis situation among such patients have been neglected. This qualitative study, thus, investigated the experiences of Kashmiri women with breast cancer regarding social support. Participants were invited for in-depth face-to-face interviews between November 2018 and March 2019 using snowball sampling technique, and the participants were recruited until data saturation was reached (n= 12). The study revealed that participants received overwhelming support (emotional, financial, practical, moral, and informational) from significant others (parents, siblings, husbands, children, extended family), important others (relatives, friends, neighbours, colleagues, peers), healthcare providers (doctors, nurses, paramedics, physician's assistants), and religion and spirituality (religious beliefs and practices, spiritual healers, shrines) throughout their journey with breast cancer and reported varying positive outcomes as a result of the support received. Moreover, social support received provided them strength, and encouragement and instilled feeling of optimism that helped them to deal with their illness. The study further highlights a need for interventions that could address the unmet support needs thereby reducing the disturbance and sufferings experienced by women post-diagnosis. [ABSTRACT FROM AUTHOR]

Introduction and background: Cervical cancer is one of the leading responsible condition for causing high death rate among women after breast cancer. It is preventable and curable disorder, but the prevalence of cervical cancer remaining too high in India. Majority of women do not aware of cervical screening procedures. Maharashtra is standing in second position in possessing more number of cervical cancer cases. Methodology: A quasi-experimental pretest and post research design was used to execute the study. This study was conducted in selected hospitals of PCMC. The samples were the women age group between 30-60 years attending Gynec OPD. The systemic random sampling techniques was used to select the samples. Total sample size was 501. A self-administered tool was administered to find the reasons for participation and nonparticipation in cervical screening. Tool and content validity was done. The reliability of the tool was done r value is = 0.88. The study proposal has been approved by the Ethical Committee, MGM Institute of Health Sciences, Kamothe, Navi Mumbai. Permission has been taken from the concerned authority of the selected urban health care centers for data collection. The content was prepared on prevention and early detection of cervical screening in the form of video and modules in their regional languages. Results: Majority of participants among three experimental groups, about 38.32 % in verbal group, 41.91% in written group and 40.71 % in video group have responded that they could not take part in the cervical screening programme as they are very embarrassed with cervical screening procedure. While others had responded that, I am healthy I do not have to go for this test, some women said, I have only one sexual partner so I don't require this test. A few women have assumed that the test is very expensive, thinking that not required the Pap test as no symptoms of cancer observed and other have stated that don't know the frequency of test. Conclusion: A key strategy to improve the attendance of the women for cervical screening is to spread the awareness on prevention and early detection of cervical cancer by using various educational methods. [ABSTRACT FROM AUTHOR]

Background: People who have previously used psychiatric services may be particularly vulnerable and at greater risk of mortality following a cancer diagnosis. The present study assessed depression and anxiety among breast cancer patients. Materials and Method: The present study was conducted on 64 women with breast cancer. The Patient Health Questionnaire-2 (PHQ-2) and the Generalized Anxiety Disorder-2 (GAD-2) questionnaire were produced as ultra-brief screening instruments for depression and anxiety in all patients. Results: Age group <40 years had 12, 40-60 years had 20 and >60 years had 32 patients. The difference was significant (P< 0.05). Maximum patients were of stage III (30) followed by stage II (18), stage IV (10) and stage I (6). Treatment given was mastectomy in 46 patients and ongectomy in 18 patients. The difference was significant (P< 0.05). PHQ- 2 with score >3 was observed in 12 and GAD- 2 with score >3 was seen in 15 patients. The difference found to be significant in breast cancer patients with or without depression and anxiety (P< 0.05). Conclusion: Authors found that breast cancer patients had higher level of depression and anxiety level. [ABSTRACT FROM AUTHOR]

