Health Talk with Dr Johannes Marisa
It was not long ago when my friend’s 25-year-old sister developed a big mass in the left breast which after biopsy, came to be cancer of the breast.
Further tests showed the cancer was in its last stage after already having spread to the lungs, bones and liver.
That was unfortunate considering her age. The disease has troubled a lot of women especially those who do not go for regular checks.
Breast cancer is the most commonly occurring cancer in women with over two million new cases in 2018, according to the World Health Organisation.
It is estimated that about 600 000 people succumb to this cancer every year.
What is breast cancer?
This is a cancer that forms in the cells of the breasts. It occurs in women and rarely in men. Most breast cancers begin in the ducts or lobules of the breasts. The cancer can spread outside the breasts through blood vessels and lymph vessels. However, most breast lumps are benign and not cancer and they may be fibroadenomas.
It is prudent that women take note of the following symptoms that may be present:
Lump in the breast: The lump feels different from the rest of the breast tissue and more than 80% of breast cancer is discovered when the woman feels a lump. Make sure any lump is investigated, which includes removal and sending for histology.
Fluid coming from the nipple: The discharge may be bloody pus.
Newly-inverted nipple: A nipple which changes position or shape.
Breast tissue: Thickening different from other breast tissue.
Pain: Constant pain from the breast.
Paget’s disease of the breast: This is a syndrome that presents as skin changes resembling eczema, such as redness, discoloration or mild
flaking of the nipple skin. As Paget’s disease of the breast advances, symptoms may include tingling, itching, increased sensitivity,
burning and pain.
*Note well: It doesn’t mean that noticing one symptom means cancer is there, but should be a trigger for speedy examination and
The following factors play a role in the development of breast cancer:
Being female: 99% of all cases occur in women with men contributing less than 1%.
Genetics: 5-10% of all cases of breast cancer are attributed to genetics.
Prior history of breast cancer. Be wary about the cancer again.
Smoking: The risk is 30-50% greater among smokers.
Alcohol drinking: Risk is greatest among heavy drinkers.
Obesity: Obesity that comes with high cholesterol levels increases risk.
Hormone replacement therapy: This is hormone therapy used to treat symptoms associated with menopause. The extended exposure to female hormones like oestrogens can put women at higher risk.
If the following procedures are routinely done, breast cancer may be detected very early and chances of surviving for long are very high.
Breast exam: You can check your own breasts for lumps. Your doctor should check both of your breasts and lymph nodes in your armpit, feeling for any lumps or other abnormalities. Do the examination as often as possible and upon suspicion of anything.
Mammogram: This is an X-ray of the breast. Mammograms are commonly used to screen for breast cancer.
Breast ultrasound: Ultrasound uses sound waves to produce images. The scan can be used to determine whether a new breast lump is a solid mass or a fluid-filled cyst.
Biopsy: Biopsy is the only definitive way to make a diagnosis. Some tissue is sent to the laboratory where pathologists determine whether the cells are cancerous.
Magnetic resonance imaging: Pictures of the interior of the breast are generated and clearer analysis is done.
Once a diagnosis is done, staging of the cancer is done and a lot of other tests are ordered and these include:
Blood tests like FBC, urea and electrolytes.
CT scan of the chest and abdomen
Treatments for breast cancer have often been met with resistance especially by those who are ignorant of the disease. Some patients run away from operations and opt for lots of things. It is wise to follow what your doctors recommend. Some of the treatment modalities include:
Removing the breast cancer in a lump (lumpectomy): The surgeon removes the tumour and a small margin of healthy tissue.
Removing the entire breast (mastectomy): The entire breast is removed.
Removing a limited number of lymph nodes (sentinel node biopsy): Lymph nodes that are the first to receive lymph drainage from your tumour.
Removing several lymph nodes (axillary lymph node dissection).
Removing both breasts: Some women with cancer in one breast can choose the other healthy breast removed if there is higher risk of developing cancer.
Radiation (Kupiswa in Shona): This has always sent shivers among some patients who tend to run away from this procedure for fear of the unknown.
Chemotherapy: Drugs are used to destroy fast developing cells. Sometimes chemotherapy is given after surgery to decrease the chances of cancer recurrence.
Let us be on the lookout for this menacing disease. Tell your friend to get screened today!
Dr Marisa is a medical practitioner who can be accessed on firstname.lastname@example.org.