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By Dr T W Ngwenya Changamire
While breast cancer awareness month ended in the month of October – nonetheless the fight to end breast cancer still continues – and the need to raise awareness on the importance of breast cancer screening remains pivotal in the fight to detect breast cancer early and save lives.
Cancer is a condition where cells in the body begin to grow and replicate rapidly. This abnormal growth in cells can affect any part of the body. The normal process of replication entails that cells undergoing replication should go through certain checkpoints.
These checkpoints ensure that cells replicate correctly to produce normal functioning cells. When these checkpoints fail, cells begin to replicate in a disorganised manner leading to cancer. These “checkpoints” fail as a result of genetic mutation in that particular cell, as we continue to age these genetic mutations are common. Breast cancer is an abnormal growth of cells in the breast tissue.
The breast tissue itself has milk producing glands, ducts or passages where the milk drains to the nipple, connective tissue and fatty tissue. Breast cancer usually begins in the milk producing glands or the ducts and then invades the surrounding fatty tissues and connective tissues.
It continues to spread and extend to the lymph nodes that surround the breast and these are found under the armpits. This knowledge is crucial because it explains why self-breast examination and clinical breast examination includes the breast itself and the armpits.
Risk factors for development of breast cancer include inactivity, poor eating habits, smoking, alcohol use, exposure to radiation, being pregnant with your first child after 30 or never being pregnant and postmenopausal hormonal therapy. These are referred to as modifiable risk factors. Non modifiable risk factors include being female, above the age 40, family history of breast cancer, personal history of breast cancer, early menses before the age of 12 and late menopause.
It’s important to understand that attending to the modifiable risk factors alone such as eating healthy, exercising five times a week, cutting out alcohol and cutting out smoking will not necessarily remove all risk for developing breast cancer. While it is important to take measures on reducing the risk of breast cancer by observing the lifestyle measures advised it is just as important to go for screening because of the genetic risk that is still present.
Breast cancer affects both men and women. It is the leading cause of cancer in South African women and the second leading cancer in women in Zimbabwe
Signs and symptoms of breast cancer include a mass or a lump in the breast, change in the size, colour or appearance of the breast which may include dimpling of the breast, change in the structure of the nipple, peeling, scaling, crusting or flaking or rash developing over the of the areola which is the pigmented area around the nipple.
Other symptoms to look out for include swelling of the arm or swelling or lump in the armpit. Once you see these changes visit a doctor for a thorough clinical breast examination and referral to an ultrasound scan or mammogram depending on how old you are, your doctor will advise.
Breast cancer screening involves monthly self-breast examinations, annual clinical breast examinations and yearly or 2 yearly imaging studies depending on the age or individual risk. To be able to identify changes to the breast one has to practise regular self-breast examination. This is done monthly, usually about 1 week after your menses.
Self-breast examinations include inspection of the breast while standing in front of a mirror initially with hands down and then holding hands to hips. You then proceed to feel your breast either in a circular motion going outwards to inwards going towards the nipple or in a sequential way going up and down the breast with your fingertips, then lastly feel the area under the armpits for any lumps or bumps.
Then you lie down on the bed, back flat and repeat the examination of your breast trying to feel for any abnormalities. These monthly examinations are important and this is why it is said that prevention of breast cancer lies in your hands, literally.
Imaging studies may either be ultrasound scan of the breast usually offered to women under the age of 35, or mammogram study offered to women above the age of 35. The intervals between the scans is dependent on age and the individual risk and indicated earlier. If your GP thinks that there is need to screen you regularly then your scans will be scheduled every year. Imaging is important because in some cases the breast lumps are too small to be identified by palpation. Imaging enables us to identify these lesions.
If a lump is felt or is detected or confirmed on imaging studies a patient is referred to a breast surgeon who will biopsy that lesion, a biopsy will confirm whether the lesion is cancerous or non-cancerous (benign).
Breast cancer treatment is individualised. This means that the treatment options offered to you will take into consideration the type of breast cancer, how far it has spread and the underlying conditions of the patient. It often involves more than one type of treatment modality. Treatment modalities include surgery where the growth or entire breast tissue is removed, chemotherapy which is the use of drugs to kill and shrink the tumour, hormonal therapy which blocks the cancer cells from getting the hormones required to grow and radiation therapy which is also used to kill and shrink the size of the tumour.
Contact All In 4 Health – Dr TW Ngwenya Changamire – for General Medical Consultation, Health Screening, Medical Check-up, Health Education and Promotion. The Glen Marais Shopping Centre, 57 Veld Street, Glen Marais, Kempton park 1619
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