Context: Breast cancer is a chronic disease in which cells in breast tissue multiply uncontrolled, typically resulting in a lump. India has a predominant young population, and women in the age group of 30–50 being diagnosed with breast cancer is on the rise. Their survival rates are also rising, owing to the treatment regimens which commonly include chemotherapy. Breast cancer survivors have the challenge of dealing with side effects of treatment such as cognitive impairment, along with alterations in the appearance – breast asymmetry, changes in skin texture and sensitivity, impacting self-esteem and body image. Aim: The present study aims to explore the cognitive functioning, self esteem, and body image of women with a history of breast cancer. Settings and Design: The present study is a cross-sectional, comparative study conducted on breast cancer survivors in an urban area of Kolkata, who were selected using purposive sampling method. Subjects and Methods: A total of sixty females – thirty breast cancer survivors and thirty normal counterparts, aged 30–50 years, were included. Neuropsychological tests, Rosenberg Self Esteem Scale, and Body Image Scale were administered. Statistical Analysis: Descriptive and inferential statics were computed using SPSS 20 software. Results: The results of the study show the presence of significant difference between the two groups. Conclusion: Thus, with a rise in the number of breast cancer survivors, it becomes imperative to understand the negative impact of the various treatments and provide timely interventions, thereby ensuring better quality of life and adequate psychological and emotional support for them. [ABSTRACT FROM AUTHOR]

Introduction: Breast Cancer (Ca Br) is one of the most common cancer amongst women globally as well in India. Amongst various available modalities of treatment, the most common treatment being advised in Ca Br is mastectomy which is commonly associated with a lot of emotion and mental challenges. For Ca Br patients, any decision in this regard forms an integral part in the diagnosis, confirmatory and treatment phase. The present study aims to explore the psychosocial determinants to undertake surgical decisions. Objective: To explore the psychosocial determinants and dilemma of undertaking decision for surgical intervention in Ca Br cases amongst pre and perimenopausal women. Methods: The participants of pre and peri- menopausal women with Ca Br were selected purposively from a tertiary care hospital. The inclusion criteria included patients with Ca Br who underwent a therapeutic mastectomy and willing to be a part of the study were included. Qualitative Inquiry method was used for data collection and Content analysis was done using Atlas.ti. Results: Five themes emerged from the content analysis. It was observed that patriarchy dominates as decision-makers; surgical decision - is it a ' No - brainer' thing?, the big emotional burden on shoulder, motivators & demotivators, and inspiration. Women's passivity as decision-makers along with emotional distress conditions like fear of loss of feminity was always accompanied. Strong support system and will power were the major motivating factor for participants. Conclusion: The study gave a prominent and complex view on determinants of undertaking surgical decisions. Findings from the study would contribute to better strategizing the management of patients in a local context from all aspects and not just from the clinical lens. [ABSTRACT FROM AUTHOR]

More than two thirds of breast cancers in developing countries are diagnosed at a late stage. Awareness-based screening programmes, integrated into existing infrastructure, are the way forward for cancer control in these countries. We aim to describe a structured screening programme established in an urban community in Mumbai, India. We conducted a breast cancer awareness survey in this urban community covered by employees' health scheme. A brochure was designed to inform women about early signs of breast cancer and was posted for the women in the community. We described early signs and symptoms of breast cancer and encouraged the women to seek healthcare in the breast clinics specifically designed for early referral. A multidisciplinary team was established for further in-house care at the community hospital. A database of the detected cancers was maintained. A total of 22,500 brochures were sent in each round of mailing. Four such rounds were conducted in 3 years. A total of 3547 women reported for clinical breast examination (CBE) for various breast complaints or screening. Of these women, 53% were asymptomatic. CBE was normal in 2843 women, and 767 (21%) women were referred for further investigations. Eighty-three breast cancers were detected with 72% having early (stage I-II) cancers. Our exploratory study revealed that awareness-based screening programmes with organised infrastructure and referral pattern could lead to diagnosing early cancers. [ABSTRACT FROM AUTHOR]

