Daijiworld Media Network - New Delhi
New Delhi, Feb 21: Breast cancer cases among Indian women are increasing at an annual rate of 6%, according to a recent ICMR study. Experts point to lifestyle and metabolic changes — including poor sleep, chronic stress, and central obesity — as key contributors, particularly among younger women. Dr Shubham Garg, director of Surgical Oncology at Dharamshila Narayana Hospital, explains how these factors influence risk and what can be done to reduce it.
Sleep Disruption and Cancer Risk: Evidence linking poor sleep to breast cancer is growing. Data from the National Centre for Disease Informatics and Research in India aligns with global studies showing that disrupted circadian rhythms affect melatonin secretion, estrogen regulation, immune surveillance, and DNA repair. While not a standalone cause, chronic sleep deprivation amplifies risk, especially when combined with obesity, stress, sedentary habits, and urban lifestyles.
Modifiable vs Non-Modifiable Factors: Poor sleep is emerging as a significant modifiable risk factor, though age and family history remain the strongest predictors. Clinically, many women without a genetic predisposition develop breast cancer after prolonged sleep deprivation, night-shift work, or metabolic dysfunction, making it a crucial consideration in risk assessments.
Central Obesity: Fat accumulated around the waist carries a higher risk than overall body weight. Visceral fat produces inflammatory cytokines, drives insulin resistance, and increases estrogen, particularly after menopause when adipose tissue becomes the main source of the hormone. Waist circumference serves as a better marker of chronic inflammation and metabolic stress than BMI alone.
Lifestyle Interventions: While lifestyle changes cannot completely eliminate risk, they can substantially reduce it. Adequate sleep, stress management, and reducing central obesity help restore hormonal balance, lower inflammation, improve insulin sensitivity, and support immune function. These interventions also enhance outcomes and reduce recurrence in women already treated for breast cancer.
Impact of Chronic Stress: Persistent stress raises cortisol levels, suppresses immune defenses, promotes inflammation, disrupts estrogen metabolism, and alters glucose regulation — creating a biological environment conducive to tumor development.
Younger Onset in India: Breast cancer is increasingly diagnosed in women aged 35–50. Lifestyle-related factors such as sedentary habits, central obesity, poor sleep, delayed childbirth, reduced breastfeeding, and chronic stress accelerate risk, similar to trends seen in Western countries. Delayed diagnosis in India further highlights the need for early lifestyle interventions, risk-based screening, and community awareness programs.
Delayed Childbirth: While postponing pregnancy slightly increases lifetime estrogen exposure, risk is not inevitable. Healthy lifestyle practices, regular exercise, weight management, sleep hygiene, breastfeeding when possible, and appropriate screening can mitigate this risk.
Screening Recommendations: Women with multiple lifestyle risk factors — obesity, disrupted sleep, or chronic stress — may benefit from earlier, individualized screening. Late-30s clinical breast exams, ultrasound, or mammography can be considered for higher-risk individuals, emphasizing a risk-stratified approach rather than blanket early screening.
These insights underline the growing role of lifestyle and metabolic health in shaping breast cancer risk, calling for preventive measures that go beyond traditional screening to include sleep, stress, and weight management.