Did you know that India’s most common women’s cancer is Breast cancer?^[1] It was roughly a third (28.8%) of all women’s cancers in India in 2020.^[2]

You could be in the high-risk group for breast cancer due to certain factors. Better to know what they are, and follow an aggressive surveillance routine^[3], if that is the case.

There is no way to prevent breast cancer. Early detection is the key for survival and complete cure.

Also, not just high-risk women get breast cancer. 75%-80% of the breast cancer occurs in women with no identified risk^[4].

Hence, whether you are in high-risk group or not, it’s important to regularly screen for breast cancer.

What are the risk factors for breast cancer?

1. Age is an obvious risk factor. Most breast cancers are found in women who are 50 years and older^[5]. Hence the widely followed guidelines^[6] recommend annual mammography from the age of 40 onwards for normal risk women and earlier for high-risk women.
2. Family history of breast or ovarian cancer. If your mother, sister, or daughter (first degree relatives); or multiple family members on either your mother’s or father’s side have had breast or ovarian cancer, then it will raise your risk of having breast cancer.
3. Dense Breasts. Did you know that nearly half of all women above the age of 40 have dense breasts?^[7]. Dense breasts (with more connective tissue) raise your breast cancer risk. If you don’t know your breast density, you may please want to check through a mammogram.
4. Personal History. If you previously had breast lumps, breast disease (either cancer or non-cancerous), radiation therapy, certain genetic changes such as BRCA1 or 2, or had early mensuration before age 12 and late menopause after age 55 your risks are higher for breast cancer^[8].
5. The Factors You Can Change. While the previous four factors are out of your control, there are some risk factors that add-up due to your lifestyle, which you can change with certain choices or discipline. Inactive lifestyle, alcohol consumption, having first pregnancy after age 30, and certain hormone replacement therapy are the controllable risk factors of breast cancer.^[9]

How to protect yourself?

It’s important to add a yearly mammography routine as recommended by many Indian and world authorities^[10] to check if the breast cancer is quietly growing in you by evading self-examinations.

The latest mammography technology is called 3D mammography which has higher cancer detection rate than 2D mammography. 3D mammography takes many images from different angles, and provides clearer, more detailed pictures to the doctors to see better through the breast tissue and discover any tiny tumors that might be “hiding” from 2D mammogram^[11],^[12] and on other early screening modalities such as sonography (ultrasound).

3D mammography is especially useful in high-risk women, i.e., including those with:

• Changes or lumps in the breasts^[13]
• A family history of breast or ovarian cancer¹³
• Dense breast tissue^[14],[15]
• A previous diagnosis of breast disease¹³

This means two simple things: Earlier detection than ever before, and less anxiety about unnecessary further testing ^[16].

What action can you take today?

If you are eligible for regular breast screening either by age alone (40 years and above), or due to high-risk factors as above (in which case before 40 years), ask your doctor about an annual Mammography plan – a simple ritual that can save your life!

1. Rangarajan B, Shet T, Wadasadawala T, et al. Breast cancer: An overview of published Indian data. South Asian J Cancer. 2016;5(3):86-92. doi:10.4103/2278-330X.187561
2. Mathur P, Sathish Kumar K, Chaturvedi M, et al. ICMR-NCDIR-NCRP Investigator Group. Cancer Statistics, 2020: Report From National Cancer Registry Programme, India. JCO Glob Oncol. 2020 Jul;6:1063-1075. doi: 10.1200/GO.20.00122. PMID: 32673076; PMCID: PMC7392737. https://europepmc.org/article/pmc/pmc7392737
3. Singletary SE. Rating the risk factors for breast cancer. Ann Surg. 2003;237(4):474-482. doi:10.1097/01.SLA.0000059969.64262.87
4. Kamińska M, Ciszewski T, Łopacka-Szatan K, Miotła P, Starosławska E. Breast cancer risk factors. Prz Menopauzalny. 2015;14(3):196-202. doi:10.5114/pm.2015.54346
5. https://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm
6. https://www.acraccreditation.org/Mammography-Saves-Lives/Guidelines
7. https://www.cancer.gov/types/breast/breast-changes/dense-breasts
8. https://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm
9. https://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm
10. https://www.cdc.gov/cancer/breast/basic_info/screening.htm
11. Skaane P et al. Radiology 2013;267:47–56.
12. Rose S et al. AJR Am J Roentgenol 2013;200:1401–8.
13. Breast Cancer Risk Factors: a review of the evidence July 2009, National Breast and Ovarian Cancer Centre
14. Friedewald SM et al. JAMA 2014;311:2499–507. 2.
15. FDA submissions P080003, P080003/S001, P080003/S004, P080003/S005
16. Zuley ML, Bandos AI, Ganott MA, Sumkin JH, Kelly AE, Catullo VJ, Rathfon GY, Lu AH, Gur D. Digital breast tomosynthesis versus supplemental diagnostic mammographic views for evaluation of noncalcified breast lesions. Radiology. 2013 Jan;266(1):89-95. doi: 10.1148/radiol.12120552. Epub 2012 Nov 9. PMID: 23143023; PMCID: PMC3528971. https://pubmed.ncbi.nlm.nih.gov/23143023/