Pink Month should not end with free breast screening

October 30, 2026

5 minutes read

Ama, a 45-year-old market woman with three children, attends a free breast screening exercise at Makola Market in Accra. A health professional finds a lump and gives her a note advising her to report to a hospital for further tests.

She goes home knowing she will need money to pay for those tests. For some women, the journey ends there, largely because of the cost.

Every October, Ghana turns pink. Hospitals, churches, banks and schools organise walks and talks, while free breast screening is advertised across the country. I support all of it.

As a medical doctor, I have had the opportunity to lead and organise several breast cancer screening initiatives. One gap has repeatedly caught my attention. We are often very good at getting women to come for screening. The harder question is what happens after a lump or other abnormality is found.

This year’s World Health Organization theme is “Every story is unique, every journey matters.” It makes me think about the journey that begins after screening.

What happens after a lump is found?

A lump does not necessarily mean that a woman has breast cancer. Many breast lumps are benign, meaning they are not cancerous. However, a new lump or thickening in the breast or armpit, a change in the size or shape of the breast, or a new nipple change, such as pulling inward or bloody discharge, should be assessed by a health professional. A cancerous lump can be painless, so women should not wait for pain before seeking care.

The first step is usually a clinical examination. Depending on the woman’s age, symptoms and examination findings, she may then need an ultrasound or mammogram. A mammogram is an X-ray picture of the breast, while an ultrasound uses sound waves to produce images of the breast.

If the findings are suspicious, the next step may be a biopsy. This involves taking a small sample of tissue, usually with a needle, and sending it to a laboratory. A specialist examines the sample under a microscope to determine whether cancer cells are present.

If cancer is confirmed, further tests help determine its type and whether it has spread. Doctors may examine nearby lymph nodes, including those in the armpit. These small structures are part of the immune system, and breast cancer cells can sometimes spread to them. This information helps doctors determine the stage of the disease and plan treatment.

Broadly, Stages I and II are early-stage cancers, Stage III is locally advanced disease, and Stage IV means the cancer has spread to distant organs. Treatment may involve surgery, chemotherapy, radiotherapy, hormonal treatment or targeted medicines, depending on the individual cancer.

The journey therefore runs from finding a lump to clinical examination, imaging, biopsy, confirmation, staging and treatment. A free screening exercise may take a woman only to the first or second step.

Why does this matter in Ghana?

Worldwide, an estimated 2.4 million women were diagnosed with breast cancer and 694,000 died from the disease in 2024.

In Ghana, estimates for 2024 indicate approximately 5,487 new breast cancer cases and 2,695 deaths. Breast cancer is the most commonly diagnosed cancer among Ghanaian women. These figures are estimates rather than a complete national count, but they demonstrate the scale of the problem.

The bigger concern is the gap between finding a problem and starting treatment.

A study conducted in eight hospitals in the Oti and Volta regions examined the care pathways of 243 women referred for breast biopsy between March 2023 and February 2024. About one in five did not undergo the biopsy. Among the 102 women whose biopsies confirmed cancer, approximately six in ten had Stage III or IV disease, while about six in ten had started treatment. The median time from the first hospital visit to starting treatment was 76 days.

Access to diagnostic equipment is another concern. A nationwide survey conducted between November 2020 and October 2021 found that only 21 of 328 participating hospitals had mammography services on site. At 17 of these hospitals, mammography was not free and cost between GH¢100 and GH¢500 at the time of the survey. These figures describe the situation during the survey period, not necessarily current prices or availability.

What about the cost?

Breast cancer care can become expensive because there are several steps between discovering a lump and completing treatment.

A Ghanaian study of 217 patients estimated the median cost of one year of active breast cancer treatment at approximately GH¢31,021, using 2019 expenditure data. This included medical expenses, transport and income lost by patients and caregivers. About 38 per cent of the overall economic burden came from indirect costs. These are historical estimates, not current treatment prices.

Ghana has policies intended to reduce this burden. The National Health Insurance Scheme covers some breast cancer diagnostic and treatment services, including selected medicines and radiotherapy. However, gaps remain between formal benefits and the services patients can actually access.

The Ghana Medical Trust Fund, established under Act 1144 of 2025, includes breast cancer in its support programme. Eligible patients must meet the programme’s requirements, including Ghanaian citizenship and possession of an active NHIS card. Patient navigators at participating hospitals help patients and their families understand the treatment pathway and navigate care from diagnosis onwards.

What should Pink Month achieve?

We should continue screening, but we must also strengthen what comes after it. Women should seek medical attention promptly when they notice a new lump or other unusual breast changes. They should not wait until October.

Organisations that organise screening should ask one more question: If we find a lump today, who will help this woman take the next step?

Can she access the scan and biopsy? Will she receive her results? If cancer is confirmed, can she access appropriate treatment? Who follows up if she does not return?

These questions are not meant to discourage screening. They are meant to make it more meaningful.

A screening programme should do more than identify a possible problem. It should help connect the woman to the care she needs in a timely manner.

Pink Month should continue, and free screening should continue too. But Pink Month should not end with a free breast screening. Finding the lump is only the beginning.

The real journey starts when we tell a woman: “We found something. Now let us help you find out what it is and, if it is cancer, help you get the care you need.”

BY DR. NICHOLAS ADDAE MENSAH

The writer is a medical doctor, development economist and Health Policy Analyst at International Perspective for Policy & Governance (IPPG).

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