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Breast Cancer Awareness Month: Advancing A Risk-Informed and Equitable Approach to Breast Cancer Screening in India

In <span>India</span>, <span><a href="https://www.healthandme.com/health/breast-cancer">breast cancer</a></span> is the most diagnosed cancer among women and the leading cause of cancer-related deaths in women. According to the International Agency for Research on Cancer’s GLOBOCAN 2024 estimates, the country recorded approximately 237,231 new cases and 96,100 deaths. Across both sexes, it is the second leading cause of cancer death.

The median age of diagnosis among Indian women is 51, nearly a decade younger than in most developed countries. One hospital-based study estimates that 25% of cases occur in women under 40, underscoring the importance of breast awareness, timely symptom evaluation, clinical examination and individual risk assessment. The <span>Breast Imaging Society of India</span> recommends mammography screening from age 40, considering individual risk and available resources.

<a href="https://www.healthandme.com/health/breast-cancer" data-type="tilCustomLink">Breast cancer</a> risk does not suddenly begin at a particular birthday, and two women of the same age may have very different risk profiles. Women should be encouraged to become familiar with the usual appearance and feel of their breasts and to seek prompt clinical evaluation for unexplained breast changes. In India, where breast cancer often presents at a comparatively younger age and access to high-quality imaging is uneven, discussions about early detection should extend beyond age alone. Family history, inherited susceptibility, previous breast findings and other recognized risk factors can help determine whether a woman may benefit from earlier assessment, specialist referral or additional imaging.

A risk-informed approach should consider several factors:

<ul><li>Family history: Breast or <a href="https://www.healthandme.com/health-news/contraceptive-coil-saved-my-life-womans-persistent-abdominal-pain-led-her-to-ovarian-cancer-diagnosis-article-156346853" data-type="tilCustomLink">ovarian cancer</a> in close relatives, particularly diagnoses at younger ages, cancer affecting both breasts, male breast cancer, or multiple affected relatives may indicate inherited susceptibility. This may warrant earlier risk assessment before age 40.</li></ul><ul><li>Genetic factors: Women with BRCA1 or BRCA2 gene variants may also require earlier than average-risk screening, starting as early as age 25.</li></ul><ul><li>Breast density: Dense breast tissue can lower the sensitivity of mammography and is independently associated with breast cancer risk. Supplemental imaging such as MRI may be considered in selected women, based on the overall risk, the quality of available imaging and the potential for false-positive results and unnecessary biopsies.</li></ul><ul><li>Previous breast findings: A previous high-risk breast lesion, atypical biopsy result or suspicious imaging finding may change the recommended screening frequency or method. Women with such findings should follow an individualized plan developed with their physician.</li></ul>

Also read: <a href="https://www.healthandme.com/health-wellness/breast-cancer-are-women-in-india-being-diagnosed-too-late-article-156369203" data-type="tilCustomLink">Breast Cancer: Are Women in India Being Diagnosed Too Late?</a>

<h2>Persistent inequalities in access</h2>

Access to breast assessment, imaging and specialist interpretation remains highly unequal across India. The lifetime prevalence of breast cancer examination is only 8.8 per 1,000 women, with uptake varying by education, economic status and geography. High uptake among educated, affluent, and urban women, especially in southern India, highlights how social determinants and health system barriers shape access to <span><a href="https://www.healthandme.com/health/breast-cancer">breast cancer</a> screening</span>. India also faces shortages and maldistribution of imaging specialists, with approximately one radiologist per 100,000 people, compared with one per 10,000 in the US. Specialists are disproportionately concentrated in urban areas.

Addressing these inequalities requires more than awareness campaigns. Priorities include strengthening clinical breast examination and referral pathways, training frontline health workers, expanding access to diagnostic imaging and pathology, ensuring timely follow-up after abnormal findings, and monitoring outcomes across socioeconomic and geographic groups.

