Reported by Avik Chakraborty
Dibrugarh: A research paper on breast cancer treatment, types and challenges in Northeast India has been published in Discover Oncology, a cancer research journal published by Springer Nature.
The study was conducted by Gayatri Gogoi, Professor of Pathology at Assam Medical College, Dibrugarh, and Adjunct Faculty at ICMR – Regional Medical Research Centre, NE Region, along with her team.
The research reports biological variations and challenges of breast cancer among women in Assam, who differ in geography, ethnicity, diet and socio-economic-cultural factors compared to other regions of India.
Breast cancer is a heterogeneous disease with different pathological classifications, molecular profiles, treatment protocols and survival patterns.
In India, a woman is diagnosed with breast cancer every four minutes, and many cases are detected at an advanced stage compared to the United States.
Breast cancer management depends on staging factors such as age, co-morbidities, tumor size, lymph node status and tumor grade, according to the WHO pTNM system.
Treatment selection is based on the expression of Estrogen Receptor (ER), Progesterone Receptor (PR) and HER2/neu, which define four molecular subtypes: Luminal A, Luminal B, HER2-enriched and Triple-Negative Breast Cancer (TNBC). Luminal A has a 5-year survival rate of about 95%, while TNBC has limited targeted treatment options and a survival rate of around 50%.
Unlike Western populations where Luminal A is most common, studies from Northeast India show TNBC as the most common subtype, affecting nearly one in three patients.
Data from the Indian Council of Medical Research indicates that Northeast India has the youngest average age of breast cancer patients at 47 years, compared to 54 in India overall and 65 in the United States.
This younger age group is associated with the aggressive TNBC subtype, contributing to higher mortality rates.
The study titled “Association between molecular subtypes of breast cancer and surgical margin status from Assam, India” (https://link.springer.com/article/10.1007/s12672-026-05085-y) examined challenges in achieving tumor-free surgical margins. It found that HER2-enriched tumors had the highest rate of margin involvement.
It also reported that 57% of cases had tumor sizes between 2–5 cm, 38% exceeded 5 cm, and 77% showed lymph node involvement, indicating locally advanced disease.
Nearly 90% of patients underwent modified radical mastectomy, while only 10% received breast-conserving surgery.
The study noted that TNBC showed the lowest rate of positive surgical margins, which was unexpected.
The researchers suggested that different molecular subtypes may have varying physical properties that affect how surgeons distinguish tumor tissue from normal tissue during surgery.
The HER2-enriched subtype may have properties closer to normal tissue, making it more difficult to identify clear boundaries during surgery. A positive surgical margin is a major risk factor for recurrence and affects nearly one in three women.
The researchers stressed the importance of early detection, molecular testing and improved surgical planning to improve outcomes in Northeast India.
The research team is also developing a multimodal MEMS-based electrical sensor and a piezoelectric micromachined ultrasound transducer (pMUT) probe for real-time intraoperative margin assessment.
Gayatri Gogoi has conducted several research studies and contributed to international scientific work from Assam.
She has been honoured by medical research organisations, including ICMR, and holds a design patent for a breast self-examination model.