Breast cancer is the most common cancer in women

Heightened awareness of breast cancer risk in the past decades has led to an increase in the number of women undergoing mammography for screening, leading to detection of cancers in earlier stages and a resultant improvement in survival rates. Still, breast cancer is the most common cause of death in women between the ages of 45 and 55.

The cancer develops in the milk-producing glands in the breast, or in the passages or ducts that deliver milk to the nipples. Some breast cancers may spread into the surrounding tissue, and can spread to other parts of the body.

Symptoms

Women should be "breast aware” through knowing what is normal for them, and looking out for the following symptoms: changes in the size, shape or feel of your breasts; a new lump or thickening in one breast or armpit; any puckering, dimpling or redness of the skin; changes in the position of the nipple, a rash or nipple discharge; and pain or discomfort that is new to you and felt only on one side.

Women should report any signs to their doctor. Nine in ten breast lumps are not cancers, and all of these signs may have other causes. However, it is important that breast cancer is detected early.

Breast screening for the over 50s and breast awareness for all women, offer the best chance of finding breast cancer early.

Causes

The main risk factors include personal previous history of breast cancer, family history of the illness, genetic profile, lack of breast feeding, late first pregnancy, early menarche and late menopause.

Other risk factors include post climacteric hormone replacement therapy, socio-economic status, old age and alcohol consumption.

Doctor Patrick Kalibushi, a gynecologic practitioner in Butare Teaching Hospital (CHUB), says that research carried out at the hospital in the department of gynaecology and obstetrics from 2001 to 2007 showed that the cancer was most common in women of 49.

The problem with many patients is that they report to the doctors belatedly when the symptoms are in their advanced stage.

The doctor also revealed that most of the patients in the case study were affected by the right breast and supero-external quadrant of the breast.
 
Treatment

Staging systems have been developed to allow doctors to characterize the extent to which a particular cancer has spread and to make decisions concerning treatment options.

Doctor Kalibushi explained that breast cancer treatment depends upon many factors, including the type of cancer and the extent to which it has spread.

Treatment options for breast cancer may involve surgery (removal of the cancer alone or, in some cases mastectomy), radiation therapy, hormonal therapy, and chemotherapy.

Surgery: The two most common operations for breast cancer are lumpectomy (surgery to remove the lump and some of the surrounding tissue) and mastectomy (removal of the whole breast).

Radiotherapy: Quite often, women will have a course of radiotherapy starting two to four weeks after lumpectomy. This is to destroy any cancer cells that may still be present. Sometimes, women might also have radiotherapy after mastectomy.

Chemotherapy: Doctors often treat breast cancer with a combination of chemotherapy drugs. Women may receive chemotherapy before or after breast surgery. The doctor can also use chemotherapy to treat cancer that has come back.

Hormone therapy: The female hormone oestrogen is a major factor for the growth of many breast cancers. Hormone therapy lowers the amount of oestrogen in the blood, or blocks oestrogen from stimulating the cancer to grow. Tamoxifen is the most common hormone therapy used.

Doctor Kalibushi explained that with advances in screening, diagnosis, and treatment, the mortality rate for breast cancer has declined by about 20 per cent over the past decade, and research is ongoing to develop even more effective screening and treatment programs.

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