October is breast cancer awareness month, and thousands of organisations worldwide organise campaigns to highlight the importance of breast cancer awareness and most importantly the benefits that come with early detection. Though management and treatment of cancer techniques have advanced, breast cancer still poses a great burden to society. Medics indicate that breast cancer is one of the most common aggressive cancers in women, and the second main cause of cancer death in women, after lung cancer. Statistics from World Health Organization show that breast cancer is the most frequent cancer among women, impacting 2.1 million women each year and also causes the greatest number of cancer-related deaths among women. In 2018, it is estimated that 627,000 women died from breast cancer-that is approximately 15% of all cancer deaths among women. Dr Michael Mugaba a gynecologist at Oshen King Faisal hospital, reveals that breast cancer is a huge issue right now and that the challenge lies with public awareness. People still lack information yet they need this if they are to beat the deadly ailment. “Awareness of the symptoms is very vital; people need to seek screening services as early as possible as a way of reducing risks,” he says. Mugaba warns that if one notices a discharge from the nipple, a sunken nipple or a change in the size or shape of the breast, they need to go for a medical checkup. Other breast cancer symptoms include pain in the breast or armpits, a rash around the nipple and a swollen lump in the breast. Who is at risk? For any patient, understanding the genetics and history is very important, warns Mugaba. People who have had breast cancer before are more likely to have it again, compared to those who have no history of the disease. He also says there are people who have genetic predisposition where cancers run in the family. “There are BRCA1 and BRCA2 genes, these are hereditary and once you have these in your system you are definitely going to have that cancer.” Age is another risk factor as the gynecologist points out. “Is the woman premenopausal? Is she a teenager? This is all very important to consider because the risk increases with age, however we usually start worrying from the age of 35 and above.” Use of family planning is also another risk factor according to Mugaba. He also notes that people who have never given birth, those who start menses so early for example at the age of eight or those who experience late menopause, all of them are at high risk of having breast cancer. Other risk factors include dense breast tissue, obesity, alcohol consumption, estrogen exposure and breast-feeding among other factors. Breast exam Diane Kabarungi a midwife at Oshen King Faisal says since it’s evident that breast cancer cases are rising and that it is upon the public to be aware of this. She hence calls upon people to be alert when it comes to the initial signs by doing a breast self-examination. A breast self-exam is a screening method which helps in early detection of breast cancer and it can be done by both women and men. Kabarungi explains that it can be done from the age of 18 and above, at least once a month. For those who are still menstruating they have to do it one week after their monthly periods because then there will not be hormonal disturbances, she explains. “It can be hard to rule out suspicious swollenness because when a woman is ovulating or in their periods their hormones rise and if you do the test in this period it can be hard to know whether the changes in the breasts are due to menses or not.” She goes on to explain that when one is self examining, they have to stand straight in front of the mirror such that they visualize the breast by checking the size, color and shape to see if there are any changes. “After visualizing, you palpate your breasts when lying or sitting down. Hold up your arm to your head then palpate using the finger pads to rule out anything, you start from the collar bone and reach the arm pit as well because the breast muscles reach there too. Do this in a circular motion down to the lower part of the breast and make sure you cover the whole breast,” she says. Kabarungi says that the advantage of regular checkups is that one can easily notice the changes which can help in early detection. Management of breast cancer Breast cancer treatment is usually dealt with using surgery, chemotherapy and radiation therapy among other medical treatments. Mugaba says when it comes to breast cancer, the right staging helps connect to the right management, otherwise there can be relapses in treatment. “Depending on the stage, we can either do surgery or chemotherapy. Surgery has components; there is the breast sparing surgery where a specific mass is removed by taking out the lesion. There is mastectomy where the entire breast is removed. Most patients who get a mastectomy are those with high risk,” Mugaba says. The medic also notes that for high risk patients who want to reduce the risk of getting the cancer, a risk reduction surgery can be done. With this, the surgeons take out the breasts or ovaries to reduce the risk. Chemotherapy is a type of cancer treatment that uses one or more anti-cancer drugs as part of a standardized chemotherapy regimen whereas radiotherapy is a therapy that uses ionizing radiation, generally as part of cancer treatment to control or kill malignant cells. editorial@newtimes.co.rw
