Breast cancer awareness month comes up in October of every year, yet many women still remain unsure of the things they have to do to prevent this disease. This uncertainty has real consequences, because in Nigeria a large number of breast cancers are still diagnosed at a late stage, when treatment is more difficult and outcomes are poorer. Part of the problem is a lack of accurate information, and part of it is a set of long-standing myths that discourage women from examining their breasts or seeking medical help. The good news is that early detection does not depend on expensive equipment or a complicated routine, and it begins with understanding your own body.
To gain a clearer picture, it helps to look at what early detection involves, the myths that stand in its way, and the options available for screening at little or no cost.
Self-checks: know what is normal for you
Many women were taught to perform a strict monthly self-examination. However, health authorities now place greater emphasis on breast self-awareness, which simply means knowing how your breasts normally look and feel so that you can recognise a change quickly. The American Cancer Society stopped recommending routine self-exams for women at average risk some years ago, because they did not clearly help detect more cancers when combined with screening and often caused unnecessary anxiety. Even so, some Nigerian doctors continue to encourage a monthly check about a week after a period, when the breasts are least tender, and the principle behind both approaches is the same: familiarity with your breasts makes any changes easier to notice.
Changes that should prompt a visit to a health worker include a lump or thickening in the breast or armpit, dimpling, redness or cracking of the skin, a nipple that turns inward or produces discharge, a change in the size or shape of one breast, and persistent pain in a single spot. Looking in a mirror and feeling gently with the pads of the fingers, whether lying down or in the shower, is enough to notice most of these.
Myths about lumps that put women at risk
- A lump that does not hurt is nothing to worry about. Many cancerous lumps are painless, which means that the absence of pain offers no reassurance. A painless lump is therefore a reason to seek a check, not to wait and see.
- Every lump is cancer. Most breast lumps are not cancerous, and many turn out to be benign conditions such as cysts. Nevertheless, only a clinician can tell the difference, which is why any new or persistent lump should be examined rather than assumed to be harmless or dangerous.
- Young women do not get breast cancer. Breast cancer is more common with age, but it is not limited to older women. Cancer centres in Nigeria have treated patients as young as 16 or 17, and as such, a young woman who finds a lump should not dismiss it on the basis of her age.
- Breast cancer is a spiritual attack. Breast cancer is a medical condition and requires medical care. As the Nigerian Medical Association has stated, women should continue to pray and attend church, but they should also seek care at a medical facility, since delaying treatment for spiritual reasons is one of the ways cancers are caught too late.
- The breast is a private part and should not be examined. This belief discourages women from checking themselves or being examined by a health worker, and in doing so it contributes directly to late diagnosis. A clinical breast exam is a routine health check, in the same way as having your blood pressure taken.
- Without a family history, there is no risk. Family history does raise the risk, but many women who develop breast cancer have no relative with the disease. Consequently, the absence of a family history should never be treated as protection.
What screening involves and when to begin
Screening means checking for cancer before symptoms appear, and it generally has two parts. The first is a clinical breast exam, in which a trained health worker examines the breasts, and it is recommended at least once a year. The second is a mammogram, which is a breast X-ray. According to the American Cancer Society and the U.S. Preventive Services Task Force, women at average risk should have one every year or every other year beginning at age 40 or 45, while women at higher risk, such as those with a family history, a known genetic mutation or dense breasts, may need to start earlier or have additional imaging. A breast ultrasound is often used for younger women or to investigate a lump, since mammograms are less effective in younger, denser breasts.
Where to get screened without spending a fortune
Cost is one of the main reasons women delay screening, but there are more affordable routes than many realise. Non-governmental organisations run free programmes, and CancerAware Nigeria’s Together For Her project, for instance, offered free mammograms and breast ultrasounds in Lagos and Abuja, with women able to be directed to a participating centre through canceraware.org.ng or the helpline 08094444039. Groups such as the Pink Africa Foundation and cancer centres such as Asi Ukpo in Calabar also run screening outreach, much of it during October. In addition, private facilities often offer awareness-month discounts, as the African Medical Centre of Excellence did last year with 50 percent off mammograms, so it is worth asking hospitals and diagnostic centres near you what they are offering this month.
For women who cannot afford imaging, a clinical breast exam at a primary health centre or hospital is far cheaper and can show whether further tests are needed. Some cancer centres and foundations also assist low-income patients with diagnosis and treatment costs, so it is worth asking about this directly.
Ultimately, early detection is about giving yourself the best possible chance of successful treatment. By knowing your body, setting aside the myths and making use of the affordable options available, every woman can take a step toward catching breast cancer early, when it is most treatable.