Also read: <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>

<h2>Where artificial intelligence could support early detection</h2>

Artificial intelligence (AI) is being evaluated as a potential support for breast cancer detection in settings where imaging capacity and specialist availability are limited. Depending on the technology and clinical context, AI may assist with triage, image interpretation, workflow prioritization or risk estimation. Its clinical value depends on appropriate validation, reliable referral pathways, diagnostic confirmation, quality assurance and ongoing monitoring for unequal performance across population groups.

Integrating community health workers, portable AI technology and digital referral pathways within primary health care could potentially help reach women who face geographic, financial or health-system barriers. The most important feature is not the algorithm alone, but the complete pathway linking awareness, initial assessment, referral, diagnostic confirmation and treatment. AI output is not a diagnosis. It must be interpreted alongside the patient’s clinical history, risk factors, examination findings and appropriate diagnostic imaging.

<h2>Translating personal risk into informed screening decisions</h2>

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

For women, a more personalized approach does not mean performing more tests in every case. It means identifying those who may benefit from earlier, more frequent or different forms of assessment while avoiding unnecessary imaging and procedures among women unlikely to benefit. 

As part of a shared decision-making conversation, women may wish to ask their physician:

<ul><li>Based on my age and personal risk factors, when should breast cancer screening begin?</li><li>Does my family history suggest that I need a formal risk assessment?</li><li>Would referral for genetic counselling be appropriate for me?</li><li>If I have dense breasts, how does that affect the interpretation of my mammogram and my overall risk?</li><li>Do previous breast symptoms, imaging findings or biopsy results change my follow-up plan?</li><li>Which screening or diagnostic services are available locally, and what follow-up will be provided if an abnormality is found?</li><li>Would a formal breast cancer risk-assessment help guide my screening plan?</li></ul>

<span>Breast Cancer Awareness Month</span> is an opportunity to advocate for equitable care pathways, from risk assessment and early detection to diagnosis and timely treatment. In India, a key challenge is ensuring every woman with a concerning symptom or abnormal finding receives appropriate assessment, diagnostic confirmation and treatment without avoidable delays.

Preparing future physicians for evolving healthcare needs is central to medical and public health education at St. George’s University School of Medicine. Through a diverse, international learning environment and clinical exposure, students develop the medical knowledge, clinical skills and professional competencies needed to care for diverse patient populations.

<strong><em>By Dr. Tonia Frame, Assistant Professor and Director of the Global Health Unit in the Department of Public Health and Preventive Medicine at </em></strong><strong><em>St. George’s University</em></strong>

