Daijiworld Media Network - New Delhi
New Delhi, Oct 18: Breast cancer is often associated with older age, but in India, the disease is commonly diagnosed in women in their 40s and 50s, about a decade earlier than the average age group in several other parts of the world. Experts say the reasons are complex and cannot be attributed to a single biological or genetic factor.
Age, hormonal changes, heredity, reproductive history and environmental influences all contribute to breast cancer risk. Differences in age at first childbirth, number of pregnancies and duration of breastfeeding may historically have influenced variations in risk across populations.
Changing reproductive patterns, including delayed first pregnancies, fewer births and shorter breastfeeding periods among some groups, may also influence breast cancer risk in India.
Urbanisation has brought changes in diet, physical activity and body weight. Being overweight, particularly after menopause, and excessive alcohol consumption are established risk factors. However, these factors alone do not explain why breast cancer is diagnosed at younger ages among Indian women.
Genetic susceptibility is another important consideration. Inherited mutations in genes such as BRCA1 and BRCA2 can significantly increase the risk of developing breast cancer, including at a younger age. However, current evidence is insufficient to establish that a specific genetic background unique to the Indian population explains the difference in age at diagnosis. Further genomic research is needed.
The younger age profile of Indian patients does not necessarily mean that breast cancer is more common in India than in other countries. Western countries have reported higher age-standardised incidence rates, influenced by reproductive patterns, lifestyles and screening practices. Demographic differences and variations in access to screening and diagnosis may also contribute to the younger age at which Indian women are diagnosed.
Indian cancer centres have reported substantial proportions of hormone receptor-negative, HER2-positive and triple-negative breast cancers. Some of these subtypes can be more aggressive and may require intensive treatment. However, these findings should not be generalised to all Indian women, as tumour characteristics vary across populations and hospital-based studies may not represent the entire country.
Delayed diagnosis remains a major concern. Limited awareness, fear, social stigma, family responsibilities, financial constraints and delays in seeking medical care can allow tumours to grow or spread before treatment begins.
Younger women may also overlook a breast lump because they believe their age makes breast cancer unlikely. Health experts caution that this assumption can be dangerous.
Breast awareness should begin in early adulthood. Women should understand what is normal for their breasts and seek prompt medical evaluation if they notice changes such as a lump, nipple retraction, bloody nipple discharge or skin dimpling, regardless of their age.
For women without symptoms, the appropriate age and method of screening should be determined according to individual risk and medical guidance. Mammography is an established screening tool, while ultrasound may help evaluate breast abnormalities, particularly in women with dense breast tissue. Screening methods should be selected judiciously under medical supervision.
Women with a strong family history of breast cancer or known high-risk genetic mutations may require earlier screening and more intensive surveillance.
India needs a systematic, risk-based approach to early detection that combines public awareness, timely medical evaluation, appropriate screening and access to treatment.
Breast cancer is not confined to older women. Recognising symptoms early and seeking timely medical attention can improve the chances of effective treatment and save lives.