Breast Cancer No Longer A Disease Of The Elderly

By Dr. Mukuhi Ng’ang’a, Consultant Breast Surgical Oncologist at Aga Khan University Hospital, Nairobi

When many people think of breast cancer, they imagine it as a disease that mostly affects older women.

Yet doctors in sub-Saharan Africa are raising a red flag: more and more younger women are being diagnosed—often much earlier than their counterparts in Western countries.

This troubling trend is not limited to breast cancer alone; other cancers are also appearing more frequently in younger people.

While genetics may play a role, more research is needed to fully understand whether environmental factors, lifestyle, or yet-unidentified risks are driving this pattern.

This shift carries profound implications for how women of all ages should think about their health. The first and most important message is that every woman must know her breasts.

Being familiar with how your breasts normally look and feel can help you quickly notice if something unusual develops—whether it’s a lump, skin dimpling, nipple discharge, or any other change.

For younger women, this awareness is even more vital because routine mammograms are not typically recommended until after age 40. Instead, doctors often rely on ultrasounds, which are better suited for examining younger, denser breast tissue.

Understanding breast density is also key. Simply put, it describes how the breast appears on imaging. Younger women usually have more dense breasts because they contain more milk-producing (glandular) tissue. On a scan, this makes the breast look more solid and compact.

While density doesn’t necessarily increase the risk of cancer, it can make it harder for mammograms to detect problems. That’s why alternative imaging, such as ultrasound or MRI, may be recommended.

For many women, one of the hardest questions is how treatment might affect fertility. Chemotherapy and certain hormonal treatments can temporarily disrupt the release of eggs and, in some cases, have longer-term effects on fertility. While fertility often dips during treatment, many young women have successfully undergone therapy and later had children.

Today, doctors increasingly offer fertility preservation options—such as freezing eggs or embryos before treatment begins—to give women more choices for the future.

Surgery is often one of the first major steps in breast cancer treatment. When the cancer is caught early and remains localized, surgery is typically performed to remove it. If the tumor is small, a lumpectomy (removal of just the lump and some surrounding tissue) may be enough.

For larger tumors, or when cancer involves multiple areas of the breast, a mastectomy (removal of the entire breast) may be recommended. In other cases, doctors may begin with chemotherapy to shrink the tumor, making surgery easier and less invasive.

Surgery can also include removing lymph nodes under the arm to check if the cancer has spread. The timing and type of surgery depend on the stage of the cancer, overall health, and the woman’s preferences, but it remains a critical aspect of breast cancer care.

The decision between a lumpectomy and a mastectomy can be challenging. It depends on factors such as the size and location of the tumor, whether multiple tumors are present, and sometimes, the patient’s own preference.

Both approaches can be highly effective and are often combined with radiation therapy, chemotherapy, or hormone therapy to reduce the chance of recurrence.

One of the most promising advances in modern medicine is the shift toward personalized treatment. In the past, breast cancer was treated as a single disease.

Today, doctors analyze tumors at a genetic and molecular level to determine the best approach for each patient. For example, some cancers are fueled by hormones and respond well to drugs that block estrogen production, while others carry genetic changes that can be treated with targeted therapies.

This precision-based care has significantly improved outcomes—offering women not just longer survival but also better quality of life.

Genetics play an important role in understanding breast cancer risks. Many people have heard of BRCA1 and BRCA2, but these are simply genes we all have. In their normal form, they act like repair workers, fixing broken DNA and preventing cancer from developing.

However, when a mutation occurs in one of these genes, the repair system fails, and the risk of breast and ovarian cancer rises sharply. Women with these faulty genes can face up to a 70% lifetime risk of breast cancer, compared to much lower risk in the general population.

The good news is that genetic testing can identify women who carry these mutations, allowing for closer monitoring and preventive measures.

Life after treatment has also evolved. For women who undergo mastectomy, breast reconstruction can help restore the breast’s shape using either saline or silicone implants, or tissue from another part of the body.

Reconstruction not only aids physical recovery but also plays a powerful role in emotional and psychological healing. Modern breast cancer care focuses not just on survival, but on ensuring women live full, dignified lives after treatment.

Several risk factors can increase the likelihood of developing breast cancer. These include obesity, smoking, heavy alcohol use, long-term hormone replacement therapy after menopause, and even certain herbal treatments containing estrogen-like compounds. However, having a risk factor does not mean a woman will definitely develop cancer—it simply highlights the importance of vigilance and regular checkups.

In Kenya and across much of sub-Saharan Africa, one of the greatest challenges remains late diagnosis. Many women seek medical help only at advanced stages of the disease, when treatment options are limited and survival rates are lower. Barriers include high costs of diagnosis and treatment, fear of the disease, and limited access to specialists and diagnostic tools, especially in remote areas.

Breast cancer is not a death sentence—but it can become deadly if diagnosis is delayed. Early detection, timely treatment, and consistent follow-up are the keys to survival. Go for your screening today and get to know your breasts. When caught early, breast cancer is often treatable, and with modern advances in care, survival and recovery are more possible than ever before.

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