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Every four minutes, a woman is diagnosed with breast cancer in India, serving as an alarming indicator of the disease's expanding prevalence. Breast cancer, which was formerly the fourth most frequent cancer in the 1990s, is now the most common cancer among Indian women and a major global public health concern.
According to a new study published in the Nature Journal, the number of Indian women under treatment for breast cancer is likely to rise by 50,000 per year over the next 10 years, with an average yearly cost burden of US$19.55 billion. Several reasons, such as hereditary obesity, poor lifestyles, excessive ultra-processed food intake, smoking, and alcohol usage, have contributed to this sudden rise. The problem becomes even more complicated in India because women are diagnosed at an earlier age than in Western countries. Biological features related to breast cancer are more aggressive in young women, and they have a higher risk of relapse and metastasis, which leads to worse outcomes than in older women. To solve such issues, a thorough grasp of the existing situation, the main challenges, and possible solutions is necessary.
Biological features related to breast cancer are more aggressive in young women, and they have a higher risk of relapse and metastasis, which leads to worse outcomes than in older women.
A Lok Sabha document released in 2024 provided the estimated number of breast cancer cases and mortality rates among women from 2019-2023. As shown in Figure 1, the number of cases of breast cancer increased steadily from 200,218 in 2019 to 221,579 in 2023; at the same time, the number of deaths from the disease increased from 74,481 to 82,429 in India. Even while incidence is far higher than fatality, mortality rates have been steadily rising, which suggests problems with early detection, access to treatment, and efficient management.
Figure 1 : Estimated number of Breast Cancer incidence and mortality rate from (2019-2023) in India among female
Source: Sansad Document
A steadily rising incidence of breast cancer is only the beginning. This growing burden is a result of numerous underlying issues such as lack of awareness, lifestyle changes, geographic barriers, economic barriers, and delayed diagnosis. Compared to Western nations, India has significantly poorer breast cancer survival rates. The survival percentage for patients diagnosed with stage I cancer is roughly 93.3 percent, whereas the survival rate for those diagnosed with stage IV cancer might be as low as 24.5 percent. Approximately 60 percent of Breast cancer patients in India are identified at stages III or IV of the illness. The general ignorance of women in India about breast cancer, its symptoms, and the value of regular screenings is a significant obstacle to the early identification of the disease. Numerous studies have shown that poverty, low educational attainment, lack of awareness, living in remote and inaccessible places, and having insufficient access to care are all linked to late-stage breast cancer diagnosis, especially for women from lower socio-economic backgrounds and rural areas.
The general ignorance of women in India about breast cancer, its symptoms, and the value of regular screenings is a significant obstacle to the early identification of the disease.
The NFHS data for 2019-2021 highlights that only 0.9 percent of women aged between 30-49 have undergone breast cancer screening. A large number of women are not aware of the signs and the significance of routine testing. Breast-health-related cultural taboos and stigmas make this problem even worse by delaying seeking medical attention when symptoms appear. An initiative like the “Pink Month” campaign seeks to increase women's knowledge about breast cancer and inspire them to get help when they need it.
The increasing need for early breast cancer detection cannot be met by India's screening infrastructure since, for efficient breast cancer screening, India lacks specialist treatment facilities and sufficient mammography equipment. Despite being a widely used screening method, geographical differences in availability and access limit the effectiveness of mammography. This issue has been exacerbated by a lack of trained workers and suitable facilities. For example, the greater breast density in Indian women causes a substantial variation in mammography sensitivity, which might result in overdiagnosis and false positives. Almost 40 percent of Indian hospitals lack sufficient access to cutting-edge cancer treatment technology, and only a small number of facilities in the country offer combined chemoradiation and surgery for breast cancer. One of the biggest obstacles for many women with breast cancer is the cost of treatment, which varies from INR 100,000 to INR 1,000,000 or more, depending on several elements. Inadequate insurance reimbursements, catastrophic out-of-pocket costs, and uneven treatment quality are the leading causes of high attrition rates in breast cancer treatment, which put low-income households in a difficult financial situation. In addition, rural populations are disproportionately affected by a lack of resources (there are only 2,000 oncologists for 10 million patients) and a skewed distribution of facilities (95 percent of them are in metropolitan regions), which makes access to care worse. It has been found that some subgroups of patients with breast cancer respond better to newer treatment alternatives, including immunotherapies and targeted medicines. However, access to such costly options is extremely limited in a low- to middle-income nation like India.