Background: Breast cancer (BC) is leading cancer among women in India accounting for 27% of all cancers among women. Factors that make the policymakers and public health system worried are rising incidence of breast cancer in India and more importantly high death rates among breast cancer patients. One of the leading causes of high breast cancer deaths is lack of awareness and screening leading to the late presentation at an advanced stage. Therefore, the current research aimed to understand the knowledge of breast cancer symptoms and risk factors among women in a low socio-economic area of Mumbai.Methods: A cross-sectional study was conducted at Prabhadevi, Mumbai and primary data was collected from 480 women aged 18-55 years. Structured questionnaire was used to collect quantitative data pertaining to awareness, signs and symptoms of breast cancer. Bivariate and multivariate regression techniques were used for understanding of the socio-demographic differentials in breast cancer awareness among women.Results: The study found that around half (49%) of the women were aware of breast cancer. The women who were aware of breast cancer considered lump in breast (75%), change in shape and size of breast (57%), lump under armpit (56%), pain in one breast (56%) as the important and common symptoms. Less than one-fifth of the women who were aware of breast cancer reported early menstruation (5.6%), late menopause (10%), hormone therapy (13%), late pregnancy (15%) and obesity (19%) as the risk factors for breast cancer. The multivariate regression analysis showed women who had more than 10 years of schooling (Adjusted Odds Ratio: 3.93, CI: 2.57-6.02, P < 0.01) were about 4 times more likely to be aware of breast cancer than women who had less than 10 years of schooling.Conclusion: In conclusion, knowledge of danger signs and risk factors of breast cancer were low among women in the community. This may lead to late detection of breast cancer among women in the community. Therefore, the study calls for advocacy and larger intervention to enhance knowledge of breast cancer among women in the particular region with a special reference to women with low education. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to analyze the prevalence of molecular subtypes of all breast cancer patients treated at tertiary cancer centre in West India in 12 years. Materials and Methods: A retrospective observational study carried out in Tertiary Cancer Care Centre in Western India. Electronic medical records of all breast cancer patients were retrieved from the hospital database between March 2007 to March 2019. Patient's characteristic, histological features and molecular subtypes were collected and analyzed. Results: A total of 2062 women fulfilled the criteria for this study and were analyzed. The median age of study population was 51 years (range 22-100 years). Among these, 1357 (65.8%) were of =55 years and 705 (34.2%) were over 55 years. The overall incidence of Hormonal Receptor-positive patients (either estrogen-receptor (ER) or progesterone-receptor (PR) or both) was 1162 (56.4%). The Mean tumor size was 3.8cm (range 0-18cm). The most common histology was IDC (96%). Axillary nodes were positive in 62.5%. Luminal type A was positive in 762 (37%) patients while Luminal type B was present in 157 (7.6%) patients. Basal-like subtype was observed in 537 (26%) patients while HER2 rich subtype was seen in 229 (11.1%). The incidence of Luminal A subtype increased with age. The highest observed among patients (72%) aged 70 years or more. Incidence of Basal like subtype was highest in patients less than 30 years (52%). Conclusion: Luminal-like disease is the most common molecular subtype in India. Identification of Basal like breast cancer, a highly aggressive, biologically and clinically distinct subtype different than its non-basal variant, is important for treatment planning and target therapy. [ABSTRACT FROM AUTHOR]

