One of the most dangerous misconceptions about breast cancer is that it must hurt, or that there must be a lump
COMMENT | DR ALEESHA ADATIA | Every October, the world is painted pink. The pink ribbon has done a phenomenal job of bringing breast cancer into the public consciousness. In Uganda, we see more women coming into clinics for breast examinations and mammograms during this month than any other time of the year. However, as an oncologist, I often see patients who delayed seeking medical attention because their symptoms or risk factors didn’t align with what they traditionally understood about the disease.
In Uganda, breast cancer is the second most commonly diagnosed cancer among women, with approximately 3,000 new cases estimated in 2022, according to GLOBOCAN.
To truly combat breast cancer, we must move beyond basic awareness and address the critical nuances of this condition that remain dangerously overlooked by many women.
One of the most pervasive myths I encounter is the belief that a cancerous tumour must be painful. When women feel a lump that doesn’t hurt, they often dismiss it as a benign cyst, a swollen gland, or a temporary hormonal change.
Many breast cancers present as a painless lump, particularly in the early stages. However, breast cancer can also be painful or tender. Any new or persistent breast lump, whether painful or not, requires prompt medical assessment. Pain is not a reliable indicator of whether a lump is cancerous.
Public health messaging heavily emphasises finding a “lump,” leading many to incorrectly believe that the absence of a lump means the absence of cancer. However, breast cancer can present in several other, easily overlooked ways.
Skin changes like unexplained redness, flakiness, or dimpling of the breast skin sometimes resembling the pitted peel of an orange can be early indicators of underlying issues. A nipple that suddenly turns inward should never be ignored.
New spontaneous nipple discharge, particularly if it is unilateral, bloody or clear, warrants medical assessment. Any new or unexplained swelling, bulging or change in breast shape or symmetry should also be evaluated.
Many women know to ask about their mother’s or sister’s history with breast cancer. But what about the father’s side? Genetic mutations that significantly increase breast cancer risk, such as pathogenic variants in BRCA1 and BRCA2, can be inherited from the paternal line just as easily as the maternal line.
Furthermore, relying entirely on family history is a flawed strategy. The vast majority of women diagnosed with breast cancer have no known family history of the disease. A clean family tree does not grant immunity.
There is a lingering misconception that breast cancer risk increases with age, younger women can and do develop the disease. Women of every age should be aware of what is normal for their breasts and promptly seek assessment for a new or persistent change. Formal screening should be guided by age and individual risk, with earlier or additional imaging considered for women at increased risk. Young women must be just as vigilant with breast self-awareness and clinical screenings as directed by their physicians.
Finally, an often-overlooked element of breast cancer is the psychological toll of the diagnosis and treatment. The fear of a cancer diagnosis is frequently rooted in the outdated belief that it is an automatic death sentence or that treatment is unbearable.
Today, breast cancer care is advancing rapidly. Treatment may include surgery, radiotherapy, chemotherapy, endocrine therapy, targeted therapy or immunotherapy, depending on the cancer subtype and stage. At C-Care Uganda, our aim is to offer personalised, evidence-based care. Equally important are psychological support, symptom management, supportive and palliative care when needed, and attention to quality of life throughout treatment and beyond.
While Cancer is advancing rapidly, at C-Care Uganda, we provide comprehensive, personalized treatment plans that include the latest chemotherapy and targeted therapy options. But medical intervention is only half the battle. Cancer attacks the mind and spirit as much as the body. Holistic care, including psychosocial support, stress and anxiety management, and even tailored aesthetic advice for skin care post-chemotherapy, plays a crucial role in a patient’s recovery and long-term quality of life.
This Breast Cancer Awareness Month, I urge Ugandan women to commit to true body awareness. Know what is normal for your breasts so that you can recognise what is abnormal. If you notice any changes, do not wait for pain, and do not wait for a lump.
Early detection can significantly improve treatment outcomes. Know your risk, seek medical assessment promptly for breast changes, and speak to a healthcare professional about the screening approach appropriate for your age and individual risk.
“One of the most dangerous misconceptions about breast cancer is that it must hurt, or that there must be a lump.Breast cancer does not always announce itself that way. A new change in the breast, whether it is a lump, skin dimpling, nipple inversion, unexplained discharge or a change in shape, deserves attention. And importantly, having no family history does not mean you are not at risk. Know what is normal for your breasts, know your individual risk, and do not wait for pain before seeking medical advice.”
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Dr Aleesha Adatia is a Medical Oncologist and Palliative Care Specialist and Head of Department, Oncology, at C-Care International Hospital Kampala.
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