Correct age for Indian woman to start screening Mammogram for breast cancer – 40 or 50? Opinion is divided!!

The right age for an Indian woman to start breast cancer screening is a subject of debate, much like in the US. Recently, the United States Preventive Services Task Force (USPSTF) recommended that regular breast cancer screening for women should commence at the age of 50, contrary to the current suggestion of starting at 40 in the US.

The USPSTF’s guidelines, published in the journal “Annals of Internal Medicine,” advise against routine screening mammography for women aged 40 to 49 and recommend biennial screening mammography for women aged 50 to 74. Additionally, there is insufficient evidence to assess the benefits of screening mammography for women aged 75 or older.

Dr. Diana Petitti, the vice-chairperson of the task force, stated that the guidelines aim to reduce harm from overscreening, which can lead to unnecessary biopsies and extreme anxiety. Sometimes, mammograms detect slow-growing cancers that would not have affected a woman’s lifetime.

The USPSTF’s report indicates that one life is saved for every 1,900 women aged 40-49 who undergo breast cancer screening, compared to one life saved for every 1,300 women in the 50-59 age group.

However, similar to the US, these recommendations have sparked controversy in India as well. Some experts argue that India should adhere to the age of 40 for screening.

Dr. Sidharth Sahni, an expert in surgical oncology (breast) at Artemis Health Institute, believes that since women in India are being diagnosed with breast cancer at an early age, around 42 to 44 years, starting screening at 50 would be ineffective. He suggests continuing screening from the age of 40, once a year.

On the other hand, Dr. Ramesh Sarin, a surgical oncologist at Indraprastha Apollo Hospital, advocates mammography once every year for women aged 50. However, he acknowledges that Indian women are diagnosed with breast cancer a decade earlier than their Western counterparts and proposes screening every two years after the age of 40.

Another expert, Dr. Vinod Raina, head of medical oncology at AIIMS, suggests that high-risk groups, such as women with denser breast tissue and a strong family history of breast cancer, should start screening at 40. For general screening, he recommends Indian women undergo a mammography once every two years after reaching 50, considering the lower incidence of breast cancer in India compared to the US.

While there are differing opinions on the starting age, experts unanimously agree that India should implement a mass breast cancer-screening plan similar to those in Western countries under the country’s National Cancer Programme.

The screening mammography rate in India is currently very low, with less than 5% of women aged 50-69 undergoing mammography screening between 2000-2003, according to WHO’s latest World Health Statistics (WHS). WHO asserts that mammography screening in this age group reduces breast cancer mortality by 15%-25%. Breast cancer is the leading cause of cancer-related deaths among women globally, accounting for 16% of such deaths. In India, breast cancer is the most common form of cancer in women, with one in 26 women expected to be diagnosed with breast cancer in their lifetime, according to WHO.

Experts reveal that 50% of breast cancer cases in India are detected very late, highlighting the need for better screening initiatives.