Breast cancer is the most common cancer affecting women in South Africa — and it’s no longer a disease associated only with older women. Around 1 in 5 breast cancer cases in South Africa occur in women under 40, compared to just 5–7% in high-income countries.
This worrying trend is why the Breast Imaging Society of South Africa (BISSA) is urging women to understand their risk sooner rather than later. While not everyone faces the same level of risk, awareness and early screening can make all the difference.
Understanding Personal Risk
A breast cancer risk assessment uses a statistical model to estimate the likelihood of developing breast cancer within five years and over a lifetime. It considers your medical, reproductive, and family history and is best completed with guidance from a healthcare professional.
Although most cases still occur in postmenopausal women, local studies show that more South African women are being diagnosed younger, with an average diagnosis age of 34 among women under 40. These cases are often more aggressive, underscoring the need for early detection.
Across all ages, 1 in 27 South African women will develop breast cancer, which accounts for 23% of all cancers diagnosed in women.
The Danger of Late Diagnosis
According to Dr Peter Schoub, Chair of BISSA, late diagnosis remains one of the biggest challenges.
“Late diagnosis drastically reduces treatment options and survival rates. Contributing factors include a lack of awareness, not understanding personal risk factors, socioeconomic disparities, and limited access to healthcare facilities,” he says.
Dr Schoub recommends starting self-examinations in your 20s and annual mammograms from age 40.
“Cancers found through routine screening are often smaller and localised, increasing the chances of successful treatment and survival,” he explains. “The tumour size and whether the cancer has spread are key factors in determining prognosis.”
Breast Cancer Doesn’t Discriminate
Even if you feel healthy or lack a family history, breast cancer can still occur. “Although some women are at higher risk than others, breast cancer does not discriminate — anyone can be affected. Any abnormality, regardless of age or family history, should be evaluated by a medical professional immediately,” Dr Schoub warns.
Who’s More at Risk?
While every woman carries some risk, certain factors increase it:
- Age: Risk rises with age, but 1 in 8 invasive breast cancers occur in women under 45.
- Family history: Close relatives with breast cancer increase your risk.
- Personal history: Previous breast cancer raises recurrence risk 3–4 times.
- Dense breast tissue: Harder to detect lumps and linked to higher risk.
- Weight: Being overweight or obese increases risk.
- Lifestyle: Smoking, excessive alcohol, inactivity, and poor diet contribute.
- Hormonal factors: Never being pregnant, having a first child after 30, early menstruation (before 12), or late menopause (after 55) all increase risk.
Breastfeeding for more than a year can help reduce it. Hormone Replacement Therapy (HRT) raises risk.
How to Do a Breast Self-Examination
Knowing how your breasts normally look and feel helps you notice changes early. Aim to self-check once a month, ideally a week after your period when breasts are less tender.
1. Look:
Stand in front of a mirror with arms at your sides. Check for:
- Changes in size or shape
- Dimpling or puckering
- Unevenness or changes in symmetry
2. Feel:
Lying down (to spread tissue) or in the shower (for smooth movement), use the pads of your three middle fingers.
- Use light, medium, and firm pressure to feel different tissue depths.
- Move methodically — circular patterns, lines, or from collarbone to breastbone — to ensure full coverage.
- Take your time.
What to Watch For
Not all lumps are cancerous, but every unusual change needs checking. Look for:
- Swelling in all or part of the breast
- Dimpling or skin thickening
- Nipple inversion or pain
- Redness or rash around the nipple
- Discharge (not breast milk)
- Lumps near the underarm or collarbone
Staying Ahead Through Awareness
While breast cancer remains more common in older women, younger South African women are increasingly at risk. Knowing your risk, performing regular self-checks, and seeking medical advice for any abnormalities are key to early detection — and saving lives.
