The Uganda Cancer Institute is recording about 350 new breast cancer cases each year, with specialists warning that some patients still delay seeking medical attention because early signs of the disease may not cause pain.
James Kafeero, an oncologist who heads Clinical Services, Screening and Community Cancer Services at the institute, said improved public awareness was encouraging more women to seek breast examinations, helping health workers identify some cancers before they reach advanced stages.
However, he said many patients continued to arrive for treatment when the disease had progressed, making management more difficult.
Kafeero said the institute also treats breast cancer patients at its main facility in Kampala, while regional cancer centres in Mbarara and Gulu provide care to patients outside the capital.
He attributed part of the increase in cases recorded at the institute to greater awareness and more people seeking medical assessment. Some patients who previously went undiagnosed or sought alternative forms of care are now presenting at health facilities, he said.
The figures he cited cover the institute’s annual caseload and do not, on their own, establish whether breast cancer incidence is rising nationally.
Painless lumps can be an early sign
Kafeero said one of the main obstacles to early diagnosis was the belief that a breast lump was not a cause for concern if it did not hurt.
“Traditionally, we come to the hospital because of pain. So people who have masses in the breast and they’re not painful, they don’t see any reason to seek health care,” he said.
The World Health Organization lists a breast lump or thickening that is often painless among the possible signs of breast cancer. It advises people with an abnormal breast lump to seek medical attention, even when there is no pain. Most breast lumps, however, are not cancerous.
Kafeero said some patients only seek care after a lump becomes painful or other symptoms appear, by which time the disease may have advanced.
“Any mass in the breast needs to be examined and proved cancer unless otherwise,” he said.
Medical assessment is necessary to determine whether a lump is cancerous. Depending on the findings, health workers may recommend imaging tests or a biopsy, in which a tissue sample is examined for signs of cancer.
Early diagnosis remains a priority
Kafeero said breast examinations and increased awareness were helping specialists identify some cases at stages one and two, when treatment outcomes are generally better than for cancers diagnosed at more advanced stages.
He also said breast cancer differs from some infectious diseases because there is no established vaccine to prevent it.
“We can’t vaccinate against breast cancer, so we tend to do early diagnosis and screening,” he said.
The distinction between screening and early diagnosis is important. Screening looks for signs of disease in people who do not have symptoms, while early diagnosis involves recognising possible symptoms and seeking medical assessment without delay. Both form part of the WHO’s approach to reducing deaths from breast cancer.
Kafeero said delays were not always caused by difficulties reaching health facilities but could also result from limited knowledge of the disease’s early signs.
The institute’s annual caseload, together with patients treated at regional centres, points to the need for continued public awareness and timely assessment of unusual breast changes. However, the available figures do not establish the total number of new breast cancer cases across Uganda each year.
