October Was Breast Cancer Awareness Month

By Dr Barbara N.C. Entsuah MBChB MHSc

October is known as breast cancer awareness month in many parts of the world. It is important for all women above the age of 20years to be aware of this disease.

What Is Breast Cancer?

Breast cancer is a disease which results from abnormal multiplication of abnormal breast cells. This may start within the cells in the milk ducts or within the tissues that form the breast. It then can form a tumour or mass and can spread outside the breast to the arm pit and then to other organs. It can occur in both females and males but tends to occur more in women. In the developed countries it is the most common non-skin cancer among women. About 1 in 8 women will receive a diagnosis of breast cancer during her lifetime, and 1 in 30 will die of the disease. Early detection is the key.

What determines a woman’s chances of getting Breast Cancer?

It is not certain what causes breast cancer. Certain factors have been identified which make women more susceptible to breast cancer and these are known as risk factors. A risk factor is anything which will increase your chances of getting a certain disease. However, most women with breast cancer have none of these risk factors, and there are others with the risk factors but do not develop the disease. It is believed that a combination of your genes and environmental factors contribute to the disease. Only 5-10% of breast cancer has been linked to abnormal genes passed down from close relatives, and so just because there is no family history of breast cancer does not exempt anyone from the disease

Main Risk Factors for developing breast cancer.

a) Personal history of breast cancer: higher chance if you have had cancer in a breast

b) Gender: Females are more at risk of developing breast cancer

c) Obesity: Overweight women especially at the waist area are at more risk

d) Family History : You are at increased risk if a mother, daughter or sister has had breast cancer

e) Early age at first menses: If it starts before the age of 12 years

f) Late age of attaining menopause (ending your periods after 55years)

g) Older age: A 70yr old woman has a higher risk than a 40yr old.

h) Long term use of Hormone replacement therapy (female hormones) to relieve postmenopausal symptoms like hot flashes, night sweats etc

i) Late age at having one’s first baby – after 35years

j) Drinking alcohol: 2-5 drinks daily increases risk to 1 1/2x that of non drinkers

k) If you inherit certain defective genes known as BRCA1 and BRACA2 (Breast cancer gene) from your parents. Blood tests are able to detect this and some individuals with a strong family history of breast cancer get tested to see if they carry these genes.

l) Excessive radiation used to treat other conditions or cancers

m) Other cancers in the family – cancers of uterus, cervix, ovaries and colon

Symptoms of breast cancer

These include:

a) A lump in the breast which may or may not be painful

b) Change in the skin over the breast, e.g. a dimple

c) Redness of the skin or nipple, scaling or peeling of the skin

d) Increase in size or change in shape of the breast

e) Bloody or sticky discharge from the nipple

f) Change in shape of nipple e.g. turned inside (inverted) g) A hardened area under the skin of the breast

How can you find Breast Cancer Early?

Finding breast cancer early makes treatment more effective and makes chances of long survival or a cure a possibility. The old adage is that Prevention is better than cure. So it is important to be screened for breast cancer. Screening means you under go a test to detect a disease before it becomes obvious. There are 3 ways to detect breast cancer

(1) Have a mammogram every 1-2 years after the age of 40years. Some authorities suggest about 3 mammograms between the ages of 40-50yrs and then every 1-2 years after age of 50. Others suggest that if a woman has average risk (1-2 risk factors above) then they can start at 50 years. There is no precise age at which to discontinue screening mammography. Some suggest that if an 80year old woman is healthy and has a good quality of life she can continue having mammograms.

(2) Have a doctor/trained medical personnel exam your breasts every one to two years after the age of 20years. If your doctor forgets to do it, remind him or her that you will like to have a breast exam done.

(3) Do self breast exams in the shower or while lying down with your arm above your head once a month –best time to do this is about a week after your period, or choose the same day of the month if you have stopped having periods. Let your doctor teach you how to do this. Once you get used to how your breast feels you will know when a new lump appears. Note that normal breasts may have small lumps in them and are not necessarily abnormal. It is also important to know that not every lump in your breast is cancerous. If you find a lump let your doctor check it for you.

What is a mammogram?

A mammogram is a special kind of X-ray used to detect breast cancer. It can detect a mass about 2 years before it becomes large enough to feel it with your hand. A mammogram is the best way to detect breast cancer. The breast is pressed between a shelf to have the breast pressed so as to get a better picture of the breast tissue. In order to have less discomfort try to have your screening mammogram scheduled shortly after your period then your breasts will be less tender. The discomfort is more about a week before and the machine. It is a little uncomfortable but the process is a short one. It is important your period. Drink plenty of water before the exam. Caffeine has not been found to increase discomfort unless you already have breast tenderness when you drink caffeine containing drinks or eat chocolate. Sometimes after a mammogram, the radiologist may suggest additional views, an ultrasound or even an MRI (all these are other imaging procedures which give them a better look) of the breast in question. Some women refuse to have a mammogram because they say they do not want to know if they have cancer. This is like an ostrich hiding its head in the sand. Once you know you do not have breast cancer, you have your piece of mind, on the other hand, if you are diagnosed with breast cancer, then you can quickly be treated. It is known that screening mammograms lead to reduced deaths from the disease. Husbands encourage your wives to be screened for breast cancer. Early detection leads to less complicated surgeries.

GET SCREENED FOR BREAST CANCER YOUR CHILDREN AND HUSBANDS WANT YOU AROUND FOR A LONG TIME.