Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, 722 West 168th St, New York, NY, 10032, USA.
Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA.
Cancer Causes Control. 2021 Jun;32(6):567-575. doi: 10.1007/s10552-021-01428-y. Epub 2021 Apr 28.
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.
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.
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.
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.
在印度,乳腺癌(BC)的发病率,尤其是在年轻女性中,正在上升。如果没有基于人群的乳房 X 光筛查,发病率的上升就不能归因于筛查。需要进行调查以了解这一趋势的潜在驱动因素。
一个国际专家小组召开会议,讨论了印度乳腺癌的趋势、环境暴露和临床影响,并概述了其管理建议。
小组分为三个主要乳腺癌主题(n=10 次演讲)。研讨会最后进行了一个半结构化的思维小组讨论,旨在确定短期和长期目标,以应对印度乳腺癌的挑战。
与会者一致认为,晚期 BC 的流行和高 BC 死亡率与检测实践有关,主要是通过临床和自我乳房检查,而不是乳房 X 光检查。三阴性乳腺癌(TNBC)被广泛讨论,包括 TNBC 的病因和潜在危险因素、有限的治疗选择,以及报告的 TNBC 率是否得到严格的科学证据支持。思维小组会议确定了长期和短期目标,以进一步减少印度的 BC,并包括使用现有的印度队列和病例对照研究进行更多关于环境暴露的区域性病因研究、BC 病例的分子分型标准化,以及提高公众对乳房健康的认识。