It’s October. Let’s talk about your breasts.

Hi friend,

October is Breast Cancer Awareness Month, and you may have seen the carousel I posted on Instagram. This newsletter goes deeper. I spend my days in a cancer research lab, and the biggest gap I see isn’t really a lack of treatments. The issue is that too many women find out too late.

Let’s start with the basics. You need to concentrate on this one.

Your body is made of trillions of cells that grow, divide, and die in an orderly way. Cancer starts when cells in the breast stop following those rules. They keep dividing and build up, often forming a lump. Some cells can break away and travel to other organs like the bones, lungs, or liver. That spread is called metastasis, and it’s what makes cancer dangerous.

Most breast cancers start in the milk ducts (ductal cancer) or in the lobules, the glands that make milk (lobular cancer).

Breast cancer is the most common cancer in women in 157 of 185 countries. Nigeria is no exception. In 2022, Nigeria recorded an estimated 32,278 new cases and 16,332 deaths from breast cancer, and breast cancer was the most common cancer in the country.

The problem isn’t that the disease can’t be beaten. It’s when we find it. Reviews of Nigerian hospital data report that 61–80% of women arrive with stage III or IV disease, which is already too late. Nigerian studies also show that women here tend to be diagnosed younger than women in Europe or North America. In one Nigerian cohort, 54% of patients were under 50.

Timing changes survival. In a large breast cancer database from a Nigerian teaching hospital, women diagnosed at an early stage (I or II) had a much better outlook than those diagnosed at stage III or IV, with survival of 78.6% versus 33.3%. In the United States, where screening is widespread, the five-year survival rate for cancer still confined to the breast is 99%.

After a diagnosis, the tumor is tested, and the result guides treatment. The three main groups are:

This is why two women with “breast cancer” can have very different treatment plans.

The earlier the stage, the more options you have.

Being female and getting older are the strongest risk factors. WHO also lists obesity, harmful alcohol use, family history, past radiation to the chest, reproductive history (when periods started, age at first pregnancy), tobacco, and hormone therapy after menopause. Inherited changes in genes like BRCA1, BRCA2, and PALB2 greatly raise risk [2]. Breast cancer also occurs in men, but rarely, at about 0.5–1% of cases.

Here is the part that surprises people. Roughly half of breast cancers occur in women with no specific risk factor other than being female and older. And most women diagnosed have no known family history. Having no relatives with cancer does not give protection.

Breast cancer most often shows up as a painless lump, but it is not the only sign. See a health professional if you notice the following:

Most breast lumps are not cancer. But you can’t tell by touch, so every new lump needs checking. Please don’t wait it out.

The American Cancer Society no longer recommends formal monthly self-exams as a screening tool for women at average risk, because they haven’t been shown to improve survival. What it does recommend is breast awareness: knowing how your breasts normally look and feel so you notice a change and report it quickly.

A simple way to build that habit is to look in the mirror with your arms down and then raised, then feel each breast and up into the armpit, both standing and lying down. Do it whenever it fits your routine, for example while showering or getting dressed. It doesn’t replace screening.

Treatment depends on the type and stage, and often combines several approaches: surgery (removing the lump or the breast), radiation, chemotherapy, hormone therapy, and targeted therapy. Treatment works better and is better tolerated when started early and completed. In Nigeria, studies point to a second problem alongside late diagnosis: many women can’t access the full set of treatments they need. That’s another reason to act early, while more options are open.

You can’t change your age or genes, but the evidence supports some steps:

None of this guarantees anything. If you get breast cancer, it is never because you did something wrong.

If you have a question, just reply to this email. I read every message.

Take care of yourself,

Cassie
www.healthmartwithcassie.com

This newsletter is for education and doesn’t replace medical advice. If you notice a change in your breasts, please see a healthcare professional.