Rachel V Thomas

Health and Me

Breast Cancer: Are Women in India Being Diagnosed Too Late?

Female <span><a href="https://www.healthandme.com/health/breast-cancer">breast cancer</a></span> was the most commonly diagnosed cancer among women in <span>India</span> in 2024, with an estimated 237,231 new cases and 96,100 deaths, according to the International Agency for Research on Cancer (IARC).

Despite the importance of early detection, screening uptake remains low. Experts say India needs better access to screening and approaches tailored to age, breast density and individual risk. 

Dr. Sandeep Nayak, Chairman of Oncology at MACS-Renova Oncology Institute, KIMS Hospital, Bengaluru, told <strong><em>HealthandMe </em></strong>that population-wide screening remains a distant goal, with opportunistic screening still the norm.

“Because of this, applying blanket Western guidelines is ineffective. We need a pragmatic, age-stratified approach to imaging: utilizing breast ultrasound (USG) for women aged 35 to 45—where dense breast tissue severely limits <span>mammogram</span> sensitivity—and reserving routine mammography for women above 50, where tissue density decreases and diagnostic yield peaks,” he said.

<h2>Why Is Breast Cancer Still Diagnosed Late in India? </h2>

<strong>Also read: </strong><a href="https://www.healthandme.com/health-wellness/world-breast-cancer-day-2026-life-after-breast-cancer-the-fear-no-one-sees-article-156366572" data-type="tilCustomLink">World Breast Cancer Day 2026: Life After Breast Cancer, The Fear No One Sees</a>

“The alarming epidemiological paradox is that while our incidence is a third of Western nations, our death rate already surpasses theirs. The issue is not that this cancer has an aggressive biology in India; it is the timeline of discovery,” said Dr. Navin Gnanasekaran, Head of Clinical Services, Radiology and Interventional Radiology for the Apollo Group Chennai Region. 

Dr. Gnanasekaran said more than 60% of breast cancers in the United States are diagnosed while still localized, with five-year survival exceeding 90%. In India, many cases are detected after the cancer has spread beyond the breast, contributing to a five-year survival rate of 66.4%, he said. 

India introduced population-based screening for common noncommunicable diseases in 2016 under the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), launched in 2010. The program includes breast cancer screening among women aged 30 and above.

However, National Family Health Survey-5 (NFHS-5) data show that only 0.9% of women aged 30–49 had ever undergone a breast examination for cancer detection. Dr. Gnanasekaran placed the median age of breast cancer onset in India at around 45. 

<h2>Should Mammograms Start at 40—or Later? </h2>

<strong>Read More</strong>: <a href="https://www.healthandme.com/health-wellness/ozempic-like-weight-loss-drugs-may-cut-breast-cancer-risk-by-a-third-finds-research-article-154454016" data-type="tilCustomLink">Ozempic-Like Weight-Loss Drugs May Cut Breast Cancer Risk By A Third, Finds Research</a>

Experts differ when routine mammography should begin and whether breast density should influence imaging choices. 

Dr. Gnanasekaran recommended digital mammography every two years for women aged 40–60. He proposed linking screening reminders to Ayushman Bharat Health Account (ABHA) IDs, deploying mobile mammography units in rural areas and using validated artificial intelligence (AI) to help interpret scans. 

Dr. Nayak recommended ultrasound for women aged 35–45 and routine mammography for those above 50. 

Dense breast tissue can make some cancers harder to detect on mammograms. Women at high genetic risk, including those with BRCA mutations or a strong family history, may need earlier surveillance, potentially including contrast-enhanced breast MRI in their late 20s or early 30s, depending on individual risk. 

Dr. Gnanasekaran stressed that screening must be supported by accessible diagnostic and treatment services, including timely biopsies. 

<h2>Is Mammography Safe, and Can It Miss Cancer? </h2>

Mammography can miss some cancers, particularly in women with dense breasts. Ultrasound may be added for dense breasts or specific concerns, while MRI is generally used for women at higher risk or in selected situations. 

Dr. Garvit Chitkara, Associate Director of Breast Surgical Oncology and Oncoplasty at Nanavati Max Institute of Cancer Care, Mumbai, said the radiation risk from mammography is low, while false-positive results can lead to additional tests. 

“At the recommended intervals, mammography does not meaningfully raise your cancer risk. The more real downsides are occasional false alarms that lead to extra tests, which is a reason to have it done at a good centre and discuss any call-back with your doctor,” he told <strong><em>HealthandMe</em></strong>. 

A normal mammogram should not be used to dismiss a persistent lump or other breast symptoms. Women experiencing changes should seek medical evaluation even if their most recent screening result was normal.

Breast Cancer Symptoms, Screening & Treatment | Breast Cancer Awareness Month

<h2>Which Breast Changes Should You Never Ignore? </h2>

Many breast lumps are benign, including cysts and fibroadenomas, but touch alone cannot reliably distinguish a harmless lump from cancer. 

