By Joke Kujenya
HEIGHTENED AWARENESS of breast changes remains one of the most effective ways to detect breast cancer early, according to the World Health Organization (WHO).
The agency emphasised that while the disease can affect anyone, specific factors significantly increase the likelihood of developing it.
Women account for about 99 percent of all breast cancer cases, and risk rises with age, particularly after 40 years.
Experts note that factors such as obesity, alcohol and tobacco use, radiation exposure, reproductive history, and hormone therapy can elevate susceptibility.
Additionally, inherited gene mutations such as BRCA1, BRCA2, and PALB2 have been linked to higher risks of breast cancer.
Health professionals highlight that breast cancer is highly curable when detected early through timely diagnosis and appropriate treatment.
WHO also recommends that healthy women aged 50 to 69 undergo regular mammography screening, as it can identify potential cancers before symptoms appear.
During Breast Cancer Awareness Month (BCAM), health authorities are further urging women to pay closer attention to breast changes.
Learning how to perform Breast Self-Examination (BSE) was also being encouraged as part of breast awareness, although the WHO clarifies that it should not replace professional screening.
BSE is described as a monthly routine involving both visual observation and physical touch to check for any lumps or unusual changes.
The procedure helps women become familiar with what is normal for them so that they can promptly recognise abnormalities.
Scientists have also concluded that while BSE does not significantly reduce mortality from breast cancer, it remains valuable in settings where access to regular screening is limited.
The WHO’s cancer control guidance further states that national programmes should not recommend mass screening through self-examination or physical breast checks.
Instead, it should encourage health systems to promote breast awareness and early diagnosis, particularly for women aged 40 to 69 who visit primary healthcare centres or hospitals for other health reasons.
And these women should be offered clinical breast examinations conducted by trained professionals, the WHO stresses.
Proper technique is also critical when performing self-examination; depending on whether looking or feeling, different positions may be adopted.
Just as good lighting and the use of a mirror aid visual inspection, while examinations can be done either sitting or lying down.
The process involves using the pads of the three middle fingers to make small circular motions over the breast area, applying varying pressure levels to feel all layers of tissue.
Women are then advised to cover the entire breast region, from the middle of the armpit to below the breast, across to the breastbone, and back up to the collarbone.
Experts also say that most breast cancers occur in the upper outer quadrant of the breast, making that area particularly important.
The WHO guidance also notes that women who have undergone breast surgery should still examine the entire breast area, including any scars.
Different search patterns such as circular or triangular, may also be used, depending on individual comfort, but comprehensive coverage is essential.
Nipple checks should also be included to observe for discharge, which can sometimes indicate an underlying problem.
While discharge may often be normal, any blood-stained or unusual fluid should be promptly reported to a doctor.
During examination, women should look for specific signs such as new lumps, thickened areas, changes in skin colour or texture, redness, nipple retraction, or puckering.
Persistent pain, new swelling, or discharge also warrant medical attention.
Most breast lumps are discovered by women themselves, often during bathing, underscoring the importance of awareness and familiarity with normal breast appearance.
WHO Pushes for Early Detection and Wider Access to Treatment to Curb Global Breast Cancer Crisis
EMPHATICALLY, the WHO also insisted that breast cancer remains the world’s most common cancer among women — and one of the deadliest.
The health organ actually estimates that the disease caused around 670,000 deaths in 2022, claiming lives in every region and affecting women across all social and economic backgrounds.
Though most cases occur in women, about 0.5 to 1% of breast cancers are also found in men.
In 2022, the WHO notes that 2.3 million women were diagnosed worldwide, with half having no clear risk factor other than being female and over 40.
WHO also reports that breast cancer was the most common cancer in women in 157 of 185 countries, showing how universal the threat has become.
A Growing Global Divide
The WHO says that while breast cancer affects all countries, the risk of dying from it depends largely on where a woman lives.
In nations with a very high Human Development Index (HDI), one in 12 women will be diagnosed in her lifetime, and one in 71 will die from it.
