36-year-old actress Hina Khan recently revealed that she has stage 3 breast cancer, which is the most common type of cancer in India and around the world.

While the actress is undergoing treatment and sharing her progress reports regularly on social media, the question arises as to how breast cancer, which was once considered an old age disease, is becoming prevalent among young women.

More than a decade ago, the average age for a diagnosis of stage 3 breast cancer was about 50 to 64 years. But recently, the risk has increased significantly among people in their 20s and 30s.

Could it be that early detection of cancer would catch the disease before it reaches a critical stage? Maybe.

Technological innovations and improved access have given doctors tools to detect cancer early, and raised awareness about early diagnosis.

Although awareness can help experts detect the disease early, it is only one side of the coin.

There are several viewpoints as to why breast cancer is becoming more prevalent in young women.

Why is breast cancer so prevalent in India?

The five-year survival rate of women suffering from breast cancer in India is 66.4%, said a study by the Indian Council of Medical Research (ICMR), the country’s apex medical research body.

This rate represents the percentage of people who are still alive five years after diagnosis, not including people who die from other causes.

The study found that patients diagnosed early were 4.4 times more likely to survive five years than those diagnosed with advanced cancer.

Although there has been improvement, survival rates in India remain lower than those in developed countries such as the United States (90.2%). Delayed diagnosis and limited access to treatment facilities may contribute to this gap.

Since breast cancer contributes to 25% of all female cancers, the study highlights that Indian women lose more disability-adjusted life years (DALYs).

“It has been observed that Indian breast cancer is different from Western breast cancer. In the West, breast cancer cases peak in the early 50s, while in India, it peaks a decade earlier,” said Dr Rohan Khandelwal, MD and head of the Breast Centre at CK Birla Hospital, Gurugram.

According to Dr Pratik Varshney, Senior Director and Unit Head, Surgical Oncology, Fortis Hospital Shalimar Bagh, breast cancer has become a disease of the youth, and is being seen more in urban areas. However, this too is relative.

“This is because the type of cancer in India is more aggressive. The genetic makeup is more aggressive in most patients, not all. Also, there have been a lot of lifestyle changes in the last decade, which has led to an increase in the risk,” Dr Varshney said.

A study conducted by the Washington University School of Medicine found that women’s biological age, which reflects the state of a person’s body and physiological processes, is aging faster in the coming years.

The study revealed an association between accelerated aging and the risk of early-onset solid tumors.

In addition, screening efforts targeting younger people who show signs of accelerated biological aging may help detect cancer early.

What are the risk factors for breast cancer?

Doctors suggest that the rise in breast cancer cases in India is a multi-factorial problem. The factors can be modifiable and non-modifiable.

“Not having any children or having children at a later age is one of the other risk factors,” said Dr Pritam Kataria, consultant, medical oncology, Sir HN Reliance Foundation Hospital.

Early menarche and late menopause are non-modifiable risk factors.

The expert said that controlling diet, exercising, reducing stress, and avoiding smoking and alcohol (which are lifestyle factors) can reduce the incidence of breast cancer.

Dr Khandelwal said, “Breast cancer is a combination of many things. There are some things that we cannot assess. We cannot assess pollution, stress and their role in the development of breast cancer.”

Changes such as lack of breastfeeding, not having children, obesity, smoking and alcohol cause breast cancer.

Lack of exclusive breastfeeding is associated with an increased risk of breast cancer due to decreased hormonal protection, fewer beneficial changes in breast tissue, and less shedding of potentially harmful cells.

A meta-analysis published in The Lancet found that every 12 months of breastfeeding reduced the risk of breast cancer by 4.3%.

Although breastfeeding lowers levels of some hormones in the mother’s body, such as estrogen, as the duration and frequency of breastfeeding decreases, protective hormonal changes do not occur widely.

Diagnosis of Breast Cancer in India

As breast cancer cases are on the rise among Indian women, its diagnosis and treatment have also seen major progress over the last few decades.

Dr. Varshney said, “Indian women are becoming more aware of the symptoms of this cancer, which leads to early detection of it. Screening mammography and ultrasound are more readily available these days, making it easier to diagnose it even in women who do not have obvious symptoms of a breast lump.”

In addition, treatment protocols have evolved significantly, leading to better cosmetic outcomes in breast conservation.

“This has created a sense of trust among our general public, resulting in greater acceptance of this treatment,” the expert said.

Hence, doctors are suggesting genetic testing, self-examination, mammography, and simple ultrasound to help women diagnose the disease early and get timely treatment.

Although advances in technology and increased awareness have led to improved outcomes for early diagnosis and treatment, challenges still remain.

By promoting a comprehensive approach, we can work toward reducing the burden of breast cancer and improving survival rates for all women.