“Any new lump, or a lump that is changing in size or feel, should be examined by a doctor. A quick check usually settles it and gives you peace of mind,” Dr. Chitkara said. 

Persistent redness, itching or skin thickening, breast dimpling, puckering, an orange-peel texture, nipple retraction or unusual nipple discharge should also be evaluated. 

Early breast cancer is often painless. Women should not wait for pain before seeking medical attention.

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Female breast cancer was the most commonly diagnosed cancer among women in India in 2024, with an estimated 237,231 new cases and 96,100 deaths, according to the International Agency for Research on Cancer (IARC). Despite the importance of early detection, screening uptake remains low. Experts say India needs better access to screening and approaches tailored to age, breast density and individual risk. Dr. Sandeep Nayak, Chairman of Oncology at MACS-Renova Oncology Institute, KIMS Hospital, Bengaluru, told HealthandMe that population-wide screening remains a distant goal, with opportunistic screening still the norm. “Because of this, applying blanket Western guidelines is ineffective. We need a pragmatic, age-stratified approach to imaging: utilizing breast ultrasound (USG) for women aged 35 to 45—where dense breast tissue severely limits mammogram sensitivity—and reserving routine mammography for women above 50, where tissue density decreases and diagnostic yield peaks,” he said. Why Is Breast Cancer Still Diagnosed Late in India? Also read: World Breast Cancer Day 2026: Life After Breast Cancer, The Fear No One Sees“The alarming epidemiological paradox is that while our incidence is a third of Western nations, our death rate already surpasses theirs. The issue is not that this cancer has an aggressive biology in India; it is the timeline of discovery,” said Dr. Navin Gnanasekaran, Head of Clinical Services, Radiology and Interventional Radiology for the Apollo Group Chennai Region. Dr. Gnanasekaran said more than 60% of breast cancers in the United States are diagnosed while still localized, with five-year survival exceeding 90%. In India, many cases are detected after the cancer has spread beyond the breast, contributing to a five-year survival rate of 66.4%, he said. India introduced population-based screening for common noncommunicable diseases in 2016 under the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), launched in 2010. The program includes breast cancer screening among women aged 30 and above.However, National Family Health Survey-5 (NFHS-5) data show that only 0.9% of women aged 30–49 had ever undergone a breast examination for cancer detection. Dr. Gnanasekaran placed the median age of breast cancer onset in India at around 45. Should Mammograms Start at 40—or Later? Read More: Ozempic-Like Weight-Loss Drugs May Cut Breast Cancer Risk By A Third, Finds ResearchExperts differ when routine mammography should begin and whether breast density should influence imaging choices. Dr. Gnanasekaran recommended digital mammography every two years for women aged 40–60. He proposed linking screening reminders to Ayushman Bharat Health Account (ABHA) IDs, deploying mobile mammography units in rural areas and using validated artificial intelligence (AI) to help interpret scans. Dr. Nayak recommended ultrasound for women aged 35–45 and routine mammography for those above 50. Dense breast tissue can make some cancers harder to detect on mammograms. Women at high genetic risk, including those with BRCA mutations or a strong family history, may need earlier surveillance, potentially including contrast-enhanced breast MRI in their late 20s or early 30s, depending on individual risk. Dr. Gnanasekaran stressed that screening must be supported by accessible diagnostic and treatment services, including timely biopsies. Is Mammography Safe, and Can It Miss Cancer? Mammography can miss some cancers, particularly in women with dense breasts. Ultrasound may be added for dense breasts or specific concerns, while MRI is generally used for women at higher risk or in selected situations. Dr. Garvit Chitkara, Associate Director of Breast Surgical Oncology and Oncoplasty at Nanavati Max Institute of Cancer Care, Mumbai, said the radiation risk from mammography is low, while false-positive results can lead to additional tests. “At the recommended intervals, mammography does not meaningfully raise your cancer risk. The more real downsides are occasional false alarms that lead to extra tests, which is a reason to have it done at a good centre and discuss any call-back with your doctor,” he told HealthandMe. A normal mammogram should not be used to dismiss a persistent lump or other breast symptoms. Women experiencing changes should seek medical evaluation even if their most recent screening result was normal.   Which Breast Changes Should You Never Ignore? Many breast lumps are benign, including cysts and fibroadenomas, but touch alone cannot reliably distinguish a harmless lump from cancer. “Any new lump, or a lump that is changing in size or feel, should be examined by a doctor. A quick check usually settles it and gives you peace of mind,” Dr. Chitkara said. Persistent redness, itching or skin thickening, breast dimpling, puckering, an orange-peel texture, nipple retraction or unusual nipple discharge should also be evaluated. Early breast cancer is often painless. Women should not wait for pain before seeking medical attention.

breast cancer: are women in india being diagnosed too late?

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