“Earlier detection can give us more treatment options and, in some cases, mean less extensive treatment,” says Dr Fatima Hoosain, a surgeon with a particular interest in breast and thyroid health. “But those clinical benefits are only part of the picture. What matters to the patient is getting back to their life and having more of that life ahead of them.”
Knowing that early detection matters is one thing. Recognising when the message applies to you can be harder. When someone feels well, it can be easy to put off screening or dismiss something unusual. Age can add to that sense of reassurance, particularly when breast cancer is still thought of as something that happens later in life.
But age alone should not provide that reassurance. International research points to a rise in early-onset cancers, including breast cancer.
“Most breast changes are not cancer, so there is no reason to assume the worst when something changes,” says Hoosain. “What matters is having that change properly assessed and understanding what, if anything, needs to happen next.”
Breast cancer can be present before there is anything to see or feel, which is why screening has an important role in early detection. But if something does seem different, even when there appears to be a likely explanation, it should be checked.
For Cape Town artist and entrepreneur Nelia Annandale, there were several reasons not to suspect breast cancer. She felt well. Although breast cancer was in her family, she had tested negative for a BRCA1 mutation. And when she noticed subtle changes in her nipples, she put them down to menopause.
In November 2017, her gynaecologist recommended that she have breast imaging. Further investigation and biopsies followed, and Annandale was diagnosed with primary cancer in both breasts. She had believed that the negative BRCA1 result meant breast cancer was unlikely, but the cancer was already at stage 2. Just over two weeks later, she underwent a bilateral mastectomy. More than eight years later, she remains in remission.
Annandale now knows that a negative BRCA1 result does not mean there is no risk, and that changes in your breasts should always be taken seriously. Her journey through breast cancer also changed her relationship with art.
“One of the first things I did when I could move my arms again was paint,” she says. “I painted my breasts, with a white dove resting on my shoulder, and added the words, ‘It cannot undo joy.’ It gave me a way to work through what had happened and to express things that were difficult to put into words.”
Her work since then has explored breast cancer and survivorship. In Five Moments, five figures represent different experiences following a breast cancer diagnosis, with Annandale represented by the central figure reaching towards the light. At the heart of the painting are the words: “I am alive because of early detection.”
For Annandale, the years since her diagnosis have included becoming a grandmother, travelling, cycling and, after leaving the corporate world in 2023, becoming a full-time artist. “Early detection is not an abstract message to me. It is the reason I have lived these additional years,” she shares.
For Hoosain, Annandale’s story illustrates why the value of early detection cannot be measured in clinical outcomes alone: “When we say early detection saves lives, we should also remember what those lives contain. There are families, careers, relationships, plans and ordinary days behind every survival statistic. That is ultimately what we are trying to protect.”
Nelia Annandale’s artwork, together with further stories and information about early detection, can be viewed at: https://www.apffelstaedt-hoosain.com/what-early-detection-saves/