Background: The incidence of breast cancer has surpassed cervical cancer in India and it has now become the most common cancer in women. Multiple randomised studies have reported low α/β value in the range of 3–4 for breast cancer, which predict a potential radiobiological advantage for hypofractionated radiotherapy resulting in such schedules becoming standard in many centers with reduction in overall treatment time. Volumetric modulated arc therapy (VMAT) is a novel technique of delivering radiotherapy that reduces treatment delivery time, requires less monitor units (MU) and offers good conformity. The mean dose to normal tissue may be minimised using this technique although there will be inferior sparing if we consider the low-dose volume such as V5, the effect of which is not quantifiable yet. Aim: Reporting acute toxicity, cosmetic effects, and quality of life in patients of early breast cancer treated with adjuvant hypofractionated VMAT with SIB. Material and Methods: The records of 44 patients registered at the hospital between August 2014 and December 2015 were included in this analysis. Acute toxicities were analysed using CTCAE v4.03. Cosmetic outcomes were assessed using Harvard scale, while quality of life outcomes were assessed using EORTC scales and Health Related quality of life (HRQOL) questionnaires (QLQ-C30 and QLQ-BR23). Results: No grade ≥2 skin toxicities were recorded. Breast pain was recorded as Grade 1 in 13·8% patients and Grade 1 fatigue in 18·2%. The maximum haematological abnormality grade recorded was Grade 1. Cosmesis was assessed at the baseline, 6 months, 1 year and 2 years. A total of 88·6% of the patients had an Excellent or good cosmesis at the baseline, which was similar even at 6 months, at 88·7%, improved further at 1 year to 90·9%. At 6 months post radiotherapy, high functional scale QOL scores were noted. Conclusion: The technique is associated with minimum acute toxicity, good to excellent cosmesis and acceptable quality of life. [ABSTRACT FROM AUTHOR]

Breast cancer is dreadful and life threatening disease. The causative agent of breast cancer is still under research. Breast cancer affects one in eight women. The statistics shows that 6 percent of women in India die due to breast cancer. Breast cancer is the second important cause of death. Generally breast cancer is a malignant tumour that begins in the cells of the breast and eventually it spreads to the surrounding tissues. The disease can be treated if it is detected early. As stages increases, the chance of curing decreases. There are various imaging techniques that play a vital role in detecting breast cancer. This survey is an attempt to showcase various breast cancer detection techniques based on image processing technique. [ABSTRACT FROM AUTHOR]

Introduction: Community based programs can assist in early detection and improved survival of breast cancer.Aims: To assess the feasibility and explore challenges of a district-wide door-to-door breast cancer screening program "ASWAS" conducted in Kannur district, Kerala, India from 2011 to 2014. METHODS: Aggregate data from survey records were collected in terms of the population screened, referred, diagnosed, and treated. Case records of breast cancer patients who were identified were reviewed and updated. In-depth interviews were conducted with program stakeholders. The contents of the interview were organized into a strength, weakness, opportunity and threat (SWOT) matrix to describe the screening program.Results: A total of 1,049,410 eligible women above 30 years residing in 81 panchayats were visited door-to-door by 8,200 community volunteers; of them, 93% were screened using a symptom-risk factor checklist. Of those referred with symptoms (n = 5353), 81% attended the cancer camp. In total, 23 breast cancer cases were confirmed. 14 (61%) were in early stages, treated, and are disease free at 3-year follow-up. Those in the advanced stage and old age had poor outcomes. SWOT analysis identified political support, female volunteers, community engagement, dedicated fund for treatment, and teamwork as strengths. Weaknesses included poor healthcare access, maintaining volunteer motivation, and issues around sustainability.Conclusion: Community participation with the engagement of the health system and local self-government are required for implementing a comprehensive cancer screening strategy. Breast-cancer screening program using local volunteers for early detection is feasible in low-income settings, thereby improving survival. [ABSTRACT FROM AUTHOR]

