Early detection of breast cancer by self examination, clinical examination and fine needle aspiration cytology in rural women -a population based study

Breast cancer is now the commonest form cancer in women world over.  The rise in its incidence is remarkably steep in developing countries.  Breast cancer has emerged as the commonest cancer in urban Indian women and the second commonest among rural women. 1 Like the overall poor health awareness, awareness of breast cancer is poor among the masses.  This along with a general indifference towards the health of women, a lac of breast cancer screening program and delay in seeking advice for a recognized health problem for financial and social reasons results in delayed diagnosis2,3.  As a result, Indian breast cancer patients present with advanced disease and have numerous poor prognostic features such as large tumor, lymph node metastasis, high pathological grade and negative hormone receptors in many. 3.  Majority of the multimodality treatment cancer centres are concentrated in the larger cities.  Pathologist’ services like Fine Needle Aspiration Cytology are available mainly in the medical colleges.  This along with lack of awareness of about their own breasts in rural women brings them to the doctor in an advanced stage.  In Fr Muller Medical College Hospital, all the breast lumps are subjected to FNAC.  About 50 breast cancers are diagnosed annually with no false positive diagnosis and minimal false negative rate.  However more than 100 breast cancers are studied in histopathology section.  Surgeons from peripheral hospitals either send tru-cut or excision biopsies for diagnosis due to nonavailability of pathologists to do FNAC.  Therefore there is an urgent need to create awareness about breast cancer and provide services of pathologists to rural areas.  .