Pink October: breast health and the latest research

It is not always a lump

Pink October reminds us to pay attention to breast health. The conversation can begin with a small change we have noticed, our family history or a question about when our next check-up is due.

“It is not always a lump.” Changes that deserve attention can also appear in the skin, the shape of the breast or the nipple. Most breast changes are not cancer. A medical assessment helps identify the cause and the appropriate next step.

Changes to discuss with your doctor

Contact your doctor if you notice:

• a lump or thickened area in the breast or under the arm;
• a new change in size or shape;
• unusual dimpling, puckering, redness or swelling of the skin;
• a nipple that has changed direction or has recently turned inward;
• nipple discharge that is not milk, especially if it contains blood;
• breast pain that persists.

A painless change also deserves assessment. Do not wait for a screening invitation or next October to discuss it. Even a recent normal mammogram does not remove the need to assess a new change.

Breast cancer can also occur in men, although much less often. A lump or unusual change also calls for a conversation with a doctor.

Assessment starts with your concern

Your doctor will ask when the change appeared, what you have noticed and about your personal and family history. After examining you, they may request a diagnostic mammogram, an ultrasound or other tests, depending on the situation.

If a finding needs clarification, a biopsy may be needed: taking a sample of tissue to examine in a laboratory. Being referred for additional tests is not in itself a cancer diagnosis. It is important to know who will review your results and what the next step will be.

For guidance within Albania’s public health service, you can start with your family doctor. The Institute of Public Health (ISHP) report describes this contact as part of the assessment and referral pathway. Ask your health centre about the service’s current arrangements and conditions.

When there are no symptoms, we talk about screening

Screening aims to find cancer before it causes symptoms. Mammography is the standard examination for most women in screening programmes. It also has a role in investigating symptoms, but the reason for the examination and the assessment process are different.

The starting age, frequency and need for additional examinations depend on age, risk, personal and family history, and the guidance being followed. Some people at high risk may also be advised to have MRI. An ultrasound or breast self-examination should not, on its own, replace the screening plan agreed with your doctor.

Screening has benefits and limitations. Further tests may be requested for a finding that turns out not to be cancer; a cancer may be found that would not have caused problems during a person’s lifetime; and some cancers may not be visible on the examination. These are reasons for an informed decision and a clear follow-up plan.

Be familiar with what is usual for your breasts. This can help you describe a change, but it does not replace screening when screening is recommended.

Reducing risk in everyday life

Physical activity, maintaining a healthy weight and limiting or avoiding alcohol can lower breast cancer risk. These steps offer no guarantee, and a diagnosis does not mean that someone has done something wrong.

Family history matters, but having no relatives with breast cancer does not rule out risk. When personal history, family history or a known genetic change suggests a high risk, a doctor may discuss specialist assessment and options for reducing risk. Preventive medicines and surgery require an individual assessment of benefits and harms; they are not routine measures for everyone.

What 2025–2026 has brought

Recent studies are helping us understand which examinations different people need and how images can be interpreted more effectively. These advances mainly concern early detection. Prevention aims to reduce the chance of the disease developing; a test that finds more cancers does not in itself demonstrate prevention.

The four developments below were selected from sources published by 4 October 2026. The dates refer to the relevant studies or presentations.

WISDOM and risk-based screening

The US WISDOM study, published online on 12 December 2025, included 28,372 women aged 40–74 with no history of breast cancer. It compared annual screening with a plan that used clinical and genetic factors to tailor examinations.

During a median follow-up of 5.1 years, 21 cancers at stage IIB or higher were recorded among 14,212 participants in the risk-based group, compared with 31 among 14,160 participants in the annual-screening group. The study met its prespecified noninferiority criterion: for this measure of disease stage, risk-based screening was not worse than the comparison approach beyond the margin allowed by the protocol. It was not shown to be better. Fewer mammograms were performed, but biopsies were not significantly reduced.

This supports the study of more personalised plans. It is not advice for readers to reduce the frequency of their examinations themselves; there were few stage IIB-or-higher cancers, and adherence to the plan was incomplete.

MASAI and AI support for radiologists

In January 2026, the Swedish MASAI study reported what happened between two screening rounds as well. The analysis included 105,915 participants and compared reading supported by artificial intelligence with standard reading by two radiologists.

Cancers diagnosed between screening examinations occurred at rates of 1.55 versus 1.76 per 1,000 participants. The difference was not statistically significant. The noninferiority criterion was met, and screening sensitivity was higher with AI, while specificity was the same.

The result is important for how radiologists’ work may be organised. It does not demonstrate a reduction in cancer deaths, and it applies to the system and way of using it that were tested, not automatically to every AI product.

BRAID and additional imaging for dense breasts

The UK BRAID study, published on 21 May 2025, randomised 9,361 women aged 50–70 with dense breasts and negative mammograms. Breast density can make cancer harder to distinguish on a mammogram.

In the interim results from the first round, among women who underwent a supplemental examination, 17.4 cancers were detected per 1,000 examinations with abbreviated MRI, 19.2 with contrast-enhanced mammography and 4.2 with automated ultrasound. The contrast-based methods also led to more recalls for assessment; reactions to contrast agents were reported.

These results do not demonstrate a reduction in mortality and do not establish the extent of overdiagnosis. Choosing an additional examination calls for a discussion of density, risk, benefits and limitations. BRAID provides context from 2025, before Pink October that year.

A vaccine in the early stages of research

An experimental vaccine targeting the protein alpha-lactalbumin was presented with phase 1 results at the SABCS conference on 11 December 2025. The study had 35 participants: most had been treated for triple-negative breast cancer; four were in the prevention group, with genetic risk and a planned risk-reducing mastectomy.

Dose, safety and immune response were studied. Immune responses were observed, but so were grade 3 injection-site reactions. These data do not show that the vaccine prevents cancer, reduces recurrence or extends life. This was a scientific poster and an early clinical study, not a vaccine proven for routine use.

What blood tests can and cannot tell us

Routine blood tests and tumour markers such as CA 15-3 are not routine breast cancer screening tests for people without symptoms. A normal result does not rule out cancer; an elevated value does not prove it.

Certain markers may be used in selected situations in cancer care, as determined by a doctor. This differs from looking for cancer in someone without a diagnosis. New blood tests for detecting several cancers are also being studied for their benefits and limitations. They should not be used as a reason to bypass assessment of a change or recommended screening.

A useful question for any test is: “What are we looking for, and how will the result change the next step?”

A conversation you can start this October

You can bring previous reports and imaging, along with a note about the change you have noticed, to your appointment. Ask:

• Are we assessing a symptom or planning screening?
• How does my personal and family history affect this plan?
• Which examination do you recommend, and why?
• Who will review the result, and when should I take the next step?

Breast care continues throughout the year. October can be a time to start this conversation or make the plan clearer.