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Breast cancer screening holds the power to transform outcomes dramatically. While international guidelines provide a strong foundation, local adaptation is essential.
ndia’s breast cancer landscape is distinct as a significant proportion of cases are seen in women under 50, late-stage presentation is more common, especially in public hospitals and mammography access remains uneven, particularly outside major cities
Breast cancer continues to be the most commonly diagnosed cancer among women in India, surpassing cervical cancer over the past decade. Global guidelines now emphasize risk-based screening over one- size-fits-all approaches. This includes taking family history, genetics, menstrual and reproductive history, lifestyle, and breast density into account. With increasing awareness, evolving technologies, and more robust global and Indian data, 2025 marks a pivotal year in how we think about breast cancer screening. Dr Karishma Kirti, Consultant Breast Specialist and Oncoplastic Surgeon shares all you need to know:
International bodies such as the American Cancer Society (ACS) and the U.S. Preventive Services Task Force (USPSTF) now recommend:
1. Mammography beginning at age 40 for average-risk women
2. Annual or biennial mammograms depending on individual risk and access
3. 3D digital mammography (tomosynthesis) for improved detection where available
4. Earlier screening from age 30–35 for high-risk individuals (e.g. BRCA1/2 mutation carriers)
5. Less emphasis on clinical breast examination (CBE) and breast self-examination (BSE)
These recommendations, while evidence-based, assume high availability of mammography, robust referral systems, and widespread health coverage, all of which are often not reflective of Indian healthcare infrastructure.
What Works in India: Indigenous Evidence, Practical Models
India’s breast cancer landscape is distinct as a significant proportion of cases are seen in women under 50, late-stage presentation is more common, especially in public hospitals and mammography access remains uneven, particularly outside major cities.
One of the most important contributions to global breast cancer screening evidence actually comes from India itself. The Mumbai cluster randomized controlled trial, followed nearly 150,000 women over 20 years. It demonstrated that biennial clinical breast examination (CBE) by trained female health workers led to a significant stage shift to earlier detection. Among women aged 50 and above, there was a 15% reduction in breast cancer mortality. CBE was found to be low-cost, acceptable, and scalable. (Mittra I, et al. Lancet Oncol. 2021;22(3):402–15.)
This study offers conclusive, real-world evidence that CBE, when done systematically with proper follow- up, saves lives especially in low- and middle-income countries (LMICs) like India.
What about breast self-examination?
While breast self-exams are no longer formally recommended for screening in the West, breast awareness knowing what’s normal for you is still vital in India. Encouraging monthly self-checks and timely reporting of lumps or changes can lead to earlier diagnosis. Many women first discover their cancer themselves, not through screening, but by noticing a lump or change.
In the absence of national guidelines, these are some of the recommendations I use in my clinic to guide my patients through screening for breast cancer. This tiered, risk-based approach is based on both the evidence and the ground realities of healthcare access in India.
| Age Group | Recommended Screening Modality |
| 25-30 years | Encourage monthly breast self -examination (BSE) and breast awareness. Clinical evaluation if symptomatic or high-risk. |
| 30-40 years | Clinical Breast Examination (CBE) every year by trained health workers |
| 40 years + | Continue annual CBE; add biennial mammography if accessible. |
| High-risk (genetic mutation, family history) | Consult an oncologist to understand risk. Start annual screening at 30; include mammography and MRI annually. |
Breast cancer screening holds the power to transform outcomes dramatically. While international guidelines provide a strong foundation, local adaptation is essential.
For Indian women, the best approach combines:
Early vigilance,
Accessible technology, and
Open conversations around breast health.
The earlier we detect, the more lives we save.
Swati Chaturvedi, a seasoned media and journalism aficionado with over 10 years of expertise, is not just a storyteller; she’s a weaver of wit and wisdom in the digital landscape. As a key figure in News18 Engl…Read More
Swati Chaturvedi, a seasoned media and journalism aficionado with over 10 years of expertise, is not just a storyteller; she’s a weaver of wit and wisdom in the digital landscape. As a key figure in News18 Engl… Read More
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