Almost 40 percent of Indian hospitals lack sufficient access to cutting-edge cancer treatment technology, and only a small number of facilities in the country offer combined chemoradiation and surgery for breast cancer.
Every diagnosis of breast cancer exposes a story of a life or existential crisis that requires a great deal of resilience and has a direct psychological influence on the patient. The patients experience psychological discomfort as a result of the diagnosis, which includes feelings such as uncertainty, disbelief, despair, rage, fear, anxiety, and grief. Their everyday lives and families are impacted by this abrupt change.
Regardless of these important obstacles, there are a lot of chances for advancement that could increase breast cancer treatment and outcomes in India. Breast cancer awareness relies heavily on public health campaigns. Outreach initiatives can be strengthened by partnerships between governmental and non-governmental organisations through social media campaigns and community workshops. In workplaces, by conducting awareness programs and providing screenings, and in schools and community programs, by making breast cancer an imperative part of their curriculum, awareness can be raised early.
National screening programs and community awareness are crucial for early detection, but so are providing medical professionals with the knowledge and skills to effectively address the issue. In partnership with the University of East Anglia (UEA), United Kingdom, the International School of Oncoplasty (ISOS), the capacity-building arm of Prashanti Cancer Care Mission (PCCM), has made progress in this field by bringing advanced breast cancer management training with an emphasis on oncoplastics to the Indian subcontinent. Through a structured fellowship, this program seeks to improve surgical outcomes and patient care while promoting breast conservation and expanding its indications through oncoplastic assistance.
Personalised medicine, medication development, remote patient monitoring, and improved image analysis are all being revolutionised by regenerative AI in the diagnosis and treatment of breast cancer. It can use complex algorithms to examine enormous volumes of medical data, such as MRI scans, ultrasounds, and mammograms, and spot minute patterns and abnormalities that might point to the existence of cancer. “MammoAssist” and other regenerative AI systems have demonstrated promise in enhancing diagnostic precision through more effective mammography analysis. These developments have the potential to improve patient outcomes while reducing some of the strain on medical professionals.
“MammoAssist” and other regenerative AI systems have demonstrated promise in enhancing diagnostic precision through more effective mammography analysis.
The Breast Health Initiative (BHI) was started to show how to enhance access to early breast cancer diagnosis and treatment using a scalable paradigm. As part of the BHI implementation plan, auxiliary nurse midwives (ANMs), staff nurses, and medical officers at the primary care clinics received quality clinical breast examination (CBE) training, and female community health workers—known as accredited social health activists [ASHAs]—were trained and deployed to conduct customised breast cancer awareness programs for women between the ages of 30 and 65. Nonetheless, comprehensive national policies that cover every facet of cancer care from prevention to treatments, are required to provide fair access for people from all socioeconomic backgrounds.
India's growing breast cancer rate mandates quick, multifaceted solutions. Despite the substantial obstacles, there are still plenty of promising prospects for advancement. India has the potential to revolutionise breast cancer treatment by emphasising policy changes, infrastructural development, early detection, and awareness. Regardless of a woman's socioeconomic situation, breast cancer can be made tolerable and survivable for all women with strategic healthcare investments and community-driven initiatives.
Madhavi Jha is a Research Intern with the Observer Research Foundation
The views expressed above belong to the author(s). ORF research and analyses now available on Telegram! Click here to access our curated content — blogs, longforms and interviews.
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