Breast Cancer: A Growing Concern Among Young Women

Breast cancer, once considered a disease of the elderly, is now increasingly affecting young women in India. The recent diagnosis of actress Hina Khan, 36, with Stage 3 breast cancer has raised concerns about the rising incidence of the disease among women in their 20s and 30s.

In the past, the average age for diagnosing Stage 3 breast cancer was around 50-64 years. However, recent studies have shown that people in their 20s and 30s are now more prone to it. This sudden shift has led to questions about the factors contributing to this trend.

One possible reason is the improvement in early cancer diagnosis. Advances in technology and better accessibility have enabled doctors to detect cancer quickly, and spreading awareness about early diagnosis has also played a crucial role. However, there are other factors at play.

The Indian Council of Medical Research (ICMR) has conducted a study that reveals a five-year survival rate of 66.4% for women diagnosed with breast cancer in India. This rate indicates the percentage of people who are alive five years after diagnosis, excluding those who pass away from other causes. The study found that patients diagnosed early had a 4.4 times better chance of living for five years compared to those diagnosed with advanced cancer.

The survival rate in India is lower than in developed countries like the United States (90.2%). Delayed diagnosis and limited access to treatment facilities may contribute to this difference. Breast cancer constitutes 25% of all female cancers, and the study highlighted that Indian women lose more disability-adjusted life years (DALYs).

Dr. Rohan Khandelwal, lead consultant and head of the Breast Centre at CK Birla Hospital, Gurugram, observed that Indian breast cancer is different from Western breast cancer. In the West, the peak age at which breast cancer occurs is in the early 50s, whereas in India, the peak occurs a decade earlier. Dr. Prateek Varshney, Senior Director and Unit Head, Surgical Oncology, Fortis Hospital Shalimar Bagh, added that breast cancer has become the disease of the young, witnessed more in urban cities. However, even that is relative.

The reason for this is the type of cancer which we get in India is more aggressive. The genetic build-up is more aggressive in most patients, not everyone. Also, in the last decade, there have been a lot of lifestyle changes which have led to increased rise in the risks.

A study by the Washington University School of Medicine found that the biological age of women, which refers to the condition of a person’s body and physiological processes, is ageing faster in the coming years. Breast cancer has become the disease of the young, witnessed more in urban cities.

Doctors suggest that the rise in breast cancer in India is a multi-factorial problem. The factors can be modifiable and non-modifiable. Having no children or having children at a later age is one of the other risk factors. Early menarche and late menopause are among the non-modifiable risk factors.

The expert said that managing diet, exercising, reducing stress, and avoiding smoking and alcohol, which are lifestyle-related factors, can lower the incidence of breast cancer. “Breast cancer is a combination of multiple things. There are certain things we cannot quantify. We cannot quantify pollution, stress, and do they have a role in breast cancer development,” explained Dr. Khandelwal.

Changes like reduced breastfeeding, not having children, obesity, smoking, and alcohol have a contribution in causing breast cancer. Reduced breastfeeding, in particular, is linked to an increased risk of breast cancer due to less hormonal protection, fewer beneficial changes in breast tissue, and reduced shedding of potentially damaged cells.

A meta-analysis published in The Lancet found that for every 12 months of breastfeeding, the risk of breast cancer decreased by 4.3%. While breastfeeding lowers the levels of certain hormones in the mother’s body, such as estrogen, by reducing the duration and frequency of breastfeeding, the protective hormonal changes do not occur as extensively.

As the incidence of breast cancer is increasing in Indian women, the advances in its diagnosis and treatment have also taken a giant leap in the last few decades. Indian women are becoming more aware of the symptoms of this cancer leading to early self-detection. Screening mammography and ultrasound are more easily available nowadays making the diagnosis easy even in women without obvious symptoms of a lump in the breast.

Moreover, the treatment protocols have developed a lot leading to better cosmesis outcomes in terms of breast conservation. This has led to a sense of confidence among our general population leading to more acceptance for the treatment.

Doctors are suggesting genetic testing, self-examination, mammography, and a simple ultrasound as tools to help women diagnose the disease quickly and undergo timely treatment. While advancements in technology and increased awareness have improved early diagnosis and treatment outcomes, challenges remain.

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

Historical Context:

Breast cancer has been a significant health concern for women worldwide for decades. In the past, it was often associated with older women, but in recent years, there has been a growing trend of younger women being diagnosed with the disease. This shift has led to increased awareness and research into the causes and risk factors of breast cancer.

In the 1970s and 1980s, breast cancer was often referred to as a “silent killer” because it was often diagnosed at a late stage, making treatment more challenging. However, advances in medical technology and screening methods have improved early detection and treatment outcomes.

In the 1990s, the American Cancer Society launched the “Early Detection and Treatment” campaign, which emphasized the importance of regular mammograms and self-examination. This campaign helped increase awareness and reduce the number of deaths from breast cancer.

In the 2000s, genetic testing became more widely available, allowing women to identify their risk of developing breast cancer due to genetic mutations. This led to increased awareness and screening among high-risk women.

In recent years, there has been a growing focus on the importance of lifestyle factors, such as diet, exercise, and stress management, in reducing the risk of breast cancer.

Summary in Bullet Points:

• Breast cancer is increasingly affecting young women in India, with a recent diagnosis of actress Hina Khan, 36, with Stage 3 breast cancer. • The average age for diagnosing Stage 3 breast cancer has decreased from 50-64 years to 20-30 years. • Factors contributing to this trend include improved early cancer diagnosis, lifestyle changes, and genetic factors. • Indian women have a lower five-year survival rate (66.4%) compared to developed countries like the United States (90.2%). • Breast cancer is more aggressive in India, with a higher incidence of advanced cancer. • Lifestyle changes, such as reduced breastfeeding, obesity, smoking, and alcohol consumption, contribute to the rise in breast cancer. • Modifiable risk factors include managing diet, exercising, reducing stress, and avoiding smoking and alcohol. • Non-modifiable risk factors include early menarche and late menopause. • Advances in diagnosis and treatment have improved early detection and treatment outcomes. • Genetic testing, self-examination, mammography, and ultrasound are recommended tools for early detection and timely treatment. • A comprehensive approach is needed to reduce the burden of breast cancer and improve survival rates for all women.