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She said a couple of cases of breast ironing had been reported in Birmingham and London over the past few years, but the prevalence is likely to be far higher.

"People within the practising community know that it is happening, but it is hidden and done at home.

A successful nationwide awareness campaign in schools, churches and across media outlets has drawn attention to the harmful physical and psychological consequences.

However, despite the work of children’s rights activists, 1.3 million girls are still victims of the brutal practice today.

But for Nyuydzewira, even if there is not a clear villain, there is a clear victim.

"The responsibility has to lie with the mother because the girls are still children and they are agreeing to do it out of fear and respect," she said.

"We Africans take our culture everywhere we go, so I am sure it is happening in Britain and America too," said Margaret Nyuydzewira, who was born in Bamenda in northwest Cameroon, where breast ironing is common.

Nyuydzewira co-founded CAWOGIDO, an organization that campaigns against breast ironing in Britain, where 9,600 Cameroonians live according to the last census in 2011.

"Mick-Sophie started developing breasts very early and she was becoming attractive.

The government survey, funded by GIZ, found that a number of respondents had a range of medical problems, including breast cancer.

"We found 20-year-old girls who had already been diagnosed with breast cancer," Ndonko said.

"We don't know if there is a direct link between the practice and cancer, but it certainly raises suspicions." Thirty-two percent of respondents complained about pain in the breasts and 17 percent spoke of cysts and abscesses.

Thirteen percent suffered heaviness of the breasts and eight percent permanent deformation, according to the study The lasting physical scarring and damage can have a long-term psychological impact too, it concluded.