India is facing a growing burden of breast cancer, with projections indicating a significant rise in mortality in the coming decades. According to a new study published in The Lancet Oncology, global breast cancer deaths are projected to increase substantially by 2050, underscoring the importance of strengthening early detection and screening efforts. At the same time, national data points to limited screening uptake. According to the National Family Health Survey (NFHS-5), only 0.9% of women in India have undergone breast cancer screening, reflecting gaps in awareness, access, and utilisation of preventive health services. Breast cancer in women (Unsplash)Breast cancer accounts for ~26–27% of all female cancers in India (GLOBOCAN 2022), yet screening remains fragmented and inequitable across the country. Addressing this challenge requires more than isolated programmes; it calls for a coordinated national mission, similar to India’s large-scale successes in HIV, polio and tuberculosis. Importantly, screening alone does not improve outcomes unless it is linked to timely, accurate tissue diagnosis and treatment planning. Strengthening this continuum—from detection to diagnosis to care—is critical to realising the full life-saving potential of screening.Low awareness, stigma and fear of diagnosis continue to limit early uptake of screening in India. However, gaps extend beyond screening access to diagnostic follow-through. For women with suspicious breast lesions, timely and accurate tissue diagnosis is essential. In such cases, core needle biopsy often provides more comprehensive histological information than fine needle aspiration alone, enabling better diagnostic accuracy, biomarker evaluation, and treatment planning.Infrastructure and workforce constraints persist, particularly in rural areas where access to imaging and image-guided biopsy services is limited, often leading to delays in diagnosis. Importantly, the constraint is not only resource availability but also capability. Variability in procedural expertise, limited training in image-guided biopsy techniques, pathology readiness for biomarker testing, and weak referral coordination also contribute to delays and suboptimal outcomes. As a result, a large proportion of breast cancer cases in India are diagnosed at later stages, increasing treatment complexity, cost, and patient burden.The Government of India has taken important steps in this direction. Breast cancer screening is included under the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), which offers basic screening services for women above 30 years. and Ayushman Bharat, which supports treatment access.However, screening coverage remains limited and uneven across states. A dedicated nationwide mission may be the need of the hour, to standardise implementation and improve outcomes. Such a mission must go beyond screening volumes and include:Awareness campaigns and frontline workforce trainingStructured capability building across breast imaging, image-guided biopsy, and multidisciplinary care pathwaysDeployment of mobile screening units and outreach programmesConfirmatory core needle biopsy where clinically indicated, to ensure accurate diagnosisStrengthening of pathology services and biomarker testing capabilitiesDefined referral pathways and standardised protocolsA focus on both access and quality of diagnosis will be critical to improving outcomes at scale.India is seeing rapid innovations in this space including AI-based tools like thermal breast screening and portable 3D mammography that enable scalable, low-cost detection.At the same time, technological progress should extend beyond screening to strengthen diagnostic and care pathways. In this context, advanced minimally invasive diagnostic and interventional techniques, such as vacuum-assisted breast biopsy in appropriate settings, may further enhance precision and expand care options.Without bold and immediate action, India risks seeing thousands of preventable women cancer deaths in the coming decades. A national mission can shift the narrative from delayed diagnosis to timely care bridging equity gaps, saving lives and making women’s health a true national priority.(The views expressed are personal)This article is authored by Atul Grover, MD, BD India/South Asia and member, NATHEALTH.