Srinagar, Oct 26 (KNO): Breast cancer is emerging as a major health challenge in Kashmir, with medical experts stressing the need for greater public awareness, early diagnosis and timely treatment to improve survival rates.
Although breast cancer is one of the most common cancers affecting women worldwide, experts say the challenge in Kashmir extends beyond the disease burden, as many patients approach hospitals only after the cancer has progressed to an advanced stage. Doctors said that breast cancer is often treatable, particularly when detected early, and that timely medical intervention can significantly improve outcomes and quality of life.
Speaking to the news agency—Kashmir News Observer (KNO), Dr Shabnam Bashir, Director of Surgical Oncology specialising in breast and colorectal cancers at New City Hospital, Tengpora Bypass, said understanding the disease, recognising its warning signs and seeking medical advice without delay are essential to reducing its impact. "Breast cancer develops when cells in the breast grow abnormally and uncontrollably, usually originating in the milk ducts or lobules. Although it predominantly affects women, men can also develop the disease," he said.
Global and national burden
Breast cancer remains one of the most frequently diagnosed cancers worldwide and the leading cancer affecting women in many countries. Millions of women are diagnosed every year, while hundreds of thousands lose their lives to it. The burden varies across countries, with differences in awareness, screening facilities, access to diagnostic services and availability of timely treatment contributing to variations in survival rates. In countries with well-established screening programmes, more cases are detected early, allowing treatment to begin before the disease spreads. In settings with limited screening or delayed access to specialist services, women are more likely to be diagnosed at advanced stages.
In India, breast cancer has emerged as the leading cancer among women, surpassing cervical cancer in incidence. A considerable proportion of Indian patients continue to reach healthcare facilities after the disease has progressed. Social stigma, fear of diagnosis, lack of awareness about symptoms and delays in seeking medical attention are among the factors contributing to late presentation. Experts say these challenges underline the importance of making breast health a routine part of women's healthcare rather than seeking medical assistance only when symptoms become severe.
Rising concern in Kashmir
Studies conducted at tertiary-care centres in Kashmir have reported that approximately 70–73 per cent of breast cancer patients presented with stage III disease, highlighting the need for earlier detection and faster referral for specialist assessment. A late diagnosis can limit treatment options and increase the complexity of care, whereas cancers detected early generally offer better prospects for successful treatment.
Why is breast cancer a growing concern?
Experts say the burden is influenced by a combination of reproductive, biological, genetic, lifestyle and healthcare-related factors. No single factor can explain the trends observed in Kashmir.
Changing reproductive patterns — early onset of menstruation, later age at first childbirth and having fewer children — may influence risk through hormonal pathways, while breastfeeding is associated with a protective effect. Obesity and sedentary lifestyles, particularly excess body weight after menopause and insufficient physical activity, are recognised risk factors. Women with close relatives who have had breast or ovarian cancer may face a higher risk, and inherited genetic alterations, including those involving BRCA1 and BRCA2, can substantially increase susceptibility in some families.
Limited knowledge about early symptoms, fear of a cancer diagnosis and hesitation in discussing breast-related problems can delay consultation, while travel costs, geographical challenges and delays in reaching specialist services can make timely diagnosis difficult, particularly for those in remote and rural areas. Greater public awareness, better diagnostic facilities and improved cancer registration may also contribute to the increased number of cases identified over time. Experts caution that breast cancer can develop even in women with no identifiable risk factors, making awareness and timely evaluation important for everyone.
Warning signs
One of the most common signs is a new lump or thickening in the breast or underarm. Importantly, a cancerous lump may be painless in its early stages, and the absence of pain should never be a reason to ignore a new abnormality. Women should seek medical assessment if they notice a new lump or thickening in the breast or armpit, a change in the size, shape or appearance of a breast, dimpling, puckering, redness or thickening of the skin, a newly inverted or retracted nipple, unusual nipple discharge, particularly if blood-stained, a wound or sore that does not heal, or swelling around the armpit or collarbone. While many lumps are caused by non-cancerous conditions, any new or persistent abnormality warrants medical evaluation.
Risk factors and lifestyle
Age and sex remain important risk factors, with the likelihood generally increasing as women grow older. Other factors include a strong family history of breast or ovarian cancer, inherited genetic mutations, dense breast tissue, previous radiation exposure to the chest, early menstruation and late menopause. Lifestyle and reproductive factors such as obesity after menopause, physical inactivity, alcohol consumption and combined menopausal hormone therapy can also influence risk. However, having one or more risk factors does not mean a woman will develop breast cancer, and women without a known family history can also be diagnosed.
Although breast cancer cannot be prevented in every case, experts recommend maintaining a healthy body weight, regular physical activity — at least 150 minutes of moderate-intensity activity each week — and a balanced diet rich in fruits, vegetables, whole grains and pulses. Limiting highly processed foods, avoiding tobacco and limiting alcohol are also important. Breastfeeding, where possible, is associated with reduced risk. Those with a strong family history should seek advice on individual risk assessment, genetic counselling and surveillance.
Early detection and treatment
Early detection is among the most effective ways to improve outcomes. Doctors emphasise breast awareness — becoming familiar with the normal appearance and feel of one's breasts and promptly reporting unusual changes — while noting it is not a substitute for clinical examination or imaging. Clinical breast examination and mammography may help identify abnormalities depending on age, individual risk and available guidance. Women with a strong family history may require an individualised screening plan, potentially starting earlier.
For Kashmir, experts say awareness campaigns must be accompanied by accessible diagnostic facilities and reliable referral systems so that women with suspicious findings undergo further investigation without delay. Mobile screening initiatives and peripheral camps can help, but their effectiveness depends on ensuring timely diagnostic confirmation and treatment. Any suspicious lump or persistent change should be evaluated promptly rather than waiting for a routine screening appointment.
Diagnosis generally begins with clinical examination, followed by imaging such as breast ultrasound or mammography, and a biopsy to confirm whether a lesion is cancerous and to determine hormone-receptor and HER2 status. Treatment is tailored to the patient and may involve surgery, radiation, chemotherapy, hormone therapy or targeted medicines, supported by rehabilitation, nutritional support, physiotherapy and psychological counselling. Doctors stress that breast cancer care requires a multidisciplinary approach.
Dr Shabnam Bashir said the availability of diagnostic and treatment facilities in Kashmir has made it possible for patients to access comprehensive breast cancer care within the region. She stressed that women should not delay seeking advice because of fear, stigma or the belief that treatment would require travelling outside Kashmir—(KNO)