Breast cancer remains the most common cancer affecting South African women, with younger women increasingly impacted.

According to the Breast Imaging Society of South Africa (BISSA), one in 27 South African women will be diagnosed with breast cancer in their lifetime. In developing countries like South Africa, around 20% of breast cancer cases occur in women under the age of 40, compared to just 5-7% in high-income countries.

A local study found the average age of diagnosis among South African women under 40 was just 34. Alarmingly, these younger patients are often diagnosed with more aggressive forms of the disease.

Dr Peter Schoub, chairperson of BISSA, said one of the biggest challenges in South Africa is the late detection of breast cancer.

“Late-stage diagnosis severely limits treatment options and reduces survival rates. Women need to understand their personal risk and be proactive,” he said.

He stressed that while most breast cancer patients are postmenopausal, there has been a noticeable rise in premenopausal cases.

A breast cancer risk assessment tool can help estimate a woman’s likelihood of developing the disease over the next five years and across her lifetime. These assessments consider medical and reproductive history, along with family background. Results should be discussed with a healthcare provider to determine if earlier or additional screening is required.

“Routine screening increases the chance of early detection,” said Schoub.

“Cancers found this way are usually smaller and have not yet spread, meaning treatment is more likely to succeed.”

He recommended that women begin monthly self-examinations in their 20s and schedule annual mammograms from the age of 40.

“There are various risk factors women need to be aware of. Understanding and monitoring these, alongside routine checks, is key to early intervention and survival.”

Schoub concluded with a warning.

“Although some women are more at risk than others, breast cancer does not discriminate. Any abnormality, regardless of age or family history, should be checked immediately.”
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Who is at higher risk of breast cancer?

While all women face some risk, certain factors can significantly increase the chances of developing breast cancer:

•  Age: Risk increases with age, though one in eight invasive cases are found in women under 45.
•  Family history: Having a close relative with breast cancer raises your risk.
•  Personal history: Previous breast cancer increases the chance of developing it again.
•  Dense breast tissue: Denser tissue (seen on a mammogram) makes cancer harder to detect and more likely to occur.
•  Weight: Being overweight or obese, especially after menopause, raises the risk.
•  Lifestyle choices: Smoking, drinking, inactivity and diets high in saturated fats contribute to higher risk.
• Hormones: Early menstruation (before 12), late menopause (after 55), hormone therapy, never having a full-term pregnancy or first pregnancy after 30 may increase risk. Breastfeeding can lower breast cancer risk, especially if a woman breastfeeds for longer than one year.

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