In my chamber, the women who arrive with a lump in stage I look almost identical to the women who arrive with one in stage III — same age, same family, often the same village. The difference, more often than not, is who reached me sooner. Early detection is not a slogan. It is the single biggest lever we have.
What to look for, in plain language
Once a month, after your period ends, spend three minutes checking your breasts. Stand in front of a mirror, arms relaxed, then arms raised. You are looking for anything new — a lump, a dimple in the skin, a change in shape, nipple discharge that is not milk, or skin that looks orange-peel textured. Then lie down and feel each breast in small circles, working from the outside in.
Most lumps you feel will not be cancer. But every new lump deserves a conversation with a doctor.
When to seek imaging
- Age 20–39: monthly self-exam; clinical breast exam every 1–3 years.
- Age 40 and above: annual mammogram, or ultrasound if breast tissue is dense.
- Any age, any time: if you find a new lump, skin change, or nipple discharge — see a doctor within two weeks. Do not wait it out.
If your mother or sister had breast cancer
Begin annual imaging ten years earlier than the age your relative was diagnosed (so if your sister was 38, start at 28). Ask your doctor whether genetic counselling is appropriate — BRCA testing is increasingly available in Dhaka and Chittagong.
The barriers I see most
Shame, cost, distance, and the belief that "if it is not painful, it cannot be serious." Early breast cancer is almost always painless. Pain is a late sign, not an early one. Please do not let the absence of pain reassure you out of a check.
One last thing
If you take only one thing from this essay: any new lump, in any breast, at any age, deserves a clinical exam within two weeks. Most will be benign. The ones that are not, we can treat — far better when we meet them early.
