BENGALURU: ?Our community has no awareness of any kind of screenings. Despite the fact that we use extra hormones and also under breast implant surgeries, even I have not gone to doctor for any cancer screenings,? says Chandani, who?s a transgender activist who is working for the cause of Transgenders.

Like Chandani thousands of transgenders refuse to get breast cancer screenings and experts worry that it is not only this community but even other women in general who still shy away from screenings and many are not even aware of ?routine follow up? of screenings like getting a mammogram done.

Dr Krithika Murugan, Consultant Surgical Oncologist, HCG Cancer Hospital says, many women on the routine follow up examinations, when advised for a sonomammogram the common response she gets from women is ?can?t I skip the mammogram, doctor? And go for an ultrasound instead,? this according to Krithika is more to do with howuncomfortable even the means to diagnosis is for women.

According to the data provided by Kidwai Cancer Hospital in Bengaluru, in Karnataka, it is estimated that annually over 9,800 new cases of breast cancers are diagnosed and 26,000 to 30,000 prevalent cases are there. 

?Over the years Bengaluru is showing second highest increase in the country only to next to incidence rates in CHennai Based on this data it is estimated that around 1688 new cases of breast cancers are diagnosed every year and prevalent cases in city alone are around 4558 cases,? added a release from Kidwai.

According to Dr Ramachandra, Director of Kidwai Cancer Institute, the most important apart from lack of awareness about breast cancer the problem is that there is no Organised Screening Programme for Breast cancer in the state or in India. 

There are only few camps which are held but mammography screening can be easily held at the district hospitals too which can ensure early diagnosis of cancer.

?We have to equip our district hospitals with oncology units to diagnose and manage the three major cancers: cervix, breast and oral cancers besides many other cancers,? he said.

However, Dr Krithika quoting the literature about uncomfortable means to diagnosis from the book by Alexandra D Lahav?s ?Medicine Is Made for Men? which says: In medical research, drug regulation, and product design, the male body is too often considered as the default, which can have dangerous, even fatal, consequences for women.

She highlights the fact that there is an inherent bias in medical device manufacturing, fixated on the male model. WHO talks about four core principles in medical device management: Availability, Accessibility, Appropriateness, and affordability.

?How appropriate are our medical devices for women? From the mammogram to the dreaded PAP smear, women simply have to bear the discomfort with a grin. In fact, some healthcare innovations smack of a serious gender bias. 

Despite the fact that women involvement in the healthcare industry is to the tune of 75%, the medical equipment manufacturing is largely designed by men for men.,? she explains.

Citing an example of an Operation Theatre scenario she says, In preparation for surgery, the supply room sends a surgical kit to the Operating room comprising key instruments, and surgical gowns. Now, since the gowns are not made to order in line with the body measurements of the team members, extra-large gowns are sent as the best workaround solution. The presumption that extra-large will suit everybody fine implies that members with slight frames will essentially be wearing a tent. 

In the operating room, this oversized clothing impacts the comfort and focus of the surgical team, affecting their work and motivation. Yet, these practices have been rarely addressed.

She calls for fresh investigations towards innovating the PET mammo and CT tomography procedures may be a step in the right direction.

Agreeing to this Rajamma Nagaveni from a remote village near Yadgir says, ?I find it embarrassing to go for any scans as I find the method not only painful but also weird as most technicians are men. I don?t like it.? she says.
 

Ranking and incidence rates for breast cancer

Survival statistics
India: 60% or less (only one in 2 indian women with breast cancer
survives the first five years of diagnosis)