Breast Cancer Statistics

Breast cancer is the most frequent cancer among women, impacting 2.1 million women each year, and also causes the greatest number of cancer-related deaths among women. In 2018, it is estimated that 627,000 women died from breast cancer – that is approximately 15% of all cancer deaths among women. While breast cancer rates are higher among women in more developed regions, rates are increasing in nearly every region globally.

In parallel to the socioeconomic development in India and the subsequent shift from communicable to non-communicable diseases, cancer is moving to the forefront of health threats to Indian middle-resource populations. With respect to breast cancer, the incidence rates are increasing, while healthcare systems are often ill prepared to deal with diseases such as this, requiring multidisciplinary, comprehensive care.

Breast cancer is on the rise, both in rural and urban India. A 2018 report of Breast Cancer statistics recorded 1,62,468 new registered cases and 87,090 reported deaths in that year.

Breast cancer has ranked number one cancer among Indian females with age adjusted rate as high as 25.8 per 100,000 women and mortality 12.7 per 100,000 women. Data reports from various latest national cancer registries were compared for incidence, mortality rates. The age adjusted incidence rate of carcinoma of the breast was found as high as 41 per 100,000 women for Delhi, followed by Chennai (37.9), Bangalore (34.4) and Thiruvananthapuram District (33.7). A statistically significant increase in age adjusted rate over time (1982-2014) in all the PBCRs namely Bangalore (annual percentage change: 2.84%), Barshi (1.87%), Bhopal (2.00%), Chennai (2.44%), Delhi (1.44%) and Mumbai (1.42%) was observed. Mortality-to-incidence ratio was found to be as high as 66 in rural registries whereas as low as 8 in urban registries. Besides this young age has been found as a major risk factor for breast cancer in Indian women. Breast cancer projection for India during time periods 2020 suggests the number to go as high as 1797900.

The chances of survival is usually explained in terms of 5 year/10 year survival rate in oncology. The 5-year survival rate tells you what percent of people live at least 5 years after the cancer is found. Percent means how many out of 100. The average 5-year survival rate for women with non-metastatic invasive breast cancer is 91%. The average 10-year survival rate for women with invasive breast cancer is 84%. The survival rate changes as per the stage of your disease. If the invasive cancer is located only in the breast, the 5-year survival rate of women with breast cancer is 99%. If the cancer has spread to the regional lymph nodes, the 5-year survival rate is 86%. If the cancer has spread to a distant part of the body, the 5-year survival rate is 27%. That’s why It’s important to get detected early.

Here are some alarming facts about breast cancer in India that will help patients understand breast cancer and the reason to opt for a personalized treatment :

  • Breast cancer is the most common cancer in women in India.
  • Breast cancer is the most common cancer in most cities and the second most common in rural India.
  • Breast cancer accounts for 25% to 32% of female cancers in all cities across India.
  • In India, one woman is diagnosed with breast cancer every 4 minutes.
  • One woman dies of breast cancer, every 13 minutes in India.
  • An estimated 70,218 women died of breast cancer in India, in the year 2012, the highest in the world for that year.
  • Only 60% of women who are treated for breast cancer, survive for at least five years post-treatment in India as compared to 89% in the US.
  • The high mortality rate is due to the lack of awareness and delay in diagnosis.
  • More than 50% of breast cancer patients in India are suffering from stage 3 and 4, where the chances of survival are extremely low.
  • India sees a spurt in the cases of breast cancer in the age group of 30 to 50, and the same is likely to increase.

Breast cancer attains top rank even in individual registries (Mumbai, Bangalore, Chennai, New Delhi and Dibrugarh) in females during the period of 2012–2014 (Table). The relative proportion of breast cancer in different registries varied from 30.7% in Chennai to 19% in Dibrugarh (Table ) Increasing urbanization and westernization associated with changing lifestyle and food habits has lead breast cancer to attain top position in all major urban registries, whereas in Barshi rural registry still cervical cancer is at top position in females and cancer of breast holds second position. Breast cancer crude rate (CR) among different registries showed highest rate in Thiruvananthapuram 43.9 (per 100 000) followed by Chennai (40.6), New Delhi (34.8) and Mumbai (33.6). Among all the PBCR’s top four places were occupied by Delhi with AAR 41.0 (per 100,000), Chennai 37.9, Bangalore 34.4 and Thiruvananthapuram District 33.7. A total district wise minimum age adjusted incidence rate per 100 000 for India is shown in Fig. S2. AAR more than 20 per 100 000 has been reported for districts Chandigarh (39.5), Panchkula (34.6), Aizwal (36.2) and Goa (36.8)

