Reporter
leeanna.maharaj@guardian.co.tt
October, Breast Cancer Awareness Month. was a time to shine a light on the most common cancer affecting women across the globe.
Every minute, four women are diagnosed with breast cancer, and every minute, one woman loses her life to it. That’s the sobering reality from the United Nations’ latest findings.
Here in T&T, the picture is also troubling, with approximately 37 women per 100,000 affected by the disease.
Breast cancer occurs when cells in the breast grow uncontrollably, forming a lump or tumour that may be non-invasive or invasive. Non-invasive cancers remain confined to their place of origin, while invasive cancers spread to surrounding tissues.
The disease is classified by stages (0 to 4), which describe how far it has spread, and by types, based on hormone receptors or HER2 status—factors that help guide treatment.
Despite the statistics, experts stress that a diagnosis does not mean the end of the road. According to the American Cancer Society, when breast cancer is detected early and remains localised, the five-year relative survival rate is 99 per cent.
That’s why screening and early detection remain the most effective tools in saving lives.
In an exclusive interview with Guardian Media, Dr Steven Allen, Consultant Radiologist at The Royal Marsden Hospital in London, underscored this point.
“It’s worthwhile pursuing a screening programme, because if you can get an earlier diagnosis, the clinical outcomes will be much better,” he said. “Even if it’s an aggressive tumour, if you find it early enough, you can be cured. If it’s the other way around, it won’t happen, unfortunately.”
The most common screening tool remains the mammogram.
“Mammography is still the most evidenced screening method for breast cancer diagnosis,” Dr Allen noted. “But it really needs to be done annually—or, worst case, every two years.”
He acknowledged that some women may feel anxious about mammograms, but encouraged them to go through with the test.
“It’s best to have it done, even if you get a recall for something that’s ultimately benign. It could save your life. The worst case is you’ll get an ultrasound, maybe a biopsy that takes five minutes—but if it finds something small and dangerous, you’ll live to fight another day. It’s very rare these days for people to undergo surgery unless it’s cancer.”
For women with dense breast tissue—a condition more common among younger women—MRI screening can provide clearer results.
While breast cancer in younger women is still relatively rare, Dr Allen warned that it is becoming more common.
“When I started my career, it was one in nine or one in ten women. That was about 20 years ago. It’s now one in seven,” he said. “Lifestyle factors are a big part of it—having fewer children, breastfeeding less, having children later, poor diet, lack of exercise, and weight-related issues. Unfortunately, some doctors assume younger women can’t have breast cancer, and that’s a very dangerous mindset.”
He emphasised that women should know their bodies and perform monthly self-examinations, but cautioned against doing them too often.
“You probably don’t need to do it more than once a month. Doing it too frequently isn’t good for your mental health,” he advised. “Use the flat of your hand to check each of the four quadrants of the breast—upper inner, upper outer, lower inner, lower outer—then behind the nipple and under the arm. The whole process should take about 30 seconds on each side.”
Some women, he noted, have discovered serious issues through self-examination alone.
As technology evolves, so do the methods for diagnosis and treatment. Dr Allen says minimally invasive biopsies now allow doctors to detect cancer without major surgery.
“We can now remove small bits of breast tissue—up to two centimetres—to get a therapeutic sample. We can also remove borderline-type lesions that are not cancerous but not definitively benign,” he explained.
Imaging technology is also advancing to make screening faster and more accessible.
“There’s something called a fast MRI. Traditional MRIs can take half an hour to an hour, but research is now showing we can do a ten-minute version. It’s especially useful for women with denser breast tissue or higher risk,” he said.
He added that 3T MRI scanners provide even more detailed imaging.
“They allow us to do functional imaging to assess tumour cellularity—what’s called diffusion imaging—which gives us greater diagnostic accuracy,” he explained.
Looking ahead, Dr Allen believes artificial intelligence (AI) will play a key role in breast cancer detection.
“AI isn’t quite in practice yet, but it’s coming. It’s being trialled in the UK and other countries,” he said. “If an algorithm could even identify 80 per cent of normal scans automatically, it would free radiologists to provide a better service. Results from these studies are expected in the next few years.”
After more than two decades in the field, Dr Allen continues to push the boundaries of innovation—from advanced imaging to AI integration—but his motivation remains deeply personal.
“Finding something small… I feel quite relieved that I found it,” he shared. “I’d feel absolutely terrible if I didn’t. Even after decades of experience, I know I’m just one moment away from not bringing my best game. So I’m always very vigilant.”
