THE BURDEN OF BREAST CANCER

Every person affected deserves timely assessment, and appropriate treatment, write CHIMEZIE ANYAKORA and UJUNWA PRINCESS ONYEKABA Every October, breast cancer awareness campaigns bring the disease into public conversation. Communities organize health talks, organizations share educational materials, healthcare professionals encourage people to pay attention to their breast health, and survivors share experiences that help others feel less alone. These efforts matter. But an important question remains: what happens after someone notices a change in their breast? For Bloom Public Health, that question is deeply personal. We have experienced the pain of losing a staff member to breast cancer. Our colleague’s absence is a reminder that this disease is not merely a statistic or an annual campaign topic; it affects real people, families, workplaces and communities. We cannot undo that loss, but we can let it strengthen our commitment to sharing reliable information and encouraging people to seek care without avoidable delay. Awareness can make a difference only when it is connected to timely medical assessment, accurate diagnosis and appropriate treatment. Where these services are difficult to reach, unaffordable or poorly coordinated, awareness alone cannot bridge the gap. The challenge is not simply to tell people that breast cancer exists, but to help ensure that those who need care can obtain it. The World Health Organization (WHO) estimates that approximately 2.4 million women were diagnosed with breast cancer worldwide in 2024, and about 694,000 people died from the disease that year. Breast cancer occurs in countries at every income level, yet inequalities in early diagnosis and access to treatment contribute to very different outcomes. In many settings, substantial barriers remain between noticing a symptom and receiving appropriate care. The burden of breast cancer is also evident at the country level. In Nigeria, the International Agency for Research on Cancer (IARC) estimated 44,196 new breast cancer cases in 2024, making it the most frequently diagnosed cancer among women in the country. In Zambia, an estimated 1,555 new cases occurred in the same year, with breast cancer ranking second among cancers affecting women, after cervical cancer. These figures highlight the importance of country-specific responses that reflect local health needs and the capacity of healthcare systems to provide timely diagnosis and appropriate treatment. Breast cancer does not always cause pain in its early stages. A new lump or thickening in the breast or underarm, a change in breast size or shape, dimpling of the skin, a change in the nipple, or unusual nipple discharge may require medical assessment. Not every breast lump is cancerous, but anyone who notices a new or unusual change should consult a qualified healthcare professional rather than assume it is harmless or wait for pain to develop. Recognizing a symptom is only the beginning. The next steps may depend on the availability and cost of healthcare, distance to a suitable facility, access to diagnostic services and the effectiveness of referral systems. Fear and stigma can also discourage people from seeking care. Some worry about what a diagnosis could mean for their families, livelihoods or finances; others do not know where to go or what to expect. These barriers should not be seen simply as failures of individual awareness. They also reflect the conditions in which people seek care. An effective public health response must do two things: help people recognize when to seek medical attention and ensure that health services can respond when they do. Primary healthcare facilities often provide the first point of contact for people concerned about breast changes. Frontline health workers need the training and support to assess symptoms, explain next steps and refer patients promptly for further investigation. Depending on the findings, diagnostic assessment may involve imaging, tissue sampling and pathological examination. Together, these steps help establish whether cancer is present and inform treatment decisions. When essential services are unavailable, unaffordable or poorly coordinated, patients may face repeated visits, extra expenses and prolonged uncertainty. Delays can also occur when referral arrangements are unclear or patients receive little support in completing the next steps. Stronger links between primary healthcare, diagnostic services and specialist care can make the journey from first concern to diagnosis more reliable. Evidence from Nigeria illustrates the importance of strengthening access to diagnostic services. Early diagnosis matters, but it must lead to appropriate care. Treatment depends on the type and stage of breast cancer and the individual’s circumstances. It may involve surgery, radiotherapy, medicines or a combination of approaches. Many people, particularly those whose cancers are found early and treated appropriately, have better prospects. A breast cancer diagnosis is not automatically a death sentence; patients deserve accurate information, compassionate support and access to suitable care. Early diagnosis and screening are not the same. Early diagnosis focuses on evaluating people who already have symptoms or signs of possible disease. Screening is intended for people who do not have symptoms and should follow appropriate national guidance and individual risk assessment. Anyone who notices a concerning breast change should seek medical evaluation rather than wait for a routine screening appointment. The journey through suspected cancer, diagnosis and treatment can involve several facilities and healthcare professionals. Patient navigation and continuity of care can help people arrange appointments, complete referrals, understand next steps and access practical or emotional support. Care should be organized around the patient’s journey, rather than leaving each person to coordinate every stage alone. Improving breast cancer outcomes requires coordinated action from governments, healthcare institutions, health professionals, development partners and communities. Public health communication can help people recognize symptoms and find reliable information. Healthcare facilities need trained personnel, diagnostic capacity and clear referral pathways. Policymakers must also address affordability, geographic access, treatment availability and systems that show whether patients are reaching the services they need. Families, friends and employers have a role as well. Someone facing a possible cancer diagnosis may be managing fear, uncertainty, financial pressure and concern for loved ones. Support can be practical: accompanying someone to an appointment, helping with daily responsibilities or listening without judgment. No one should be blamed, shamed or isolated because of a cancer diagnosis. For public health organizations, outcomes depend not only on information, but also on whether services are accessible and work together. Strengthening the systems that connect people to qualified healthcare is essential to turning awareness into timely diagnosis and effective care. Breast cancer awareness should not end when October ends or the pink ribbons are put away. Its impact should be seen in everyday conversations, timely medical assessments, effective referrals and sustained efforts to make diagnosis and treatment more accessible. Success should be measured not only by the number of events held or materials distributed, but by whether people know where to seek help and can obtain the care they need. We cannot undo the loss of our colleague, and no campaign can promise that every life will be saved. But we can honor those we have lost by helping others recognize symptoms, share accurate information and seek appropriate medical attention. The pink ribbon can open a conversation; reliable healthcare services must help carry it forward. Breast cancer does not wait for the right moment, for fear to disappear or for life to become less busy. Neither should we wait to take breast health seriously. If you notice an unusual change, seek medical advice. If someone close to you is concerned, encourage them to seek care and offer support. If you can help make credible information or healthcare more accessible, take that opportunity. Every life matters, and every person affected deserves to receive timely assessment and appropriate treatment. Turning awareness into action means making sure that no one is left to navigate the path without reliable information, support or a fair chance of receiving the services they need. Prof. Anyakora is the CEO Bloom Public Health, while Ms Onyekaba is the Special Assistant on Media to the CEO Bloom Public Health