SCREENING MAMMOGRAPHY - A UNDERUTILISED TOOL AGAINST BREAST CANCER IN INDIA Indian context of breast cancer: Breast cancer is the most common cancer diagnosed in india, close 1.5 lakh new cases are diagnosed each year. It Constitutes around 10% of all new cancer cases diagnosed in a year. In india approximately 40% of breast cancer patients are younger then 50 years while this could be real but may also be due to underreporting of breast cancer in elderly indian women. Almost half of the indian breast cancer patients present in stages III and IV. Advancing age is the most important risk factor for breast cancer. One of the major reasons for late diagnosis is lack of awareness regarding screening programmes in breast cancer. 2016 update US preventive service task force makes for following recommendation: -Recommends screening mammography every 2 years in asymptomatic average risk*women between age 50-74 years. *A women is said to be at average risk of breast cancer provided they do not have any preexisting breast cancer or a high-risk breast lesion and wthout any high risk genetic mutation (such as a BRCA1 or BRCA2 gene mutation or other familial breast cancer syndrome) or a history of chest radiation at a young age. -For average risk women between age group of 40-49 years, the decision to start screening or not should be an individualised knowing that the absolute benefit in survival is small. - Maximum benefit of screening mammography in terms of prolonging life is seen in age group of 60-69 years. Questions regarding breast cancer screening in indian women? - Cost effectiveness was not taken into consideration by US preventive task force, which may be an important consideration in developing country like india. - As we know indian women are being diagnosed at younger age and probably should benefit more if routine screening age is 40 years.