Why Breast Cancer Isn’t Just An ‘Older Woman’s’ Issue Anymore: Doctor Explains

Though generally thought of as a disease in post-50-year-old female patients, recent research and clinical experiences are defying this myth. Breast cancer demonstrates that there is a growing menace for younger women, with diagnoses in under-50-year-old individuals increasing during the last two decades, with a steep rise in cases over the last few years, especially in India. In India, the average age of breast cancer diagnosis is around 47 years, with the peak incidence occurring between 45 and 50 years. In contrast, the average age in Western countries is around 60. This means that Indian women are developing breast cancer nearly a decade and a half earlier than women in Western populations.

This trend increases awareness and attention to the early signs and symptoms that need urgent notice in younger populations who tend to get diagnosed in later stages due to guideline-based screenings starting at age 40. The reasons for this are complex, including advanced detection techniques and changes in life and hormonal aspects, with genetic predispositions being possibly responsible. Ethnically, the Indian population differs significantly from the Western (Caucasian) population, which partly explains the variation in disease patterns. In conversation with The Daily Jagran, Dr. Mandeep Singh Malhotra, Director of Surgical Oncology at the CK Birla Hospital, Delhi, shares on Breast Cancer Awareness Month that tailored interventions, earlier screenings for women at high risk and stronger support systems for younger patients can reduce the occurrence of breast cancer in younger women.

Changing Lifestyle And Reproductive Patterns

Several socio-cultural changes over the past few decades have contributed to this shift:

Delayed Childbearing: Women are now choosing to have children later, typically in their 30s, whereas earlier generations had children in their early 20s.

Fewer Or No Pregnancies: The number of children per woman has decreased, and more women are choosing to remain child-free.

Reduced breastfeeding: Post-childbearing lactation has become shorter or is sometimes absent, reducing the protective effect breastfeeding offers against breast cancer.

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Lifestyle And Environmental Influences

• Modern lifestyle factors also play a significant role:
• Increased obesity and higher BMI
• Alcohol and tobacco use
• Chronic stress and sedentary habits

Exposure to pollution - including contaminated air, water, and food
Hormonal influences such as the use of hormone replacement therapy (HRT) and assisted reproductive technologies (ART)

Breast Cancer In Younger Women (Image Credits: Canva)

Genetic And Biological Factors

From a biological perspective, Indian women show a higher prevalence of triple-negative breast cancer (TNBC), a more aggressive form of the disease that often occurs in younger women. Dr. Mandeep Singh Malhotra states, “TNBC is also associated with hereditary breast and ovarian cancer syndromes, which can be passed down through families.” Although genetic data from India is still evolving, preliminary findings suggest that the hereditary component of breast cancer may be more significant in the Indian population than in Western populations.

Implications For Screening And Early Detection

Since Indian women tend to develop breast cancer at a younger age, conventional screening methods such as mammography, which are most effective after 40 - 45 years (when breast tissue density decreases), may not be as useful for early detection in younger women. Therefore, India needs a more age-appropriate and holistic screening strategy that includes:

1. Self-breast examination (SBE) - encouraging women to regularly check for any unusual changes.

2. Clinical breast examination (CBE) - periodic check-ups by healthcare professionals.

3. Targeted imaging - using ultrasound for younger women and mammography for older age groups.

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Relying solely on mammography in younger populations can lead to false reassurance and delayed diagnosis, often resulting in cancers being detected at a more advanced stage.

Breast cancer is no longer just an “older woman’s disease.” The rising incidence among younger women in India reflects a complex interplay of genetic predisposition, lifestyle shifts, reproductive choices, and environmental factors. The key lies in awareness, early detection, and age-appropriate screening strategies, empowering women to take charge of their breast health and improving outcomes across all age groups.