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In India, breast cancer is the most diagnosed cancer among women and the leading cause of cancer-related deaths in women. According to the International Agency for Research on Cancer’s GLOBOCAN 2024 estimates, the country recorded approximately 237,231 new cases and 96,100 deaths. Across both sexes, it is the second leading cause of cancer death.The median age of diagnosis among Indian women is 51, nearly a decade younger than in most developed countries. One hospital-based study estimates that 25% of cases occur in women under 40, underscoring the importance of breast awareness, timely symptom evaluation, clinical examination and individual risk assessment. The Breast Imaging Society of India recommends mammography screening from age 40, considering individual risk and available resources.Breast cancer risk does not suddenly begin at a particular birthday, and two women of the same age may have very different risk profiles. Women should be encouraged to become familiar with the usual appearance and feel of their breasts and to seek prompt clinical evaluation for unexplained breast changes. In India, where breast cancer often presents at a comparatively younger age and access to high-quality imaging is uneven, discussions about early detection should extend beyond age alone. Family history, inherited susceptibility, previous breast findings and other recognized risk factors can help determine whether a woman may benefit from earlier assessment, specialist referral or additional imaging.Why individual risk mattersA risk-informed approach should consider several factors:Family history: Breast or ovarian cancer in close relatives, particularly diagnoses at younger ages, cancer affecting both breasts, male breast cancer, or multiple affected relatives may indicate inherited susceptibility. This may warrant earlier risk assessment before age 40.Genetic factors: Women with BRCA1 or BRCA2 gene variants may also require earlier than average-risk screening, starting as early as age 25.Breast density: Dense breast tissue can lower the sensitivity of mammography and is independently associated with breast cancer risk. Supplemental imaging such as MRI may be considered in selected women, based on the overall risk, the quality of available imaging and the potential for false-positive results and unnecessary biopsies.Previous breast findings: A previous high-risk breast lesion, atypical biopsy result or suspicious imaging finding may change the recommended screening frequency or method. Women with such findings should follow an individualized plan developed with their physician.Also read: Breast Cancer: Are Women in India Being Diagnosed Too Late?Persistent inequalities in accessAccess to breast assessment, imaging and specialist interpretation remains highly unequal across India. The lifetime prevalence of breast cancer examination is only 8.8 per 1,000 women, with uptake varying by education, economic status and geography. High uptake among educated, affluent, and urban women, especially in southern India, highlights how social determinants and health system barriers shape access to breast cancer screening. India also faces shortages and maldistribution of imaging specialists, with approximately one radiologist per 100,000 people, compared with one per 10,000 in the US. Specialists are disproportionately concentrated in urban areas.Addressing these inequalities requires more than awareness campaigns. Priorities include strengthening clinical breast examination and referral pathways, training frontline health workers, expanding access to diagnostic imaging and pathology, ensuring timely follow-up after abnormal findings, and monitoring outcomes across socioeconomic and geographic groups.Also read: World Breast Cancer Day 2026: Life After Breast Cancer, The Fear No One SeesWhere artificial intelligence could support early detectionArtificial intelligence (AI) is being evaluated as a potential support for breast cancer detection in settings where imaging capacity and specialist availability are limited. Depending on the technology and clinical context, AI may assist with triage, image interpretation, workflow prioritization or risk estimation. Its clinical value depends on appropriate validation, reliable referral pathways, diagnostic confirmation, quality assurance and ongoing monitoring for unequal performance across population groups.Integrating community health workers, portable AI technology and digital referral pathways within primary health care could potentially help reach women who face geographic, financial or health-system barriers. The most important feature is not the algorithm alone, but the complete pathway linking awareness, initial assessment, referral, diagnostic confirmation and treatment. AI output is not a diagnosis. It must be interpreted alongside the patient’s clinical history, risk factors, examination findings and appropriate diagnostic imaging.Translating personal risk into informed screening decisions   For women, a more personalized approach does not mean performing more tests in every case. It means identifying those who may benefit from earlier, more frequent or different forms of assessment while avoiding unnecessary imaging and procedures among women unlikely to benefit. As part of a shared decision-making conversation, women may wish to ask their physician:Based on my age and personal risk factors, when should breast cancer screening begin?Does my family history suggest that I need a formal risk assessment?Would referral for genetic counselling be appropriate for me?If I have dense breasts, how does that affect the interpretation of my mammogram and my overall risk?Do previous breast symptoms, imaging findings or biopsy results change my follow-up plan?Which screening or diagnostic services are available locally, and what follow-up will be provided if an abnormality is found?Would a formal breast cancer risk-assessment help guide my screening plan?Breast Cancer Awareness Month is an opportunity to advocate for equitable care pathways, from risk assessment and early detection to diagnosis and timely treatment. In India, a key challenge is ensuring every woman with a concerning symptom or abnormal finding receives appropriate assessment, diagnostic confirmation and treatment without avoidable delays.Preparing future physicians for evolving healthcare needs is central to medical and public health education at St. George’s University School of Medicine. Through a diverse, international learning environment and clinical exposure, students develop the medical knowledge, clinical skills and professional competencies needed to care for diverse patient populations.By Dr. Tonia Frame, Assistant Professor and Director of the Global Health Unit in the Department of Public Health and Preventive Medicine at St. George’s University

breast cancer awareness month: advancing a risk-informed and equitable approach to breast cancer screening in india

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