Bulgaria still has no national breast cancer screening programme, even though the disease is the most common cancer among women, doctors warn. Some regions also have no specialists who carry out the more complex tests.
"We badly need a screening programme," Dr Vanya Mitova, head of the breast surgery department at the Prof. Ivan Chernozemski oncology hospital, told BNT. She said doctors are also needed who look specifically for breast cancer.
Early detection gives a woman a chance to live a full life without having her whole breast removed, doctors say. Dr Mitova said women who have breast-conserving surgery, where the breast is kept, live longer and have a better quality of life.
Many women see a doctor only when the tumour is at a very advanced stage. Dr Yoana Milusheva, a trainee doctor at the oncology clinic of Tsaritsa Yoanna – ISUL hospital, said patients outside Sofia and in more remote places find it hard to reach a breast specialist. When the disease is found early, chemotherapy can be avoided, and in most cases it is, she said. She added that this applies to almost every type of cancer.
In Vidin, women pay for check-ups with a breast specialist. Dr Plamenka Tsenkova manages the medical centre in the city. Once a month a breast specialist comes from Sofia and sees about 20 women. He cannot work there under a contract with the National Health Insurance Fund (NZOK), because each breast specialist may hold only two contracts, and he uses them for the hospital and for his private practice in Sofia.
NZOK said it has contracts with medical facilities in every region for breast ultrasound and mammography. Tsvetanka Georgieva, chief expert in the "Methodology of Medical and Dental Activities" directorate at NZOK, explained what the Fund covers at each age. Women aged 30 and over are entitled to a manual breast exam once a year. Between 30 and 50, the Fund pays for a breast ultrasound once every two years, and between 45 and 69 it covers mammography.
In the first 8 months of the year, more than 1.08 million women had the mandatory preventive check-up, NZOK data show. That is about 24,000 more than in the same period of 2025.
A woman who has had breast cancer told BNT she never went for preventive check-ups and was sure she would never get ill. Three years ago she found a lump in her breast herself, after a friend was diagnosed with cancer. Her doctor told her the diagnosis even before the biopsy, and the test confirmed it. There were no metastases, and her treatment was only surgery and radiotherapy.
The Complex Oncology Centre in Burgas announced on 2 October free preventive check-ups for breast cancer throughout the month. They were for women aged 35 to 50 with a family history of the disease, who had to book in advance at the reception desk.
"Cancer can be treated, and to a large extent that depends on us too. Not only on the doctors," the woman said.