Breast cancer, the most prevalent cancer among South African women, is increasingly being detected in women under 40. This trend mirrors global patterns, where younger women are being diagnosed with more aggressive forms of the disease, underscoring the need for early detection and awareness.

A recent study in the United States found that breast cancer is the leading cause of cancer death among women aged 20 to 49 years. Similarly, a South African study reported that the average age of breast cancer diagnosis for women under 40 was 34 years. Across all ages, breast cancer affects 1 in 27 women in South Africa, accounting for 23% of all cancers diagnosed.

The Aggressive Nature of Breast Cancer in Young Women

The Breast Imaging Society of South Africa (BISSA), a sub-specialty group of the Radiological Society of South Africa, warns that young women are more likely to develop breast cancers with aggressive biological characteristics. These cancers often present with larger tumours and more advanced stages of the disease at diagnosis, making early detection vital for improving outcomes.

Dr Peter Schoub, Chair of BISSA, emphasises the importance of early detection through regular self-examinations starting in a woman’s 20s, and annual mammograms from age 40.

"Awareness and education about breast cancer in young women can lead to earlier diagnoses and less invasive treatment options. The growing number of younger women being diagnosed with breast cancer highlights the need to expand awareness campaigns and improve screening programs, especially for those at higher risk," says Dr Schoub.

The Importance of Early Detection

One of the biggest hurdles in South Africa remains the late-stage diagnosis of breast cancer, which severely limits treatment options and reduces survival rates.

"Although most major medical schemes offer complimentary mammogram screenings for women over 40, only about 20% of women take advantage of this service,” says Dr Schoub. "We must also be mindful that breast cancer is increasingly being detected in women in their 30s, who experience more aggressive forms of the disease that can spread rapidly if not detected early.”

Dr Schoub adds that routine self-examinations and clinical breast checks by a healthcare professional at least once a year are essential.

Who is at Risk of Developing Breast Cancer?

Although every woman is potentially at risk of getting breast cancer, certain factors increase the likelihood:

• Age: While breast cancer risk increases with age, 1 out of 8 invasive breast cancers occur in women under 45.
• Family history: Women with close blood relatives who've had breast cancer are at higher risk.
• Personal history: Women with cancer in one breast have a 3-4 times increased risk of developing a new cancer in the other breast or another part of the same breast.
• Dense breast tissue: Identified through mammograms, denser breasts are linked to a higher risk of cancer.
• Lifestyle: Factors such as excessive alcohol consumption, obesity, lack of physical activity, and smoking contribute to risk.
• Hormonal factors: Women who start menstruation before age 12, have children after age 30, or use hormone replacement therapy (HRT) are at a higher risk.

How to Self-Examine Your Breasts

Regular self-examinations can help detect changes early. Here’s how to do it:

1. Visual examination: Look for changes in size, shape, or symmetry in front of a mirror.
2. Physical examination: Use the pads of your fingers to check for lumps, applying different pressure levels (light, medium, and firm) while lying down or in the shower.

Signs to Look Out For

It’s important to see a healthcare provider if you notice any of these signs:

• Swelling of all or part of the breast,
• Skin irritation, dimpling, or ridges,
• Nipple pain or inward turning,
• Redness or thickening of the nipple or breast skin,
• A lump near the underarm.

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