Hyderabad: Fear of losing a breast, social stigma, misconceptions about cancer and poor awareness continue to prevent many Indian women from undergoing breast cancer screenings despite a national screening programme being in place for nearly a decade, a pilot study by Hyderabad-based Ushalakshmi Breast Cancer Foundation has found.Presented at the American Society of Clinical Oncology (ASCO) Annual Meeting 2026, the study was conducted under the Charles M Balch Endowed International Fellowship in surgical oncology at The University of Texas’ MD Anderson Cancer Center.The survey, conducted among nearly 700 women in Hyderabad and Warangal in Oct 2025, identified behavioural, social and service-delivery barriers that continue to limit participation in screening.It was undertaken as a follow-up based on the foundation’s large-scale breast cancer screening programme carried out jointly with the Telangana and Andhra Pradesh govts between 2012 and 2016. During this time, over two lakh underprivileged women across nearly 4,000 villages underwent Clinical Breast Examination (CBE) by more than 3,000 specially trained ASHA and frontline health workers.Despite the central govt adopting CBE under the National Health Mission (NHM) as the national breast cancer screening strategy, only around 1% of eligible women are currently being screened, prompting researchers to examine why women are not participating.“Breast cancer is no longer just a medical challenge; it is also a social and behavioural challenge. The biggest barrier is often not the availability of screening, but the reluctance to come forward,” said Dr P Raghu Ram, noted surgeon and founder & chairperson, Ushalakshmi Breast Cancer Foundation.“Most breast lumps are not cancers. Even if breast cancer is diagnosed, detecting it early dramatically improves the chances of cure and often allows less extensive treatment,” said Dr Raghu Ram, while also appealing families to encourage women above 40 years to undergo regular screening.He highlighted that many women believed breast examinations were unnecessary unless they had symptoms, while others feared a cancer diagnosis, assumed treatment would invariably involve removal of the breast, or considered breast cancer a taboo topic. Women also preferred screening at primary health centres rather than during home visits and expressed greater confidence if examinations were performed by doctors.“Our study demonstrates that expanding screening services alone is not enough. We need sustained breast health education, culturally sensitive communication, continued training of frontline healthcare workers and screening services that women trust and feel comfortable using,” added Dr Raghu Ram, who is also one of the lead authors of the study.Additionally, Dr Nina Tamirisa, breast surgical oncologist, MD Anderson Cancer Centre, the US emphasised that while mammography (a low-dose X-ray of the breast used to detect cancer early) remains the gold standard where resources permit, CBE is the most practical strategy for India.“The choice is not between mammography and CBE; it is between implementing an evidence-based screening strategy that is feasible today and having no organised screening programme at all,” added Dr Tamirisa, another author of the study.NARI for Breast HealthBased on the findings, the foundation will now submit recommendations to the Prime Minister to strengthen implementation of breast cancer screening under the NHM. It has also developed booklets and a mobile app in 12 languages, including Telugu, to dispel myths and encourage early detection and treatment.Moreover, the foundation recently developed NARI (National Awareness and Resource Initiative for Breast Health) that aims to democratise information about benign breast conditions and breast cancer, dispel myths and encourage early detection and treatment.