Background: Breast cancer (BC) is the most common cancer among women globally and also in India. Early detection by screening is likely to reduce mortality and improve survival. To study the determinants of compliance to BC screening and referral by women in a community based BC screening programme in urban India. Methods: A community-based one-time cancer screening programme, implemented in the urban slums of Mumbai, India. The programme involves screening for breast cancer by Clinical Breast Examination (CBE) performed by trained primary health workers (PHWs), referral of screen-positive women to the nodal hospital for further investigations, confirmation of diagnosis and treatment. Univariate and multivariate logistic regression analysis in SPSS version 16 was used. Results: The compliance to screening, referral and treatment were 90.58%, 74.22% and 100% respectively. The results of multivariate logistic regression analysis demonstrate literate women, having family history of cancer, with tobacco habit, being treated for breast abnormalities, being ever pregnant and having history of contraceptive use were positive predictors while, women belonging to Muslim religion or speaking mother-tongue other than Marathi or Hindi were negative predictors of participation to screening. Educational status was the only significant predictor of compliance to referral. Screen-positive women with education of secondary school level or more were more likely to comply with referral. Conclusions: The programme ensured good compliance with screening, referral and treatment indicating feasibility and acceptability of CBE based BC screening programme by the community. [ABSTRACT FROM AUTHOR]

Background The outcome of breast cancer treatment largely depends on the timing of detection. The health promotion interventions have an immense contribution to early detection and improved survival. Therefore, this review aimed to provide evidence on the efficacy of the health promotion interventions to increase the uptake of breast cancer screening and to develop effective interventions targeting women. Methods Online databases (PubMed/MEDLINE/PubMed Central, Ovid/MEDILINE, EMBASE, Web of Science and Google Scholar) were searched for studies published between January 2005 and January 2017. A quality coding system was assessed using Cochrane checklists for randomized controlled trial (RCT) and Downs and Black checklists for non-RCT. The score was rated for the included articles by each researcher independently and the average score is given accordingly. This study was registered in PROSPERO as [PROSPERO 2017: CRD42017060488]. Results The review dovetailed 22 studies. Thirteen studies (59.10%) were conducted in the Unite States, 4 in Iran (18.18%), 2 in India (9.09%) and 1 each in Turkey, Saudi Arabia and Israel. The interventions were classified as 'individual-based', 'community-based', 'group-based teachings and training' and 'behavioral model based'. The majority of the studies showed favorable outcomes after health promotion interventions, including improvements in women's view of breast screening, breast self-examination and knowledge of breast screening. Conclusion The review confirmed that most of the health promotion interventions targeting women boosted the breast screening in one or another way. However, the limited quality of the included studies showed that further research is needed to improve the trials in the next future. [ABSTRACT FROM AUTHOR]

Cumulatively, breast, cervical, ovarian, and uterine cancer account for more than 70% of cancers in women in India. Distinct differences in the clinical presentation of women with cancer suggest underlying differences in cancer biology and genetics. The peak age of onset of breast and ovarian cancer appears to be a decade earlier in India (age 45-50 years) than in high-income countries (age >60 years). Understanding these differences through research to develop diagnosis, screening, prevention, and treatment frameworks that ar e specific to the Indian population are critical and essential to improving women's health in India. Since the sequencing of the human genome in 2001, applications of advanced technologies, such as massively parallel sequencing, have transformed the understanding of the genetic and environmental drivers of cancer. How can advanced technologies be harnessed to provide health-care solutions at a scale and to a budget suitable for a country of 1·2 billion people? What research programmes are necessary to answer questions specific to India, and to build capacity for innovative solutions using these technologies? In order to answer these questions, we convened a workshop with key stakeholders to address these issues. In this Series paper, we highlight challenges in tackling the growing cancer burden in India, discuss ongoing genomics research and developments in infrastructure, and suggest key priorities for future research in cancer in India. [ABSTRACT FROM AUTHOR]

