Who is at the highest risk of breast cancer? Here’s why you need to get yourself screened at 40

When should you be screened for cancer?

Like many other lifestyle diseases, hormone-related cancers, such as those of the breast, can affect Indians a decade earlier than their Western counterparts. So one can begin screening at 40. But unlike the periodicity in the US, they should get mammography, an X-ray imaging method to examine the breast, done once every year. This is because two years are too long a window and many patients tend to ignore a follow-up. Many might never come back — repeated testing is the only way to detect the cancer early.

Government guidelines recommend screening at 30 but only with clinical breast examination. However, there is no evidence to show that this ensures survival benefits. The guidelines are, however, meant for a larger population. Those who can afford it — and those who reach tertiary care centres such as AIIMS and PGI, Chandigarh — should undergo mammography.

Who is at the highest risk of developing breast cancer?

Anything that increases exposure to the female hormone oestrogen is a risk factor. So obesity, early age of menarche and late age of menopause are risk factors. Now, we see girls starting menstruation at the age of 10 or 11 years, down from the previous 14 or 15 years. Menopause happens between the ages of 50 and 52 now on an average, which used to be at 45 or so earlier. Women who have never birthed babies or breast-fed have a higher risk of breast cancer because oestrogen levels go down during pregnancy and lactation. Multiple pregnancies have a protective effect while late age of pregnancy is a risk factor. Hormone replacement therapy is another risk factor. Be cautious if you have a family history.

How does regular screening for breast cancer help?

Regular screening has been shown to reduce deaths by 30 to 35 per cent. Early treatment improves the odds of survival. Data from the population based registry in India shows that most breast cancer patients — more than half — get diagnosed in stage III. Only 30 per cent cases are diagnosed in stage I and II.

Why is screening more essential now?

The number of breast cancer cases has increased from 1.5 lakh in 2016 to 2 lakh in 2022, probably triggered by exposure to air pollutants though studies are still inconclusive. There has been an increase in triple negative cancers, accounting for nearly 40 per cent of cases. These don’t have any of the three receptors found in other breast cancers. So doctors have fewer treatment options. This type affects young women and are more aggressive.