Late marriage, late motherhood: Do these factors impact breast cancer in women?

In India, breast cancer is now the most prevalent type of cancer among women and it is estimated that breast cancer is the cause of almost all cancer in women. Its incidence has been continuously on the increase within the last few decades particularly in urban locations.

This growth may be explained by the fact that the urbanisation process is accelerated, the lifestyle has changed, and the social norms have developed. The urban women are at a very high risk in comparison to their rural counterparts, this is mostly because of their lifestyle choices which are coupled with education, career and late family planning.With a larger number of women entering the urban labour force, late marriages and late pregnancies have become the norm.

Although this is an indication of the tremendous advancement of women in education and workplaces, it has undesirable health implications. Hormonal imbalance is one of the greatest underlying factors. Menstrual cycles are controlled by hormones like oestrogen and progesterone that are secreted by the ovaries and aid in the development of the breast.

Nevertheless, extended and continuous exposure to these hormones, which could be due to delayed childbirth, no breastfeeding, early menstruation or late menopause, may result in the changes in cells of the breast tissue, which contribute to the cancer development.

Medical researchers have been observing that hormonal factors are major contributors to the occurrence of breast cancer. Some disorders that include early menarche (early menstruation), late menopause, long-term use of oral contraceptive pills, and hormone replacement therapy are all linked to persistent hormonal changes. Unless the body rests these fluctuations by means of pregnancy and breastfeeding, the breast cell is subjected to repeated stimulation and this may ultimately result in abnormal growth and cancer.To this effect, the burdens of contemporary careers are wearing down the health of women. The irregular working schedule, lack of sleep, poor nutrition and excessive strain are peculiar to the urban workforce. The factors are not only disruptive in terms of hormone balance but also lead to metabolism and inflammation, which, in turn, can increase the likelihood of developing chronic illnesses, such as cancer.Older women over the age of 60 years were the ones who were mostly diagnosed with breast cancer before.

Unfortunately, current trends show that there is a change and more and more cases are being identified among younger women between the ages of 20s and 30s. This trend indicates that there is a pressing necessity to raise awareness and preventive practices of younger age groups.The multi-pronged approach is the solution to this increasing health crisis. To begin with, the issue of breast cancer early warning signs and maintaining self-examinations and screenings should be popularized.

Secondly, the healthy lifestyle like eating correctly, performing physical activities, coping with stress, and getting enough sleep, should be promoted among all women.It is also crucial to establish an enabling working environment that appreciates the health of women. To ensure that women are advised to have families at the time they want to without fear of career downturn, employers and policymakers should collaborate to guarantee that women can be advised to bear children.

Maternity leaves, flexible working hours and post childbirth reintegration packages are very helpful.Women empowerment should not be at the expense of their well-being. With the economic and social advancement of India it is of utmost importance to note that the health of women, particularly breast health should be given equal consideration. Early detection, frequent screening and favorable policies can do wonders in stemming out the increasing trend of breast cancer among the younger generation of Indian women.Dr. Anupama Mane, Consultant- Breast Surgeon, Ruby Hall Clinic, Pune