Rethinking the Risk: A Case-Control Study on the Low Prevalence of Established Breast Cancer Risk Factors in Young...

The incidence of breast cancer is rising alarmingly in the Indian subcontinent, with the steepest increase observed in women in their 20 s and 30 s. While lifestyle westernization is often cited as a cause, its relevance to younger women remains unexplored. This study aims to evaluate the prevalence of established and suspected risk factors for breast cancer among Indian women aged ≤ 40 years. A case-control study was conducted from September 2019 to April 2022 at the Department of Surgery, UCMS & GTB Hospital, Delhi. The study included 272 biopsy-proven breast cancer patients (≤ 40 ± 2 years) and 300 age-matched controls. Data were collected via a standardized questionnaire addressing clinical history, lifestyle, and risk factor profile. Logistic regression was used to determine associations, with a significance threshold of p < 0.05. The mean age of cases was 37.39 ± 5.31 years. There was a low prevalence of traditional risk factors across both groups. Only breastfeeding (protective, p = 0.038) and family history of breast cancer (OR = 2.79, p ≈ 0.05) showed statistically significant differences. Other factors, including early menarche, nulliparity, delayed pregnancy, and benign breast disease, did not differ significantly. Traditional risk factors do not adequately explain the rising incidence of breast cancer in young Indian women. The assumption that westernized lifestyles are primarily responsible may be overly simplistic. Further research into environmental, dietary, and occupational exposures is warranted.