25 per cent of breast cancer incidence observed in women under 40 years in India: Apollo

The findings are based on data from Apollo health screenings over the past five years, between 2018 and 2023

Apollo’s data shows that breast cancer incidence is getting younger. Analysing close to 150,000 screenings over the past five years, Apollo finds that over 25 per cent of breast cancer diagnosis were in women less than 40 years of age. In addition to this, the data also showed that the median age of breast cancer incidence among Indian women is almost ten years earlier than western countries like the USA and UK. This highlights a critical need for increasing awareness and early intervention through screening and diagnosis among Indian women.

Key findings from screenings at Apollo:

• Earlier onset of breast cancer: A striking 25 per cent of breast cancer cases among Indian women occurred at the age of 39 years or less. The recorded minimum age at the time of breast cancer diagnosis is 23 years.
• Consistent average age: Apollo’s data consistently indicated breast cancer diagnosis among Indian women is at an average age of 53 years, notably lower than the median age of 62 years in western countries like the USA and UK.
  • Median Age (2018-2023): 53 years
  • Median Age (2018-2021): 53 years
  • Median Age (Jan 2022 – Aug 2023): 52 years
• Significant positive predictive value: A notable 23 per cent screened with Mammography were found to have some abnormality and underwent further evaluation with histopathology. 11.2 per cent of these were diagnosed with breast cancer.

Commenting on this, Dr Sathya Sriram, CEO, Preventive Health, Apollo, said, “Global guidelines have advocated for initiating regular breast cancer screening at the age of 40 years. However, the evolving landscape and these findings necessitates a re-evaluation of these guidelines, especially for Indian women. The misconception that cancer is an improbable cause of health issues in younger age groups often results in delayed diagnoses, potentially leading to missed opportunities for early intervention, better outcomes and survival rates. I urge women across the nation to prioritize timely screenings and also encourage physicians to personalise their recommendation to patients, especially if they have a family history of cancer.”

Dr Manjula Rao, Breast Cancer Specialist and Oncoplastic Surgeon, Apollo Proton Cancer Centre (APCC), stated, “More than sixty percent of breast cancer patients in India present in more advanced stages, with increased breast cancer-related mortality when compared to the West, which reports lower mortality rate, despite higher incidence of the disease. This highlights the relevance of public awareness and breast cancer screening, which helps in early detection. I would like to emphasise that early detection is paramount in the fight against breast cancer, and we at APCC have achieved a great level of success in treating breast cancer diagnosed in the early stages. We have accomplished breast conservation rates ~60 per cent, and are able to de-escalate therapy as per global evidence-based guidelines, hence offering our patients superior quality of life outcomes.”

By prioritising routine check-ups and adopting a vigilant stance toward breast health, women can be empowered to take charge of their well-being. A few measures Apollo recommends include:

1. Breast self-exams every month starting at age 20 to familiarize yourself with any changes that may occur over time, including lumps, skin changes, or discharge.
2. Starting at age 30, women should have an annual clinical breast exam by a doctor or a trained healthcare professional. For those under 40, a combination of tests, including a clinical exam and ultrasound, is recommended. Yearly visits to the doctor for a tailored breast health screening plan are advisable, which may also include a mammogram and MRI based on individual risk factors.
3. Annual mammogram starting from the age of 40.
4. Over and above, a balanced diet rich in fruits and vegetables, 150 minutes of moderate exercise per week, minimal alcohol consumption, and no tobacco consumption can play a preventive role.
5. Lastly, family history can be a significant indicator of breast cancer risk. By age 25, or earlier if cancer is prevalent in your family, a full understanding of family health history should be compiled. Genetic testing is an invaluable tool for individuals with a family history of breast or ovarian cancer. Consider undergoing genetic tests like BRCA1/BRCA2 testing as early as age 25 if you fall into this high-risk category.