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从统计数据到故事:揭示印度西北部乳腺癌的流行病学情况

From Statistics to Stories: Unveiling the Epidemiology of Breast Carcinoma in Northwestern India.

作者信息

Kumar Naina, Gera Kriti, Patel Pinakin, Lakhera Kamal Kishore, Singh Suresh, Gurjar Bhairulal, Kumar Arjun, Singhal Pranav, Gora Bhoopendra, Sharma Raj Govind

机构信息

Department of Surgical Oncology, SMS Medical College and Attached Group of Hospitals, Jaipur, Rajasthan 302004 India.

Department of Internal Medicine, University of Florida College of Medicine, Gainesville, USA.

出版信息

Indian J Surg Oncol. 2025 Apr;16(2):543-549. doi: 10.1007/s13193-024-02104-8. Epub 2024 Sep 30.

Abstract

After receiving the pathology report for breast cancer, the first question most patients ask their doctor is about their journey ahead. The type of cancer and how it spreads can give us an idea of what to expect during follow-up. Unfortunately, there is a lack of reporting, management, and documentation of breast cancer cases in India, resulting in a shortage of information on the different types of breast cancer. To address this issue, a study was conducted to gain a better understanding of the pattern of breast carcinoma in Northwestern India. A total of 2619 breast cancer pathology reports were gathered from four major diagnostic centres in Northwest India. Out of all breast cancer patients, 97.74% (2560) were women, while men accounted for only 2.25% (59) of the sample. At the time of diagnosis, 72% of patients were in stages III and IV, while only 28% of patients were in the early stages of cancer (stages I and II). The most common type of breast cancer was infiltrating duct carcinoma (IDC), which constituted 80.71% (2114/2619) of all malignant lesions. infiltrating lobular carcinoma was the second most common pathology, accounting for 5.38% (141/2619) of all cases. The rarer pathologies had a presentation rate below 10%. Our study revealed the most common symptom as a painless lump. Significant majority presented in advanced stages. An alarming 20% presented with foul-smelling ulceration or fungation of the skin. Varied presentations of breast cancer subtypes were evident. As the age-old saying goes-the 'most common' is often ignored as a large portion of the researcher's attention is focused on 'rarer stuff'. Similarly, IDC being the commonest deserves most of our attention. Not just the histology but its grades too. The lack of awareness regarding the risk factors and early detection methods of breast cancer is unfortunately even prevalent in 49% of healthcare workers. What India needs are more data reporting, timely diagnostic strategies, standardized reporting for pathology, and guideline-based management strategies. Increasing data collection electronically in the coming years will help India in displaying more data.

摘要

在收到乳腺癌病理报告后,大多数患者向医生提出的第一个问题是关于他们未来的治疗过程。癌症的类型及其扩散方式能让我们对后续治疗情况有所了解。不幸的是,印度存在乳腺癌病例报告、管理和记录方面的不足,导致关于不同类型乳腺癌的信息短缺。为解决这一问题,开展了一项研究,以更好地了解印度西北部乳腺癌的发病模式。从印度西北部的四个主要诊断中心收集了总共2619份乳腺癌病理报告。在所有乳腺癌患者中,97.74%(2560人)为女性,而男性仅占样本的2.25%(59人)。在诊断时,72%的患者处于III期和IV期,而只有28%的患者处于癌症早期(I期和II期)。最常见的乳腺癌类型是浸润性导管癌(IDC),占所有恶性病变的80.71%(2114/2619)。浸润性小叶癌是第二常见的病理类型,占所有病例的5.38%(141/2619)。较罕见的病理类型的发病率低于10%。我们的研究显示最常见的症状是无痛性肿块。绝大多数患者在晚期就诊。令人担忧的是,20%的患者出现皮肤恶臭溃疡或糜烂。乳腺癌亚型的表现各不相同。正如那句古老的谚语所说——“最常见的”往往被忽视,因为研究人员的大部分注意力都集中在“更罕见的情况”上。同样,浸润性导管癌作为最常见的类型值得我们给予最多关注。不仅是其组织学,还有其分级。不幸的是,49%的医护人员甚至对乳腺癌的危险因素和早期检测方法缺乏认识。印度需要更多的数据报告、及时的诊断策略、病理报告的标准化以及基于指南的管理策略。未来几年增加电子数据收集将有助于印度展示更多数据。

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本文引用的文献

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Breast cancer in India: Present scenario and the challenges ahead.印度的乳腺癌:现状与未来挑战。
World J Clin Oncol. 2022 Mar 24;13(3):209-218. doi: 10.5306/wjco.v13.i3.209.
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Epidemiology of male breast cancer.男性乳腺癌的流行病学。
Breast. 2020 Dec;54:8-14. doi: 10.1016/j.breast.2020.08.010. Epub 2020 Aug 22.
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North Clin Istanb. 2018 Aug 8;5(4):365-369. doi: 10.14744/nci.2018.09124. eCollection 2018.
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Descriptive Epidemiology of Female Breast Cancer in Delhi, India.印度德里女性乳腺癌的描述性流行病学
Asian Pac J Cancer Prev. 2017 Apr 1;18(4):1015-1018. doi: 10.22034/APJCP.2017.18.4.1015.
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Male Breast Cancer in India: Series from a Cancer Research Centre.印度男性乳腺癌:来自一个癌症研究中心的系列研究
Indian J Surg Oncol. 2015 Dec;6(4):384-6. doi: 10.1007/s13193-015-0473-1. Epub 2015 Oct 19.
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Epidemiological correlates of breast cancer in South India.印度南部乳腺癌的流行病学相关因素。
Asian Pac J Cancer Prev. 2013;14(9):5077-83. doi: 10.7314/apjcp.2013.14.9.5077.

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