The Breast Imaging Society of South Africa (BISSA) is promoting a risk assessment tool that uses personal and family medical history to help women and their healthcare providers estimate lifetime breast cancer risk and plan for appropriate screening.
South Africa (30 September 2025) – October is Breast Cancer Awareness Month, a time to shine a critical spotlight on the most prevalent cancer among South African women.
In developing countries, like South Africa, 20% of breast cancer cases occur in women under 40, compared to just 5 to 7% in high-income countries.
The Breast Imaging Society of South Africa (BISSA), a sub-speciality group of the Radiological Society of South Africa, is urging women to complete risk assessments from an early age and to realise that some women are at higher risk than others and may need additional screening.
According to BISSA, a breast cancer risk assessment tool is a helpful tool, utilising a statistical model to estimate a woman’s risk of developing breast cancer over the next five years as well as over her lifetime. The tool typically involves several questions about the person’s medical history, reproductive history and family history, and the results should be discussed with a health care professional.
The concerning rise of breast cancer among pre-menopausal women
Although most breast cancer patients are postmenopausal, there has been a growth in premenopausal breast cancer, leading to a younger presentation.
A South African study reported that the average age of breast cancer diagnosis for women under 40 was 34 years and that younger women are diagnosed with more aggressive forms of the disease. Across all ages, breast cancer affects 1 in 27 women in South Africa, accounting for 23% of all cancers diagnosed.
Dr Peter Scoub, Chair of BISSA, says one of the biggest hurdles in South Africa remains the late-stage diagnosis of breast cancer.
“Late diagnosis drastically reduces treatment options and survival rates. Contributing factors include a lack of awareness, not understanding one’s personal risk factors, socioeconomic disparities and limited access to healthcare facilities. Ideally, women should start with self-examinations in their 20s with annual mammograms from the age 40.”
Scoub says the goal of breast cancer screening is to detect the disease before symptoms emerge.
“Cancers found through routine screening are often smaller and localised, increasing the chances of successful treatment and survival. The size of the tumour and whether the cancer has spread are key factors in determining the prognosis.”
“There are several risk factors that women need to be aware. Understanding and monitoring these risk factors, performing routine self-checks and regular screening is the most powerful tool we have to improve survival.”
He added that while some women are at higher risk than others, breast cancer does not discriminate and that any abnormality, regardless of age or family history, should be evaluated by a medical professional immediately.
Who is at risk of developing breast cancer?
Although every woman is potentially at risk of getting breast cancer, certain factors increase the likelihood, including age, family history, personal history, dense breast tissue, hormonal factors, lifestyle habits and being overweight.
How to self-examine your breasts
The breast changes throughout the menstrual cycle, and it is important to always self-examine at the same time of the month, usually a week after your period, when your breasts are less tender due to fluctuations in hormone levels.
Visual examination – sit or stand, without clothing, in front of a mirror with your arms to your side and look for changes in size, shape, symmetry, puckering and dimpling.
Physical examination – lying down so that your breast tissue spreads out, making it easier to feel, or in the shower using soap to glide more easily over your breasts:
- Use the pads of your three middle fingers, not your fingertips, to examine.
- Apply different pressure levels – light to feel the breast tissue closest to the skin, medium to feel deeper, and firm to feel the tissue closest to the chest and ribs.
- Use a methodical technique, such as beginning near the collarbone, then moving towards the nipples, in a clockwork fashion.
- Allow enough time and don’t rush the examination.
Signs to look out for
It’s important to note that many lumps may turn out to be harmless, but it is essential that all of them are checked. Visit your healthcare provider if you notice any of these changes:
- Swelling of all or part of the breast,
- Skin irritation, dimpling or ridges on the skin,
- Nipple pain or the nipple turning inward,
- Redness, scaliness or thickening of the nipple or breast skin,
- A nipple discharges other than breast milk, or
- A lump or knot near the underarm area.
Sources: Supplied
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