Daijiworld Media Network - New Delhi

New Delhi, Feb 1: Breast cancer cases among Indian women are increasing at a rate of around 6% per year, according to a recent ICMR study. Experts point to lifestyle and metabolic changes—especially poor sleep, chronic stress, and central obesity—as key drivers. Dr. Shubham Garg, Director of Surgical Oncology at Dharamshila Narayana Hospital, Delhi, explains how these factors are altering risk patterns, why younger women are increasingly affected, and what steps can help mitigate risk.

Evidence linking disrupted sleep to breast cancer is growing stronger. Data from the National Centre for Disease Informatics and Research adds Indian insights to global studies showing that poor sleep and circadian disruption affect melatonin production, estrogen regulation, immune surveillance, and DNA repair. While not a standalone cause, sleep deprivation amplifies vulnerability when combined with obesity, high stress, sedentary habits, and urban lifestyles—factors now common among Indian women, especially in cities.

Although genetic predisposition and age remain the strongest risk factors, poor sleep is emerging as a major modifiable risk factor. Clinically, many women with no family history of breast cancer develop the disease after prolonged sleep deprivation, night-shift work, metabolic dysfunction, and high stress. Consequently, sleep patterns are now considered an important component of comprehensive risk assessment.

Central obesity, more than overall body weight, significantly elevates breast cancer risk, particularly post-menopause. Excess visceral fat produces inflammatory cytokines, promotes insulin resistance, and increases estrogen production. After menopause, adipose tissue becomes the main source of estrogen, which can fuel hormone-receptor-positive breast cancers. Waist circumference, therefore, is a more accurate risk indicator than body weight, reflecting chronic inflammation and metabolic stress.

Lifestyle interventions cannot completely eliminate risk, but they can substantially reduce it. Improving sleep restores circadian rhythm, melatonin levels, and immune function. Stress reduction lowers prolonged cortisol exposure, which otherwise promotes inflammation and hormonal imbalance. Reducing central obesity improves insulin sensitivity, lowers estrogen production, and decreases inflammatory markers. These measures also improve outcomes and reduce recurrence risk for women who have already undergone treatment.

Chronic stress itself influences tumor biology by elevating cortisol levels, weakening immune surveillance, increasing systemic inflammation, altering glucose metabolism, and disrupting estrogen pathways. Together, these changes create a biological environment conducive to cancer development.

Breast cancer in India is increasingly being diagnosed in women aged 35–50, a shift linked to sedentary lifestyles, central obesity, poor sleep, chronic stress, delayed childbirth, and reduced breastfeeding. While genetic factors remain relevant, these modifiable risks accelerate disease onset at younger ages. Delayed diagnosis further compounds the problem, highlighting the need for prevention strategies that go beyond mammography to include lifestyle education, metabolic health, stress management, and sleep hygiene, reinforced through community counseling.

Women who delay childbirth should view these findings with perspective rather than fear. While later pregnancies slightly increase lifetime estrogen exposure, risk can be mitigated through regular exercise, weight management, adequate sleep, breastfeeding when possible, and appropriate screening.

For women with multiple lifestyle risk factors, earlier and individualized screening is advisable. Although population-wide early screening is challenging in India, a risk-based approach—including clinical breast exams, ultrasound, or mammography starting in the late 30s—can help detect disease earlier in high-risk groups.

This emerging pattern underscores that breast cancer prevention in India now requires a holistic approach, combining medical vigilance with lifestyle modifications to protect younger and urban populations increasingly at risk.