Breast Cancer in India: Challenges in Early Detection and the Need for Better Awareness

KKN Gurugram Desk | Breast cancer remains a significant public health challenge in India, with nearly 200,000 new cases diagnosed annually, according to the WHO’s Global Cancer Report 2022. The disease accounts for 14% of all cancer cases in the country. While India’s breast cancer incidence rate (37 cases per 100,000 population) is lower than in high-income nations (90–100 cases per 100,000 population), the mortality rate is much higher due to late-stage diagnosis.

Why Breast Cancer Mortality is High in India

A major factor contributing to high breast cancer deaths in India is delayed detection. Nearly 60% of cases are diagnosed at stage 3 or 4, significantly affecting treatment outcomes and survival rates. Some of the primary risk factors associated with breast cancer include:

• Lifestyle changes
• Obesity
• Smoking and alcohol consumption
• Delayed childbirth

Despite rising awareness, early detection remains a major challenge, especially in rural and low-resource settings where access to proper screening is limited.

Early Detection: A Low-Cost Solution That Needs More Awareness

One of the simplest and most cost-effective ways to detect breast cancer at an early stage is through a Clinical Breast Examination (CBE) performed by trained healthcare workers like nurses. CBE does not require any equipment and can be widely implemented even in resource-limited settings.

However, less than 2% of Indian women undergo breast cancer screening, according to the National Family Health Survey (NFHS).

Barriers to Breast Cancer Screening in India

Dr. Anita Gadgil, Senior Research Fellow at The George Institute for Global Health, India, identifies social stigma as a major barrier to early detection. She notes that:

• Many healthcare workers feel uncomfortable discussing breast health, even though they regularly screen for hypertension and diabetes.
• Women often lack trust in Primary Health Centers (PHCs), assuming they will have to visit larger hospitals anyway.
• Fear of cancer diagnosis causes many women to ignore or hide lumps, leading to delayed diagnosis and treatment.

Role of Lifestyle Modifications in Breast Cancer Prevention

Preventive measures, particularly lifestyle modifications, play a crucial role in reducing breast cancer risk.

• Integrating traditional health practices, like yoga, with modern medical interventions can help promote healthier lifestyles.
• This approach is particularly beneficial in rural areas, where access to tertiary cancer care centers is limited.

Improving Access to Treatment in District Hospitals

Surgical treatment for breast cancer, such as mastectomy, can be performed effectively at district hospitals if surgeons receive proper training. Currently, these surgeries are mainly conducted at tertiary centers, while peripheral hospitals lack standardized guidelines and perform procedures inconsistently.

Training district-level surgeons would:

• Reduce the burden on large cancer centers
• Ensure better treatment access across different regions
• Improve uniform treatment outcomes nationwide

Technology and AI: The Future of Breast Cancer Detection

Dr. Gadgil highlights the potential of technology-driven solutions to bridge the gap in healthcare accessibility. She suggests integrating:

• Artificial Intelligence (AI) for screening
• Mobile apps to spread awareness
• Telemedicine for remote diagnosis and consultations

Unfortunately, very few research programs in India are focusing on solution-driven approaches using technology. Most studies have been limited to identifying the problem, while innovative interventions remain restricted to high-tech labs or behavioral change initiatives.

Combining Strategies to Reduce Breast Cancer Mortality

To reduce breast cancer deaths and improve survival rates, India needs a multi-pronged approach, including:

• Early detection strategies like CBE and AI-based screening
• Better training for healthcare workers to handle breast cancer diagnosis and treatment
• Improved accessibility to low-cost interventions in rural areas
• More awareness programs to eliminate social stigma

By adopting these measures, India can enhance survival rates, reduce breast cancer-related mortality, and ensure better healthcare access for women nationwide.