In South Africa, the battle against breast cancer has reached alarming levels, affecting 1 in 27 women and accounting for 23% of all diagnosed cancers in 2019, as revealed by the National Health Institute report.
The need for awareness and early detection has never been more vital.
With Breast Cancer Awareness Month upon us, the Breast Imaging Society of South Africa (BISSA) steps forward as a guiding light, urging women to prioritise self-examinations and annual mammograms starting at the age of 40 or even earlier.
Breast cancer silently hides within the lives of thousands of South African women, only to strike when least expected.
Dr Peter Schoub, the Chair of BISSA and a prominent member of the Radiological Society of South Africa, makes a point that early detection is the beacon of hope.
It not only increases survival rates but also minimises the need for aggressive treatments that can cause physical and emotional trauma.
“One of the most significant challenges in South Africa is the late-stage diagnosis of breast cancer when the cancer is advanced, reducing the chances of successful treatment.
“This late diagnosis is often due to a lack of awareness, limited access to healthcare facilities, and socio-economic inequalities,” he said.
Schoub added: “Although most of the major medical schemes offer a yearly complimentary mammogram screening to women over the age of 40, only about 20% take advantage of this service.”
Breast cancer can happen to women of all ages. It's becoming more common in women in their 30s, which is concerning.
Young women experience more aggressive breast cancer that progresses rapidly and would be at an advanced stage by the time of diagnosis, increasing the risk of cancer spreading to other parts of the body, Schoub explained.
Who is at risk of developing breast cancer?
Every woman is potentially at risk of getting breast cancer. However, certain factors will place them in a higher risk category, including:
Age
The risk of developing breast cancer increases as one gets older. However, 1 out of 8 invasive breast cancers are found in women younger than 45, according to Breastcancer.org foundation.
Family history
Women with close blood relatives who've had breast cancer are at higher risk.
Personal history
A woman with cancer in one breast has a 3-4 times increased risk of developing a new cancer in the other breast or another part of the same breast.
Dense breast tissue
Women with dense breast tissue (as identified on a mammogram) have more glandular tissue and less fatty tissue, and thus, a higher risk of breast cancer.
Overweight or obese women
Research in the past has shown that being overweight or obese increases the risk of breast and other cancers.
Lifestyle
Excessive alcohol consumption, lack of physical activity, smoking, and diets high in saturated fats contribute to risk.
Hormonal factors: Women who have not had a full-term pregnancy or have their first child after age 30 have a higher risk of breast cancer compared to women who gave birth before age 30.
Breastfeeding can lower breast cancer risk, especially if a woman breastfeeds for longer than one year.
Women who started menstruating younger than age 12 have a higher risk of breast cancer later in life. The same is true for women who go through menopause when they are older than 55.
Current or recent past users of hormone replacement therapy (HRT) have a higher risk of being diagnosed with breast cancer.
How to self-examine your breasts
The breast changes throughout the menstrual cycle, and it is important to always self-examine at the same time of the month, usually a week after your period, when your breasts are less tender due to fluctuations in hormone levels.
Visual examination – sit or stand, without clothing, in front of a mirror with your arms to your side and look for changes in size, shape, symmetry, puckering and dimpling.
Physical examination – lying down so that your breast tissue spreads out, making it easier to feel, or in the shower, using soap to glide more easily over your breasts:
Use the pads of your three middle fingers, not your fingertips, to examine.
Apply different pressure levels – light to feel the breast tissue closest to the skin, medium to feel deeper, and firm to feel the tissue closest to the chest and ribs.
Use a methodical technique such as beginning near the collarbone, then moving towards the nipples in a clockwork fashion.
Allow enough time, and don’t rush the examination.
Signs to look out for
It’s important to note that many lumps may turn out to be harmless, but all of them must be checked.
Visit your healthcare provider if you notice any of these changes:
Swelling of all or part of the breast.
Skin irritation, dimpling or ridges on the skin.
Nipple pain or the nipple turning inward.
Redness, scaliness or thickening of the nipple or breast skin,
A nipple discharge other than breast milk, or a lump or knot near the underarm area.