The Indian scene.

Breast cancer is the second most common cancer among women in India, after cancer of the cervix uteri. Presently, 75,000 new cases occur in Indian women every year. This figure must be viewed against the backdrop that the national cancer registry and the hospital-based tumor registries hardly sample 3% of the total population. Locally advanced breast cancer constitutes more than 50% to 70% of patients presenting for treatment. The management of the patients varies according to the hospital the patient seeks treatment from. In this vast country, hospitals vary from peripheral hospitals with basic facilities to the specialized institutions in the metropolitan centers with all specialists, medical oncologists, radiation oncologists, surgical oncologists, and supporting facilities. In the peripheral hospitals, the treatment is invariably a radical mastectomy with or without radiotherapy. In the metropolitan areas and in specialized cancer institutions, management mirrors international recommendations with brachiocephalic trunk or modified radical mastectomy, radiation therapy, and chemotherapy.