By Dr Aleesha Adatia
Every October, the world turns pink to mark Breast Cancer Awareness Month. The pink ribbon has played an important role in raising public awareness about the disease.
In Uganda, more women visit clinics for breast examinations and mammograms during this month than at any other time of the year.
However, as an oncologist, I often see patients who delayed seeking medical attention because their symptoms or risk factors did not match what they understood about breast cancer.
In Uganda, breast cancer is the second most commonly diagnosed cancer among women. According to the International Agency for Research on Cancer’s GLOBOCAN estimates, approximately 3,000 new cases were recorded in 2022.
To tackle breast cancer effectively, we must move beyond basic awareness and address the misconceptions and overlooked signs that can prevent women from seeking timely medical attention.
One of the most persistent myths I encounter is the belief that a cancerous tumour must be painful. When women discover a lump that does not hurt, they may dismiss it as a harmless cyst, a swollen gland or a temporary hormonal change.
Many breast cancers present as painless lumps, particularly in the early stages. However, breast cancer can also cause pain or tenderness.
Any new or persistent breast lump, whether painful or painless, should be assessed promptly by a healthcare professional. Pain alone cannot reliably determine whether a lump is cancerous.
Public health messages often emphasise the importance of identifying a lump. While this is essential, it can leave women believing that the absence of a lump means they do not have breast cancer. In reality, the disease can present in several other ways that are easily overlooked.
Unexplained changes to the skin of the breast, including redness, flaking or dimpling, may indicate an underlying problem.
Dimpling can sometimes give the skin an appearance resembling the surface of an orange. A nipple that suddenly turns inward, particularly when this is a new change, should also be assessed.
New, spontaneous nipple discharge, especially if it comes from one breast or is bloody or clear, warrants medical evaluation. Other changes, including unexplained swelling, bulging, changes in breast shape or new asymmetry, should not be ignored.
Family history is another area where misconceptions can put women at risk. Many women know to ask whether their mother or sister has had breast cancer, but fewer consider their father’s side of the family.
Inherited genetic changes that increase breast cancer risk, including pathogenic variants in the BRCA1 and BRCA2 genes, can be passed down through either parent.
A family history of breast or related cancers on the father’s side can therefore be just as important as one on the mother’s side.
However, relying entirely on family history is also a mistake. Most women diagnosed with breast cancer have no known family history of the disease. Having no affected relatives does not mean a woman is immune to breast cancer.
Another misconception is that breast cancer affects only older women. Although the risk generally increases with age, younger women can also develop the disease.
Women of all ages should understand what is normal for their breasts and seek medical assessment if they notice a new or persistent change.
Screening recommendations should be guided by age, personal risk and family history. Women with an increased risk may need earlier screening or additional imaging, depending on their circumstances.
Younger women should not ignore changes simply because they are below the age at which routine screening is recommended. They should discuss any concerns and their individual screening needs with a healthcare professional.
Beyond the physical effects, breast cancer can take a significant psychological toll. Fear of diagnosis and treatment is often fuelled by the outdated belief that cancer is automatically a death sentence or that treatment is always unbearable.
Breast cancer care has advanced considerably. Depending on the cancer’s type and stage, treatment may include surgery, radiotherapy, chemotherapy, endocrine therapy, targeted therapy or immunotherapy. The appropriate combination varies from patient to patient.
At C-Care Uganda, our aim is to provide personalised, evidence-based care, including appropriate chemotherapy and targeted treatment options. However, medical treatment is only one part of supporting a patient through the disease.
A cancer diagnosis can affect a person’s emotional well-being, relationships, confidence and quality of life. Psychological and social support, management of stress and anxiety, relief from treatment-related symptoms and palliative care when needed are important components of comprehensive cancer care.
Patients may also benefit from practical guidance on managing changes to their skin and appearance during and after treatment. Such support can help them maintain their dignity, confidence and quality of life throughout recovery and beyond.
This Breast Cancer Awareness Month, I urge Ugandan women to commit to knowing their bodies. Understand what is normal for your breasts so that you can recognise when something changes.
Do not wait for pain, and do not assume that you must find a lump before seeking medical attention.
Early diagnosis can improve the chances of successful treatment, although outcomes depend on the type and stage of the cancer and access to appropriate care.
If you notice a new or unexplained breast change, seek medical assessment promptly. Speak to a healthcare professional about your individual risk and the screening approach appropriate for your age and circumstances.
One of the most dangerous misconceptions about breast cancer is that it must hurt or present as a lump. Breast cancer does not always announce itself that way.
A new breast change, whether it is a lump, skin dimpling, nipple inversion, unexplained discharge or a change in shape, deserves attention.
Importantly, having no family history does not mean you are not at risk. Know what is normal for your breasts, understand your individual risk and do not wait for pain before seeking medical advice.
Dr Aleesha Adatia is a medical oncologist and palliative care specialist, and head of the oncology department at C-Care International Hospital Kampala.
