Breast Cancer Awareness Month is observed every October to raise awareness and knowledge about breast cancer. Breast cancer is a disease in which abnormal cells in the breast grow uncontrollably and form tumours. If left untreated, these cells can spread to other parts of the body and become life-threatening.
While breast cancer is serious, it is treatable, especially when detected early. Knowing what signs to look for and seeking help promptly can significantly improve outcomes. We recently spoke with Dr Mayday Fanueli, a surgical registrar at Samoa’s main hospital, Tupua Tamasese Meaole Hospital, to gain a better understanding of the reality of breast cancer in Samoa. Here are 5 key things we learned.
1. Breast cancer is the leading cancer among women in Samoa
Breast cancer is the most common cancer affecting women worldwide, including in Samoa. According to the latest figures from the International Agency for Research on Cancer, breast cancer accounts for 35.9% of all cancer cases among Samoan women.
“We see quite a lot of breast masses that confirm breast cancer. For the past five years, the average is 30 women per year,” explained Dr Fanueli. “The youngest we’ve seen is a 26-year-old, and the oldest we've operated on is an 81-year-old.”
2. Many women are diagnosed at a late stage
Dr Fanueli shared that many women come to the hospital when the disease is already advanced, often at stage 3 or 4. This makes treatment more complex and reduces the chances of recovery.
“They come in already stage 3, meaning that the mass is more than 5 centimetres, or there’s lymph nodes present. And sometimes they come in stage 4, which means it’s already spread to other organs,” said Dr Fanueli. “It really impacts their probability of getting better early, feeling better, and going back to their lives.”
“And that’s why we urge our women to come in earlier than how they are doing now,” she added.
3. Breast cancer may not show symptoms early, that’s why regular self-checks matter
When breast cancer is still in its early stages, women may not experience any noticeable symptoms.
“It’s a silent disease, basically,” Dr Fanueli said. “Breast cancer can be a painless lump, and you can have some subtle changes in the skin.”
Conducting monthly breast self-exams is crucial. When women regularly check their breasts, they become more familiar with their bodies and are more likely to notice any unusual changes. Common symptoms of breast cancer can include a lump or thickening in the breast, changes in breast size or shape, skin dimpling or redness, changes in the nipple or areola, and abnormal or bloody discharge from the nipple.
“I urge every woman in Samoa to do breast self-exam. You can do that every month during your period, during your shower, and if you feel a lump, if you feel any changes, please present to the hospital or any doctor for help,” she emphasized.
For post-menopausal women, choosing a consistent day each month to do the exam can help build the habit and ensure regular checks.
Currently in Samoa there is no formal screening programme, and mammography is not available in public hospitals. This makes self-awareness and early presentation even more critical.
4. Treatment is available in Samoa, with referrals overseas for advanced care
Despite the limitations, Samoa does offer treatment options. The care pathway includes diagnosis, staging scans, counselling, surgery, and hormonal therapy.
“When we get referred anyone with any breast issue, we do a triple assessment whereby we take a full history and examination,” Dr Fanueli explained. “We order ultrasound scan and we do a biopsy to confirm the diagnosis. Once breast cancer is confirmed, we order a CT staging to see how far the disease has gone to. And after that, we do family counselling on the necessary treatments.”
Surgery and hormonal therapy are available locally, and patients needing radiotherapy or chemotherapy are referred overseas. For those with advanced disease, palliative care is also being provided by the Samoa Cancer Society.
5. There is hope but it’s important to act early
Approximately half of breast cancers develop in women who have no identifiable risk factors other than being female and over the age of 40. While some risk factors cannot be changed, other behavioural factors can help reduce the risk, such as maintaining a healthy weight, staying active, and limiting alcohol and tobacco use.
Dr Fanueli emphasized that fear often holds women back from seeking help, and this is why raising awareness and providing accurate information can empower women to overcome their fears and access the support they need.
“People think that if you have cancer, you have a death sentence,” said Dr Fanueli. “But we know, and studies have shown, that cancer can have better prognosis if they’re found early.”
“That’s what we must educate our patients about, that they shouldn’t fear cancer. It’s good that they know so that something can be done early about it,” she added.
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Dr Mayday Fanueli, a surgical registrar at Tupua Tamasese Meaole Hospital and a breast cancer advocate, stresses the importance of early detection and treatment for a better prognosis for Samoan women. Photo: WHO/Faizza Tanggol
Breast cancer remains a serious health concern for women in Samoa, with challenges including late presentation. Women in Samoa have the power to take charge of their own health and well-being. If you are an adult woman, performing monthly breast self-exams and seeking medical advice when changes are noticed can lead to earlier diagnosis and better outcomes. With greater awareness, timely action, and supportive care, more women can live longer, healthier lives.