But in low-HDI countries, only one in 27 women is diagnosed, yet one in 48 will die, due to weak health systems, late diagnosis, and limited treatment access.
This stark inequality affirms WHO’s call for stronger cancer control systems that ensure early detection, timely diagnosis, and access to quality care for all women — regardless of geography or income.
How Breast Cancer Develops
Breast cancer begins when abnormal cells grow uncontrollably in the milk ducts or lobules of the breast. The earliest stage, known as in situ, is not life-threatening and can be treated effectively if found early.
But when the cancer spreads to nearby tissue, that is, invasive cancer, it forms tumours that may travel through the bloodstream or lymphatic system to other parts of the body, a process known as metastasis.
If left untreated, metastasis can be fatal. That’s why WHO stresses early diagnosis and comprehensive treatment, which often combine surgery, radiation therapy, and medications such as chemotherapy, hormone therapy, or targeted biological agents.
Who Is At Risk?
The biggest risk factor for breast cancer is being female. Other factors include age, obesity, alcohol consumption, radiation exposure, tobacco use, family history, and postmenopausal hormone therapy.
Still, around half of breast cancer cases occur in women with no identifiable risk factors beyond sex and age.
Certain inherited gene mutations, especially BRCA1, BRCA2, and PALB2, dramatically increase risk.
Women carrying these mutations may consider preventive options, such as surgery or medication to reduce their chances of developing cancer.
Recognising The Signs
In its early stages, breast cancer may cause no symptoms. However, as it progresses, common signs can include:
A new lump or thickened area in the breast or underarm
Changes in the size, shape, or appearance of the breast
Dimpling, redness, or pitting of the skin
A change in the nipple or areola
Abnormal or bloody nipple discharge
Most breast lumps are not cancerous, but any new or unusual lump should be checked by a healthcare professional. Cancerous lumps are more treatable when detected before they spread to the lymph nodes or other organs.
Treatment and Recovery
Breast cancer treatment is determined by how far the cancer has spread and its biological subtype. Surgery may involve removing just the tumour (lumpectomy) or the entire breast (mastectomy), often alongside radiation therapy to kill residual cells.
For hormone-positive cancers, drugs such as tamoxifen or aromatase inhibitors can reduce recurrence risk by nearly half.
Cancers that overexpress the HER2 gene are treated with targeted drugs like trastuzumab, usually combined with chemotherapy.
WHO emphasises that completing the full course of treatment is critical to recovery. Partial or interrupted therapy can lower survival chances and increase recurrence risk.
The Role of Multidisciplinary Care
Cancer care goes beyond medical treatment. WHO recommends multidisciplinary support, including nutrition, physical therapy, mental health care, and rehabilitation.
These services help patients regain independence, cope with side effects, and improve their overall quality of life.
Lifestyle support before and during treatment — such as healthy eating, exercise, and emotional counselling — can also improve outcomes, a process known as prehabilitation.
Closing The Survival Gap
In high-income countries, breast cancer deaths have dropped by 40% since the 1980s, thanks to early detection, effective treatments, and strong referral systems.
But millions of women in developing nations still face late diagnosis, long travel distances to treatment centres, and unaffordable care.
WHO says strengthening primary healthcare, ensuring referral pathways, and making essential medicines widely available will not only save lives but also improve treatment for other cancers such as cervical, colorectal, and prostate cancers.
Global Effort for Change
In 2021, WHO launched the Global Breast Cancer Initiative (GBCI), bringing together governments, health organisations, and civil society to reduce breast cancer deaths by 2.5% per year — a goal that could save 2.5 million lives by 2040.
The initiative focuses on three main pillars:
Health promotion for early detection and awareness.
Timely diagnosis through improved access to screening and pathology services.
Comprehensive management to ensure effective treatment, rehabilitation, and palliative care.
The WHO says that even in the absence of advanced screening technologies, public education — helping women recognise early symptoms and seek medical care promptly — can significantly reduce deaths.
“When women know the signs and can access timely care, breast cancer becomes one of the most treatable cancers,” the agency noted. “Awareness saves lives.”
