Breast Cancer

Breast cancer starts when cells in the breast grow out of control and form a tumour. It can begin in the milk ducts (ductal carcinoma — the most common type), the lobules that produce milk, or, less often, in other breast tissue. Over time, cancer cells can spread to lymph nodes in the armpit and then to other parts of the body such as the lungs, liver, bones, or brain. Both women and men can develop breast cancer, although it is far more common in women. In Ethiopia, breast cancer is the leading cancer in women and accounts for a significant proportion of all cancer-related hospital admissions.

Many early breast cancers cause no pain at all, which is why regular screening is so important. See a health worker promptly if you notice any of the following:

Diagnosis usually begins with a clinical breast examination by a trained health worker, followed by imaging tests. Ultrasound is widely available in Ethiopia and is the first imaging tool used for a breast lump. Mammography (X-ray of the breast) is used for screening and diagnosis in women over 40. The only definitive way to confirm cancer is a biopsy — a small sample of tissue is removed and examined under a microscope. Results may include hormone receptor status (ER, PR) and HER2 status, which guide treatment decisions.

After diagnosis, doctors determine the stage — how far the cancer has spread. Stage I: Small tumour confined to the breast. Stage II: Tumour is larger or has spread to nearby lymph nodes. Stage III: Cancer has spread to nearby lymph nodes, skin, or chest wall. Stage IV (metastatic): Cancer has spread to distant organs such as lungs, liver, or bones. Staging guides treatment choices and helps predict outcomes. Because most Ethiopian patients present at Stage III or IV, raising awareness for earlier presentation is critical.

Treatment depends on the stage, tumour type, hormone receptor status, and HER2 status, as well as the patient's overall health and preferences. According to NCCN Guidelines, treatment may include one or more of the following:

Cancer treatment can be physically and emotionally demanding. Eating nutritious foods rich in protein, fruits, and vegetables supports recovery. Gentle physical activity such as walking helps reduce fatigue and improve mood. Reach out to family, community support groups, or religious leaders — emotional support matters. Follow-up appointments after treatment are essential to monitor for recurrence. Report any new symptoms — such as bone pain, shortness of breath, or unusual swelling — to your doctor promptly.

No method can prevent breast cancer entirely, but risk can be reduced and early detection greatly improves survival. Recommended actions: perform a monthly breast self-examination 7–10 days after your period starts; have a clinical breast exam at least once a year; avoid prolonged use of combined hormonal contraceptives if there is a strong family history of breast cancer; maintain a healthy weight; limit alcohol consumption; and breastfeed if possible, as breastfeeding is associated with reduced risk.