Breast cancer awareness month: Why women should opt for regular screenings after 40

It is Breast Cancer Awareness Month, also known as ‘Pink October’. Breast cancer is one of the most common cancers that affects women and people assigned female at birth, including transgender men and nonbinary people.

According to the World Health Organization (WHO), breast cancer caused 670,000 deaths globally in 2022. The disease is treatable when detected early. Medical experts suggest women should get screened at age 40.

Here’s why women should heed this advice.

Breast cancer

Breast cancer is the type of cancer where there is an abnormal growth of cells in the breast tissue that leads to tumours. The symptoms of breast cancer include a lump or thickening in the breast or armpit, a change in size, shape or appearance of the breast, unusual nipple discharge, redness or dry skin on the breast, and pain or swelling in the breast.

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In the United States, breast cancer is the second most common cancer affecting women. It is also the second leading cause of cancer death in women. As per the US Centers for Disease Control and Prevention (CDC), 42,000 women and 500 men lose their lives to the disease every year.

Breast cancer is the most common cancer among women in India. The South Asian country has a lower five-year survival rate than Western and other high-income countries.

Who is at risk?

Women who have a family history of cancer are at higher risk of breast cancer. However, the WHO says that most women diagnosed with breast cancer do not have a known history of the disease.

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“While breast cancer is most typically diagnosed in post-menopausal women, this is a condition that can and does happen in young women, too,” Yale Medicine radiologist Liva Andrejeva-Wright, MD, who specialises in breast imaging, was quoted as saying by Yale Medicine.

Poor lifestyle habits such as smoking, heavy alcohol consumption and tobacco use can also heighten the risk of breast cancer.

Increasing age, obesity, radiation exposure and reproductive history (age when menstruation began and age at first pregnancy) are also major risk factors.

Speaking to India Today, Dr Aditi Chaturvedi, Senior Consultant, Breast Surgical Oncologist at Max Super Speciality Hospital, Saket, said that a reduced duration of breastfeeding, or a lack thereof, may increase the risk of breast cancer. “Lack of breastfeeding or shortened duration of breastfeeding may also be contributory to this increased risk. Prolonged exposure to hormonal therapy in terms of oral contraceptive pills and other hormonal agents can also increase a woman’s risk of developing breast cancer," she explained.

Why younger women should start screening

Breast cancer has steadily increased in women under age 50 over the past two decades.

With more younger women across the world being diagnosed with the disease, it is important to the cancer at an early stage.

Earlier this year, the US Preventive Services Task Force, an influential group of medical experts, recommended mammograms – an X-ray of the breast – for women at age 40 instead of the previously suggested 50 years of age.

The task force called for women to get mammography screening every other year until age 74.

In India, the Radiological Society of India suggests mammography from age 40, once in two years. After the age of 50, it recommends screening for breast cancer once a year.

“Over the last 10 to 15 years, breast cancer has become more frequent among the younger population, between the ages of 35 and 45. Eleven per cent of our younger women develop breast cancer compared to seven per cent in the West, that too several years earlier than Western women,” Dr Ramesh Sarin, senior consultant, oncology, Indraprastha Apollo Hospitals, New Delhi, told Indian Express.

However, women must talk to their healthcare providers to make a decision, especially if they notice changes in their breasts. Depending on their risk factors and health profile, doctors may recommend mammography even before the age of 40.

“It’s crucial that women know their risk factors and receive screening accordingly. Screening, by definition, is done before there are any symptoms. Screening can help detect cancers at an early stage before it has spread, when there is the best chance for successful treatment,” Dr Leana Wen told CNN.

When cancers are too small and people have dense breasts, it could be difficult to detect breast cancer through mammograms. Experts recommend additional testing in women with dense breast tissue such as a breast MRI.

“Indian women tend to have denser tissue than their Western counterparts. Also less body fat makes it more likely that you’ll have less fatty tissue and more dense tissue in your breasts. That’s why we need to include some extra tests like ultrasound and MRI of the breast as part of the early screening package at age 40. There’s no point missing out 20 per cent of these smaller cancers. But since breast MRIs can be expensive, these should be reimbursed by insurance companies,” Dr Sarin told Indian Express.

A mammogram at 40 is necessary as the mortality from breast cancer could fall if it is detected early, as per a study in the journal Lancet Oncology.

According to the American Cancer Society, breast cancers in the early stage have a survival rate of 99 per cent compared to later-stage cancers at 24 per cent.

Studies have shown the risk of cancer can be lowered with exercise. Cutting down on ultra-processed foods is also good for you. Experts also recommend adopting an active and healthy lifestyle to reduce your cancer risk.

With inputs from agencies