TITLE: A PROSPECTIVE STUDY OF ASSESSMENT OF BREAST ANTHROPOMETRY IN INDIAN BREAST CANCER PATIENTS INTRODUCTION: India has one of the youngest populations but there is a troubling trend of increasing breast cancer incidence. With increasing affluence, awareness and social demands, the demand for breast conservation surgery and standard of care has increased. Surgical options are guided by tumor, breast volume and patient factors. There is a difference between our population and the much studied west. In the current study, we tried to explore this hypothesis and tried to establish a baseline measurement of various anthropometric parameters of breast in Indian breast cancer patients. Further, we tried to categorise these parameters and attempted a correlation with breast conservation surgery, tumor and breast volume. MATERIALS AND METHODS: The study was done prospectively in 102 patients between January to October 2016. Anthropometric measurements of breast, nipple areola complex, ptosis and mammographic breast density of the normal breast were recorded. Breast volume was measured with a geometric method devised by Qiao et al. The measurements were done with the help of measuring tape, calipers and rulers and were categorized using quartiles. Tumor size and the surgery performed in these patients was also recorded. 70 patients were suitable for correlation of breast volume and tumor size. RESULTS: Mean breast volume in the study was 303 ml (93.25 - 1345 ml). Breast volume was divided into category I (<170ml), category II (170 - 360 ml) and Category III (>360 ml). Mean areola diameter, nipple diameter, nipple projection were 4.53 cm (2.3 - 8 cm), 0.99 cm (0.6 - 1.5cm) and 0.77 cm (0.3 - 1.5cm) respectively. 51 patients had grade 3 ptosis. Most common mammographic breast density is ACR II. BCS rate in category I was 17.64 percent while categories II and III had a BCS rates of 37.14 and 38.88 percent respectively. CONCLUSION: Breast measurements of Indian women are different from their western counterparts. Ptosis is seen more often. Geometric methods can be used to calculate breast volume and can help predict breast conservation rates and in patient referral. There is a paucity of literature on breast anthropometry in Indian breast cancer patients and this is one of the first studies to address it and its implications on surgery. [ABSTRACT FROM AUTHOR]

Background: Breast and cervical cancer are two of the most common cancers among women worldwide and were the two leading causes of cancer related death for women in India in 2013. While it is recognized that psychosocial and cultural factors influence access to education, prevention, screening and treatment, the role of stigma related to these two cancers has received limited attention.Methods: Two qualitative exploratory studies. One focusing on cervical cancer, the other on breast cancer, were conducted in Karnataka, India using in-depth interviews and focus group discussions. In the breast cancer study, 59 in-depth interviews were conducted with patients, primary caregivers and healthcare providers. In the cervical cancer study, 147 respondents were interviewed including older and younger women, husbands, healthcare providers and community leaders. While stigma was not the focus of either study, themes relating to stigma emerged and are the focus of this analysis.Results: Cancer stigma emerged as a general theme across both data sets. It appeared throughout the transcripts as descriptions of how women with breast or cervical cancer would be treated and talked about by husbands, family and the community (manifestations of stigma) and the reasons for this behavior. Stigma as a theme also arose through discussions around managing disclosure of a cancer diagnosis. Stigma was juxtaposed with a narrative of support for women with cancer. Three major themes emerged as driving the manifestations of cancer stigma: fear of casual transmission of cancer; personal responsibility for having caused cancer, and; belief in and fear of the inevitability of disability and death with a cancer diagnosis. Manifestations of cancer stigma were described in terms of experienced (enacted) stigma, including isolation or verbal stigma, and anticipated (fear of) stigma, should a cancer diagnosis be disclosed.Conclusions: The presence in these communities of cancer stigma and its many forms emerged across both the cervical and breast cancer data sets. Stigma was a feared outcome of a cancer diagnosis and described as a barrier to screening, early diagnosis and treatment seeking for women with symptoms. While further research on cancer stigma is needed, this exploration of some of the driving factors provides insight for future programmatic efforts to reduce cancer stigma and improve access to information, screening and treatment. [ABSTRACT FROM AUTHOR]

