Every October, communities around the country and world come together to commemorate Breast Cancer Awareness Month, which promotes breast cancer awareness, education, screening, fundraising, and more. It is also a time for honouring those who have been treated for breast cancer or are living with metastatic breast cancer.

Pink ribbon

Everywhere you will see trees in different shades of pink. The aim of these thirty-one days is to raise public awareness of the importance of preventing breast cancer, its risks, its warning signs, the steps you can take to safeguard your health and the value of routine screening for the early diagnosis of breast cancer.

The pink ribbon has become the universal symbol of breast cancer, raising awareness and bringing together communities in solidarity. It is more than just a symbol. It stands for hope, unity, and resilience. It reminds us that we are united in this fight, supporting one another through this challenge of breast cancer.

Breast cancer is the second most diagnosed cancer globally. An average of 2.3 million new cases and 458 000 deaths from breast cancer are recorded each year. The incidence among South African women is increasing: It is one of the most common cancers among women in South Africa, with a lifetime risk of 1 in 27, according to the National Cancer Registry (NCR).

Although breast cancer mortality rates have decreased in developed countries due to early screening programmes and modern therapy, in South Africa the majority of women still present with advanced-stage cancers, which has a negative impact on their prognosis. It is the most prevalent cancer amongst white and Asian females, and the second most common cancer among black and coloured females.

Early detection

Social standing, financial ability and level of education do not impact the risk of developing breast cancer. And although male breast cancer is rare – accounting for 1% of all breast cancers – men can also develop breast cancer. 

Early detection can lead to effective treatment and a positive prognosis. When the breast cancer is detected at an early stage, about 90% of patients survive for many years after diagnosis. Regular self-breast examination and mammograms are key to early detection.

Self-examination: All women need to examine their breasts and under-arms regularly (every month). The examination entails a visual and manual examination of the entire breast, from the collarbone to the bra line, and from the armpit to the breastbone. Self-examination can help women detect cysts or other benign breast problems. If you notice any changes in your breast during self-exams, inform your doctor or local clinic. The best time to examine your breasts is just after your period, when they are less tender. If your menstruation is irregular, conduct your self-examination on the same day each month.

Preventative screening: A mammogram is an X-ray examination of the breast to detect and diagnose breast disease, including a tumour that is not yet large enough to be felt. A mammogram serves to detect early warning signals or issues before they escalate.? Women from the age of 40 should go for an annual mammogram. Women 55 years and older should have a mammogram every two years – or, if they choose, continue with an annual mammogram. If you have a strong family history of breast cancer, screening should start even prior to 40, and would require a combination of mammogram and sonar, since the breast tissue is much denser at a younger age. However, a mammogram cannot be used to diagnose breast cancer on its own. In most cases, a biopsy is the only test that can tell for sure whether breast cancer is present.

What each of us can do

Breast Cancer Awareness Month is about demonstrating your commitment to your breast health, encouraging others to do the same, and standing up with those battling breast cancer in unity and compassion. In October, communities come together to share stories, extend a helping hand, and offer support to those in the breast cancer journey, as well as their families.

This awareness also contributes to fundraising, and every cent raised during this month creates hope. These funds channel into research, treatments, and support services – all indispensable in the fight against breast cancer.

This October, we call for unity against an illness that can affect us all. Encourage the people around you to learn more about breast cancer, to go for a check-up, to start doing a monthly breast self-examination, and to schedule regular screenings. May we live all 365 days of the year caring for our health and, as communities, caring for each other.

How to do a breast self-examination:

1. Visual check: Stand in front of a mirror and examine your breasts for anything unusual. Raise one arm behind your head and use the opposite hand to gently feel for lumps in the corresponding breast.
2. Circular motion: Use your fingertips in a circular motion, starting from the outer area and moving toward the nipple. Don't forget to examine your armpit as well.
3. Lying down: Lie flat with one hand behind your head and repeat the examination.
4. Check for nipple discharge: If you're not pregnant or breastfeeding, consult your doctor about nipple discharge, as it could be a sign of infection or cancer.

Signs and symptoms that may indicate breast cancer:

• Most breast cancers present as a lump without pain.
• Thickening in or near the breast or in the underarm area.
• A change in the size or shape of the breast.
• Dimpling in the skin of the breast making it look like the skin of an orange.
• An inverted nipple (nipple turned inward into the breast).
• Bloody discharge from the nipple.
• Skin changes: Scaly, red, or swollen skin on the breast, nipple, or areola (the dark skin around the nipple).
• Changes in how the breast feels (hardness, tenderness, or unusual warmth).

It is important to note that these signs and symptoms can also be caused by other conditions than cancer. Therefore it is important to consult a doctor for an accurate diagnosis.

Risk factors for developing breast cancer:

• Aged above 40.
• Family history of breast cancer.
• Personal history of cancer and have received treatment for it.
• Gave birth to your first child after 30, or have never had children.
• Menstruation before your teens.
• Experienced menopause after the age of 50.
• Long-term hormone replacement therapy.

Other possible risk factors of breast cancer include alcohol and tobacco use, obesity, a diet high in fat, and a lack of physical exercise.

How can the risk for breast cancer be lowered?

• Balanced lifestyle: Be physically active on a regular basis; maintain a healthy weight; and avoid known cancer-causing agents (carcinogens) such as tobacco and alcohol.
• Family history: Find and know as much of your family's medical history as you can; and go for regular health checks and cancer screening.
• Know your body: Be aware of any changes to your body; do regular self-examinations; and get any breast changes checked out by a medical health practitioner.

Institutional experts can be found at: https://www.ufs.ac.za/media/leading-researchers