The Relevance of Established Risk Factors in Context to Indian Breast Cancer Patients

Breast cancer is the most common female cancer in the world with an estimated 1.67 million new cancer cases diagnosed in 2012. Though the age adjusted incidence rates of breast cancer in India is lower than the western countries, because of the large population the burden of breast cancer is high and increasing day by day. With an annual incidence of approximately 1,44,000 new cases of breast cancers in India, it has now also become the most common female cancer in India [1]. Many risk factors are presumed to increase the chance of having breast cancer. These factors have been summarized in a systematic review conducted by an expert panel committee of the International Agency for Research on Cancer (IARC) and the American Institute of Cancer Research (AICR) on the basis of the strength of the existing evidence [2,3]. Factors with convincing evidence for increasing the risk of breast cancer include increasing age, age at first childbirth, parity, alcohol consumption, obesity and use of oral contraceptives. Further breast feeding has also shown sufficient evidence for decreasing the risk of breast cancer. However, this classification of the risk factors was based on studies conducted in patients from western countries. The physique and lifestyle of Indian women is quite different from those of western world. Early marriage, young age at first childbirth, multiparity and long durations of breast feeding is traditionally seen in a majority of Indian women. The use of oral contraceptives is not very common in Indian women as tube ligation is by far the most prevalent birthcontrol method used in threefourth of the female population [4]. The consumption of alcohol in Indian women is also very less, as it is a social taboo for majority of them [5]. With this background, this review was done to evaluate the prevalence of breast cancer risk factors in Indian women, which include age, age at first childbirth, parity, duration of breast feeding, obesity and alcohol use as reported in various recent studies from India.