Apart from non-melanoma skin cancer, breast cancer is the most common cancer in women of all races, with a lifetime risk of 1 in 27 in South Africa, according to the 2019 National Cancer Registry (NCR).
Both breast and cervical cancer have been identified as a national priority with increasing incidences occurring.
Approximately 19.4 million women aged 15 years and older live at-risk of being diagnosed with breast cancer – the cancer affecting women in South Africa the most. In 2013, deaths from breast cancer and cancers of the female genital tract, accounted for 0.7% and 1% of all deaths in South African respectively.¹
¹Vorobiof D, Sitas F, Vorobiof G. Breast cancer incidence in South Africa. Journal of Clinical Oncology 2001 (September 15 Supplement); Vol 19, No. 18s: 125s -127s
Risk factors: The risk for breast cancer increases as women grow older, but many women under the age of 40 are diagnosed with breast cancer. All women are at risk, and in particular women with a family history of breast cancer. Being overweight, inactive, consuming alcohol, poor dietary habits, smoking and exposure to chemicals also increases risk.
Melissa Willemse: “When it comes to breast cancer age is not a factor. The first doctor I saw immediately dismissed my question about the painful lump under my arm because I was too young for breast cancer. When I eventually went for a second opinion we found out I had stage 3 Triple negative breast cancer. I was 28 the first time and now at 32 I have just finished treatment for a recurrence. My advice is if you feel something is wrong don’t hesitate to get a second opinion. Cancer doesn’t care how old you are.” (cancer Survivor)
Cynthia Erasmus: “Don’t ignore your body if something feels off, no matter how insignificant, like excessive hair fall, nail discolouration, tiredness – this is your body warning you that something is wrong. I had all of these symptoms before I even felt the lump that changed my life. Looking back now I realize that if I had acted sooner, perhaps I could just have had a lumpectomy instead of a double mastectomy.” (cancer Survivor)
Reduce Risk Through Regular Examinations:
Self Breast Examinations
While not all breast lumps indicate cancer, they should be investigated, especially if accompanied by other changes in breasts or the under arm area, such as lumps, texture changes, thickening, dimpling, changes in shape or size of nipples or breasts, tenderness, discharge, rash or swelling, or one breast suddenly being slightly larger than the other.
Research has shown that a regular Breast Self-Examination (BSE), plays an important role in discovering breast cancer, compared to finding a breast lump by chance.
A BSE should be done once a month, preferably at the same time of day, following a woman’s menstrual cycle.
If you feel or see any change in your breasts or underarms, arrange for a Clinical Breast Examination at your local CANSA Care Centre, primary health care centre or health practitioner.
Clinical Breast Examinations
A Clinical Breast Examination (CBE) is a visual and manual examination of the entire breast, from the collarbone to the bra line, and from the armpit to the breast bone. It is advisable to have a CBE as part of your annual medical check up.
Women are entitled to an annual clinical breast examination when visiting primary health care centres (according to the National Department of Health’s Breast Cancer Control Policy).
Contact your local CANSA Care Centre, primary health care centre or health practitioner to arrange for a Clinical Breast Examination.
Ask Care Centre staff about Mobile Health Clinic visits scheduled in your community, especially if you live in a remote area.
Should any abormalities be detected you will be referred for further testing by a medical professional.
Mammograms (a special x-ray to detect lumps in the breast), do not prevent breast cancer, but they can save lives by finding breast cancer as early as possible. Finding breast cancers early with mammography has also meant that many more women being treated for breast cancer are able to keep their breasts. When caught early, localised cancers can be removed without resorting to breast removal (mastectomy).
Women from the age of 40 should go for an annual mammogram, for purposes of non-symptomatic breast screening. Women 55 years and older, should have a mammogram every two years – or if they choose, continue with an annual mammogram. Women, who have other risk factors such as mutated BRCA1 /2 gene, should be referred for an annual mammogram. See CANSA Breast Cancer Position Statement regarding this.