Table Ranking and rates for breast cancer

Breast Relative Proportion Rank Crude rate per 100 000 Age adjusted rate per 100 000
Mumbai
28.8
1
33.6
33.6
Bangalore
27.5
1
29.3
34.4
Chennai
30.7
1
40.6
37.9
Thiruvananthapuram
28.5
1
43.9
33.7
Dibrugarh
19
1
12.7
13.9
New Delhi
28.6
1
34.8
41
Barshi Rural
20
2
13.2
12.4

Mortality/incidence ratio (MIR) is another novel measure to evaluate cancer mortality in relation to incidence. It is used to identify whether a region has a higher mortality than might be expected based on its incidence. Barshi rural has MIR as high as 66.3 projecting a very high mortality rate in spite of low incidence of breast cancer in rural India . However, Delhi registry had a low MIR of 8.0 despite having high incidence (28.6%), possibly due to high literacy, more awareness and availability of better medical facilities in metropolitan cities. In rural areas, cancer patients are diagnosed at late or advanced stages of disease with a higher proportion of them having widespread metastasis suggesting for need of more attention in terms of awareness, treatment and facilities for early diagnosis.

Indian women having breast cancer are found a decade younger in comparison to western women suggesting that breast cancer occurs at a younger premenopausal age in India. Cancers in the young tend to be more aggressive. Studies from various registries have revealed increasing AAR for the breast cancer patients with age intervals (viz. 15–34, 35–44, 45–54, 55–64, and >64 years). The youngest age group consisting of 15–34 years had an APC of 4.24%, 1.60% and 0.80% in Nagpur, Mumbai and Chennai, respectively. For 35–44 age group, the APC ranged from 0.37% to 2.97% in these registries. However, oldest age group comprising of patients >64 years, the APC ranged from 0.53% to 2.64%. Studies suggest that the disease peaks at 40–50 years in Indian women. Trends for 5‐year age distribution among different registries showed a peak relative proportion between 45 and 49 years in all registries except in north eastern registries where the peak is seen in even 10‐year younger age group—35–39  In India, majority of patients present at locally advanced or at metastatic stages at the time of diagnosis. According to various studies, majority of carcinoma breast cases in the west report in stages I and II of disease, whereas in India 45.7% report in advanced stages. Disease presentation in such conditions results in increased mortality in India.

(See Molecular subtypes of Breast cancer)

32% of the breast tumors from women of South India are found to be co-positive for the ER and PR expression. This value is lower than reports from Northern India, which state that 40% of the breast tumors are positive for ER and PR status The cumulated ratio of ER and PR expression in breast tumors of Indian women is found to be much lower than that of Western population, where >50% are co-positive for ER and PR). Studies from Canada and Australia also reported that 73% and 59% of the BC were ER positive while 58.10% and 61% were PR positive respectively.

It is noteworthy that 51.64% of BC cases in the present investigation were found to be positive for HER-2/neu status. Studies from USA have reported that 17-27% of the BC patients are positive for HER-2/neu expression while 15-20% of BC cases were reported to be HER-2/neu positive in UK . These studies without any doubt suggest that HER-2/neu positive status is seen in a higher percentage of patients in our population when compared to other parts of the world

TNBC accounts for approximately 12% to 17% of all invasive breast cancers in Western populations and its prevalence in India is 31% This is comparable to the prevalence seen in African American women and is more than twice the rate seen in white women in western developed countries. It is  found a higher prevalence of premenopausal breast cancer, grade 3 disease, and larger tumour size, all of which are associated with triple-negative disease. Because TNBC is known to be more aggressive than other breast cancer subtypes, higher prevalence of TNBC could be a contributing factor to the high fatality rate of patients with breast cancer in India.

In a nutshell, the subtype of breast cancer found in Indian subcontinent is relatively aggressive ( prevalence for ER-PR positive tumors are lower

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