Two women of the same age hear the same words on the same day: “You have breast cancer.” One lives in Chandigarh, the other in Cleveland. The woman in Chandigarh is several times more likely to die from the disease. This disparity reflects not biology alone, but differences in screening, access to genetic testing, clinical research and timely treatment.
Every year, approximately two lakh Indian women are diagnosed with breast cancer, and nearly one lakh die from it. Although breast cancer incidence is lower in India than in many western countries, survival remains poorer, largely because cancers are often detected at advanced stages. In the US and much of Europe, screening programmes, public awareness, and evidence-based guidelines have helped reduce breast cancer mortality. Early detection often means smaller tumours, less intensive treatment, and greater chance of cure. India has made important strides through the National Programme for Prevention and Control of Non-Communicable Diseases, Ayushman Arogya Mandirs, ASHA workers, and national screening initiatives. The priority now is to move beyond opportunistic screening towards a systematic approach that includes invitations, reminders, follow-up, and clear pathways to diagnosis and treatment. A landmark study by Tata Memorial Centre demonstrated the potential impact. Clinical breast examinations conducted by trained health workers led to earlier detection and reduced breast cancer mortality by nearly 30 per cent among women over 50. Scaling such approaches could save thousands of lives.
Women also have a vital role in early detection. Knowing what is normal for their breasts and promptly seeking medical care for a lump, nipple discharge, skin changes, or other persistent symptoms can prevent delays. Women in their 40s should discuss mammography with their health care providers and follow screening recommendations based on their personal and family history. Early detection is key to reducing breast cancer deaths, and it begins with recognising symptoms promptly and not delaying recommended screening.
Genetic testing offers another opportunity to improve outcomes. Breast cancer often develops at younger ages in India, and triple-negative disease, an aggressive subtype, accounts for a substantial proportion of cases. Young patients, those with triple-negative breast cancer, and individuals with strong family histories, should be assessed for inherited cancer risk and offered genetic counselling and testing when indicated.
The benefits of identifying an inherited mutation extend far beyond the individual patient. It can help family members access genetic testing, surveillance, and preventive care. Advances in breast cancer treatment are transforming care. Targeted therapies, antibody-drug conjugates, immunotherapy, and precision medicine are expanding options across HER2-positive, hormone receptor-positive, and triple-negative cancers. New treatments are extending survival and improving quality of life for patients who once had limited options. But, scientific progress matters only when patients can access it. India must strengthen its participation in global clinical trials, which connect discoveries with clinical practice.
China has become a major force in global oncology research, demonstrating how sustained investment and large-scale trial participation can shape international treatment standards. With its scientific expertise, substantial patient population, and expanding health care infrastructure, India could play a similarly influential role. Greater participation in international breast cancer trials would help Indian patients benefit from innovation sooner while strengthening the evidence base for care. Breast cancer detected early is often curable, while advances in treatment offer hope even for patients with advanced disease. By strengthening screening, expanding genetic testing, improving access to innovative therapies, and increasing participation in clinical research, India can narrow the survival gap.
The goal is not simply to diagnose more cancers, but to ensure that every woman—regardless of where she lives—has a fair chance to survive and thrive.
Shyla Jovitha Abraham is a health and wellness writer, based in Cleveland, and Dr Jame Abraham is chairman, department of hematology/medical oncology and professor of medicine at Cleveland Clinic. The views expressed are his own and do not represent the views of Cleveland Clinic.
