Breast cancer has become the commonest cancer among women in urban India. It is now the leading cause of cancer death in women aged 35-55 years and the second biggest cause of death in women of all ages.

The figures are startling. According to the International Agency for Research on Cancer, a World Health Organisation (WHO) unit, about one lakh new breast cancer cases are reported every year in India.

The WHO is of the view that cancer rates could increase by 50 per cent to 15 million new cases in 14 years. According to WHO statistics, breast cancer occurs at a younger age in India and the cancer mortality rate is among the highest.

Delhi leads the breast cancer incidence chart followed by Mumbai, Chennai, Bangalore, Hyderabad and Kolkata.

The incidence of breast cancer in India is increasing fast enough to be on par with developed countries because of lifestyle changes including early menarche, lack of exercise and fatty diet.

As October, the national breast cancer awareness month, draws to a close, oncologists and health experts suggest "targeted therapy" to treat breast cancer. This therapy targets a specific molecular target and is efficient in more ways than one.

"The treatment is targeted at the biological processes that drive the cancer. Only cancer cells are targeted and the normal cells are spared," says senior medical oncologist Dr S.V.S.N. Prasad. In chemotherapy or radiotherapy adjoining normal tissue is also affected.

Side-effects such as hair loss, fatigue, or a decline in certain blood counts are minimal with targeted therapy. Dr Prasad suggests that for more effective results targeted therapy can be combined with chemotherapy.

Targeted therapy is being used increasingly particularly to fight HER2 or human epidermal growth factor receptor 2. HER2 is a gene that helps control the growth, division and repair of cells. It directs the production of special proteins called HER2 receptors.

Each healthy breast cell contains two copies of the HER2 gene. Sometimes a cell has many copies of HER2, which may lead to the production of too much of HER2 protein. This may play an important role in turning a normal cell into a cancer cell.

Dr Vijay Anand Reddy, radiation oncologist at Apollo Cancer Hospital, relates the increase in breast cancer rates to fast-changing lifestyles particularly. "Targeted therapies have emerged as the latest option. The therapy terminates the cancerous cells without affecting the quality of life of the patient," says Dr Reddy.

Doctors observe that the best protection against cancer is awareness. Timely detection helps towards early treatment. The World Cancer Report states that action on smoking, diet and infections can prevent one third of cancers while another one third can be cured.

Dr J. Bandana, consultant gynaecologist, says, "Lifestyle changes, smoking, usage of oral contraceptives, hormone replacement therapy, postponement of childbirth, obesity increase the risk of breast cancer."

Dr Bandana suggests regular self breast examination; women over 40 should undergo mammography once a year. Women with a history of first-degree relatives (mother, sister) suffering from breast cancer should be more cautious.