Purpose: Although cancer registry data indicate that there are large differences in breast cancer (BC) rates between rural and urban regions of India, the reasons for these differences are not well understood.Methods: We conducted a hospital based case-control study (1,637 breast cancer cases; 1,515 visitor controls) in Mumbai, India, during the years 2009-2013. Extensive questionnaire data, anthropometry measurement and blood samples were collected on all participants. Using logistic regression models, we estimated risk based on odds ratio (OR) and 95 % confidence intervals (CI) for various reproductive and anthropometric measures, stratified by rural-urban status depending upon residence in first 20 years of life.Results: Waist-to-hip ratio of ≥0.95 compared to ratio ≤0.84 was strongly associated with risk of BC in both rural and urban populations (ORurban = 4.10, 95 % CI 3.03-5.56; ORrural = 3.01, 95 % CI 1.85-4.90). First full-term pregnancy after the age of 25 compared to first full-term pregnancy below 20 years of age was associated with risk of BC in both urban and rural women (ORurban = 1.78, 95 % CI 1.32-2.41; ORrural = 2.24, 95 % CI 1.13-4.43). The prevalence of age at first full-term pregnancy was significantly lower in rural (mean age at first full-term pregnancy = 19.39 years) versus urban women (mean age at first full-term pregnancy = 22.62 years), whereas mean waist circumference was much higher in urban women (82.13 cm) compared to rural women (79.26 cm). We did not observe any association between breast feeding and risk of BC.Conclusions: Differences in the prevalence of central adiposity and age at first full-term pregnancy between rural and urban women from India may explain some differences in breast cancer rates between these two populations. [ABSTRACT FROM AUTHOR]

CONTEXT: Breast cancer incidence rates are high in developed countries and much lower in less developed countries including India. AIMS: The aim of the following study is to compare breast cancer incidence rates in rural, urban and metro regions of India and to estimate risk of developing breast cancer associated with residence in a rural area. SETTINGS AND DESIGN: Descriptive and analytical study design. MATERIALS AND METHODS: We extracted age adjusted incidence rate from 26 population-based cancer registries and data from hospital-based case-control study to estimate rate and risk ratio for developing breast cancer in an urban region compared with a rural residence. STATISTICAL ANALYSIS: The rate ratios and 95% confidence interval (CI) for developing breast cancer in the urban and metro region compared with rural registry of Barshi were estimated. The odds ratio (OR) and 95% CI for developing breast cancer in women residing in a rural region was estimated by fitting unconditional logistic regression using hospital-based case-control study data. Average annual percentage change in most recent 15 years (1996-2010) for Barshi (rural), Aurangabad (urban), and Mumbai (metro) cancer registry was obtained by fitting a log-linear model using joint point regression. RESULTS: Living first 20 years of life in a rural area reduces the risk of breast cancer (OR = 0.65, 95% CI: 0.56-0.76). CONCLUSIONS: The current study demonstrates that lifestyle operative in a rural area is protective against risk of developing breast cancer. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to conduct feasibility study of phase III breast and lung cancer clinical trials in India. Materials and Methods: Study synopsis and feasibility questionnaire were mailed to 300 oncologists for each indication. Criteria of selection were enrolment of ≥2 patients per month, frequency of Ethics Committee (EC) meeting ≤4 weeks, dropout rate <20%, adequacy of infrastructure and training of site in good clinical practice (GCP). Descriptive analyses of the data were performed. Results: For both indications, 50/300 (16.7%) sites responded. The median number of patients seen by a site per month for breast and lung cancer was 20 (range 0-300) and 10 (range 0-75), respectively. Median number of eligible patients was 4 (range 0-20) and 3 (range 0-15) per month, for breast and lung cancer respectively. The frequency of EC meeting was ≤4 weeks at 36-56% of sites. All sites were trained in GCP and had adequate infrastructure to conduct the clinical trial. For breast cancer 22 (44%) sites (public 14 [28%]; private 8 [16%)]), and for lung cancer 18 (36%) sites (public 15 [30%], private: 3 [6%]) met the criteria of selection. Conclusion: Preliminary feasibility study would require for confirmation of the important feasibility criteria by in depth discussion during the personal visit to the potential sites. [ABSTRACT FROM AUTHOR]

