The Rising Threat of Breast Cancer in Sri Lanka
In Sri Lanka, non-communicable diseases are becoming increasingly prevalent, with cancer standing out as one of the most dangerous health challenges. Among all types of cancer, breast cancer is the most common among women both globally and locally. Every October, the world observes Breast Cancer Awareness Month, also known as Pink Month, which aims to raise awareness and promote early detection of this life-threatening disease.
According to recent data from health officials, approximately 15 women are diagnosed with breast cancer every day in Sri Lanka, and around three women die from the disease daily. In 2022 alone, out of 19,457 cancer cases reported among women, 5,477 were breast cancer cases, accounting for nearly 28% of all female cancer diagnoses. Overall, cancer claims the lives of about 15,245 people each year in Sri Lanka, with breast cancer being responsible for almost 1,000 deaths among women annually.
Early Detection: A Key to Survival
At a recent media conference held at the Health Promotion Bureau, Specialist Surgeon Dr. Kanchana Wijesinghe emphasized the importance of awareness and early detection in combating breast cancer. She explained that while breast cancer is the most common type among women in Sri Lanka, it is highly treatable if detected at an early stage.
Dr. Wijesinghe outlined three key methods for early detection:
- Breast Self-Examination (BSE): Every woman over the age of 20 is encouraged to perform a breast self-examination once a month. This involves two simple steps:
- Observation: Look for changes in size, shape, or skin texture.
- Palpation: Feel for lumps or unusual changes.
Detailed instructions on how to perform BSE correctly are available in the “By You, For You” Breast Cancer Self-Examination Manual, published by the National Cancer Control Program. This manual is available in Sinhala, Tamil, and English, and family health workers can also provide guidance.
- Clinical Breast Examination: Doctors recommend that:
- Women aged 20-40 undergo a clinical breast examination once every three years.
- Women over 40 should have a clinical breast examination once a year.
These exams are conducted by trained health professionals and involve both observation and palpation.
- Mammography Screening: Mammography uses a small amount of x-ray to detect changes in the breast that may not be visible or felt. In Sri Lanka, women aged 50-69 can undergo a mammogram once every two years on request. In many other countries, annual mammograms for women over 50 are recommended.
Understanding Risk Factors
Doctors highlight several factors that increase the risk of developing breast cancer:
- Age: About 50% of breast cancer patients are women over the age of 50.
- Family history and genetic abnormalities.
- Hormonal exposure: Women who reached puberty before age 11, experienced menopause after 55, or have not had children.
- Lifestyle risks: Smoking, alcohol use, and long-term hormone therapy.
- Reproductive history: Women who have not conceived before 30 or who have never had children.
Recognizing Symptoms
Early symptoms of breast cancer include:
- A lump in the breast – the most common early sign.
- Changes in breast shape or size – swelling, shrinkage, or unevenness.
- Skin changes – thickening, redness, dimpling, or puckering of the skin.
- Pain in the breast – persistent discomfort or tenderness.
- Nipple changes – inversion (sinking inward), change in position, or unusual discharge (including blood or clear fluid).
- A lump in the armpit – swelling or nodes under the arm, which may indicate spread to nearby lymph nodes.
Specialist Dr. Budidhika Somawardena from Maharagama Cancer Hospital emphasizes that recognizing these symptoms early and seeking immediate medical help can make the difference between life and death.
Accessing Help and Support
Sri Lanka offers a wide network of free government services for breast cancer screening and treatment. Some of the key facilities include:
- Suwanari Clinics: Nearly 1,200 clinics across the island provide early detection and support services.
- Hospital breast clinics: Surgical clinics in government hospitals offer specialized care.
- Cancer early detection centers: Located in Narahenpita, Ratnapura, Matara, Galle, Jaffna, and Batticaloa – with Narahenpita serving as the main hub.
These centers operate five days a week and offer their services free of charge.
Overcoming Fear and Stigma
One of the greatest barriers doctors face is fear and stigma among women, as many delay treatment due to concerns about having their breast removed. Dr. Wijesinghe addressed this concern directly:
“Some women are afraid of having their breast removed, even when cancer is present. But modern surgery allows us to reconstruct the breast, even if it must be removed. What is important is seeking prompt treatment at the first sign of a change.”
Breast cancer does not have to be a death sentence. With awareness, early detection, and timely medical intervention, women can survive and thrive. The message from Sri Lankan doctors is clear: check yourself, seek help early, and don’t let fear keep you from life-saving treatment.