- Our CANSA Care Centres do not offer mammograms, however, women can be screened at public hospital breast clinics if they have a referral letter from a medical professional or CANSA nurse.
- Alternately contact the Radiological Society of SA (RSSA) on 011-794 4395, email: firstname.lastname@example.org or visit www.rssa.co.za, to arrange for a mammogram.
Portia Ntuli: “Drawing from my own experience as a breast cancer survivor, cancer is not necessarily painful and does not always show symptoms. It was during one of my routine mammography tests that a small tumour was detected. Doing breast exams at home was not enough, because the tumour was so small it could not be felt by hand. Those gyne visits are very important. If detected early, it can be treated successfully. Get up and get yourself tested!” (cancer Survivor)
Many women and men overestimate their exposure to ionizing radiation from mammography. Read Fact Sheet Effective Radiation Received from Routine Mammography.
MammaPrint (Genomic Testing)
The MammaPrint test, made by Agendia, is a genomic test that analyses the activity of certain genes in early-stage breast cancer.
Research suggests the MammaPrint Test may eventually be widely used to help make treatment decisions based on the cancer’s risk of coming back (recurrence) within 10 years after diagnosis. MammaPrint Testing can help some breast cancer patients avoid chemotherapy treatment – read MammaPrint Fact Sheet.
Only a licensed healthcare provider (i.e. surgeon, medical oncologist, radiation oncologist, pathologist) can submit an order request for genomic testing.
As long as a woman is in good health and expected to live longer than 10 years, all breast cancer screening should continue.
Symptoms | Risk Factors & Treatment
- Department of Health: Clinical Guidelines for Breast Cancer Control & Management
- Position Statement and Fact Sheet: Breast Cancer (female)
- Fact Sheet: Breast Cancer (male)
- Fact Sheet: Nutrition for Individuals Diagnosed with Breast Cancer
- Leaflet: Your Breast Cancer Risk, Symptoms & Screening: English
- Bookmark: Know the Signs & How to do a Breast Self-Examination
- Booklet: CANSA Detectives – Women’s Pathways to Breast Cancer Diagnosis & Care
- Fact Sheet: Metastatic Breast Cancer
- Fact Sheet: Breast Cancer – Paget’s Disease
- Fact Sheet: Phyllodes Tumours
- Fact Sheet: Herceptin (Trastuzumab)
- Fact Sheet: Breast Cancer, Pregancy & Breastfeeding
- Fact Sheet: Contraceptive Choices and Fertility Options for Women Diagnosed with Breast Cancer
- Link between Breast Cancer and Malignant Melanoma
- CANSA Caution re Preventative Double Mastectomy
CANSA funds research projects at tertiary institutions regarding breast cancer related to screening, improved management, rehabilitation and improved quality of life.
Warning Signs Breast Cancer
Prostheses & Lymphoedema Management
Breast prostheses, mastectomy bras & lymphoedema products may be ordered through our partnership with M Store. Read more…
The breast prostheses, bras and lymphoedema products are covered by medical aid and all administration is done on behalf of the patient. A breast prosthesis & bra package for non-medical aid patients is also available at a reduced cost.
Lymphoedema is a challenging complication of cancer surgery or radiation therapy and is called secondary lymphoedema (lymphoedema occurring at birth due to dysphasia is called primary oedema). It is a common side effect of treatment for women’s cancers, especially Breast Cancer.
It is the accumulation of fluid due to inactive or damaged lymph glands. Lymphoedema causes: Swelling of a body part and usually occurs in the arms or legs, but can also occur in the face, neck, abdomen or genitals. Read more: Lymphoedema Fact Sheet.
Diagnosis & CANSA Support
If you have been diagnosed with breast cancer, please contact your local CANSA Care Centre so that our staff can offer you and your loved ones care & support, including medical equipment hire, wigs, counselling, support groups, online support groups and resources, as well as CANSA Care Homes where patients receiving treatment far from home can stay during treatment.
Staff can also help guide you through the public health care system.
Read the Buddies for Life online lifestyle publication and find tips for breast cancer Survivors.