The aim of this study is to analyse the portrayal of cancer in print media. The English daily newspapers published from Chandigarh (a Union Territory of India), The Tribune and The Times of India, were selected and a total of 273 articles were analysed in a span of three years. The analysis of data showed various themes such as theories regarding causes and prevention of cancer, risk factors for breast cancer, treatment of breast cancer, and social problems among cancer patients. The liberal use of battle metaphors was also found, along with a number of personal testimonies of breast cancer patients. [ABSTRACT FROM AUTHOR]

Background: The burden of breast cancer in Asia is escalating. We evaluated the impact of ethnicity on survival after breast cancer in the multi-ethnic region of South East Asia. Methodology/Principal Findings: Using the Singapore-Malaysia hospital-based breast cancer registry, we analyzed the association between ethnicity and mortality following breast cancer in 5,264 patients diagnosed between 1990 and 2007 (Chinese: 71.6%, Malay: 18.4%, Indian: 10.0%). We compared survival rates between ethnic groups and calculated adjusted hazard ratios (HR) to estimate the independent effect of ethnicity on survival. Malays (n = 968) presented at a significantly younger age, with larger tumors, and at later stages than the Chinese and Indians. Malays were also more likely to have axillary lymph node metastasis at similar tumor sizes and to have hormone receptor negative and poorly differentiated tumors. Five year overall survival was highest in the Chinese women (75.8%; 95%CI: 74.4%-77.3%) followed by Indians (68.0%; 95%CI: 63.8%-72.2%), and Malays (58.5%; 95%CI: 55.2%-61.7%). Compared to the Chinese, Malay ethnicity was associated with significantly higher risk of all-cause mortality (HR: 1.34; 95%CI: 1.19-1.51), independent of age, stage, tumor characteristics and treatment. Indian ethnicity was not significantly associated with risk of mortality after breast cancer compared to the Chinese (HR: 1.14; 95%CI: 0.98-1.34). Conclusion: In South East Asia, Malay ethnicity is independently associated with poorer survival after breast cancer. Research into underlying reasons, potentially including variations in tumor biology, psychosocial factors, treatment responsiveness and lifestyle after diagnosis, is warranted. [ABSTRACT FROM AUTHOR]

Background: Demographic, socioeconomic and cultural changes in India have increased longevity, delayed childbearing, decreased parity and resulted in a more westernised lifestyle, contributing to the increasing burden of cancer, especially among women.Methods: We evaluated secular changes in the incidence of breast, cervical and ovarian cancer in Mumbai women aged 30-64 between 1976 and 2005. Age-standardised incidence rates were calculated and presented by site and calendar period. An age-period-cohort (APC) analysis quantified recent time trends and the significance of birth cohort and calendar period effects. The estimated annual percent change (EAPC) was obtained from the drift parameter, expressing the linear time trend common to both calendar period and birth cohort.Results: Over the 30-year study period, the age-standardised rates significantly increased for breast cancer (EAPC: 1.1% (95% confidence interval (CI): 1.0, 1.3)), significantly decreased for cervical cancer (EAPC: -1.8% (95% CI: -2.0, -1.6)) and there was no statistically significant change for ovarian cancer (EAPC: 0.3% (95% CI: -0.1, 0.6)). For breast and cervical cancer, the best-fitting model was the APC model.Conclusions: The rates of breast, cervical and ovarian cancer remain low in comparison with western countries, and the divergent trends of breast (increasing) and cervical cancer (decreasing) in Mumbai were similar to those observed in several other Asian countries. The changing risk profile in successive generations - improved education, higher socioeconomic status, later age at marriage and at first child, and lower parity - may in combination partially explain the diverging generational changes in breast and cervical cancer in Mumbai in the last decades. [ABSTRACT FROM AUTHOR]