Breast Cancer: What Women Should Know.

From relative obscurity, breast cancer has become one of the leading causes of deaths among women in the world. According to the World Health Organisation, Uganda recorded 2,318 cases of breast cancer were reported in 2018, making it the third leading cause of cancer deaths coming next to cancer of the cervix and Kaposi’s sarcoma (cancer that forms in the lining of blood and lymph vessels). Despite growing efforts to improve awareness and early detection in the country, over 89% of breast cancer patients present with late-stage disease.

But what is breast cancer and what are the risk factors?

We had a chat with Dr Priscilla Apolot, a practitioner with Rocket Health, who responded to frequently asked questions about the disease and here is what she had to say.

Breast cancer is a disease in which cells in the breast grow out of control. It can occur in both men and women but is more common in women. The most common risk factor leading to the development of breast cancer is age. People at age of 50 and above are more likely to develop it.

Other factors include;

• Genetic mutations: Inheritance of certain genes (BRCA1 AND BRCA2) puts a lot of women at risk of developing both breast and ovarian cancer.
• Reproductive history: When a woman starts her menstrual period before the age of 12 and gets menopause after the age of 55, the risk of developing breast cancer is high due to the prolonged exposure to hormones.
• History of breast cancer or non-cancerous breast diseases.
• Family history of breast or ovarian cancer
• Radiation therapy: Previous treatment using radiation therapy to the chest especially before the age of 30 increases one’s risk.

Modifiable factors

• Being physically inactive
• Being overweight or obese after menopause
• Taking hormonal treatment for hormone replacement therapy or contraception
• Reproductive history: Having a first pregnancy after 30, not breastfeeding and never having a full-term pregnancy
• Alcohol consumption and smoking

How does family history place one at risk of contracting breast cancer?

Family members may share genes, patterns, and environments that can affect the risk of getting cancer. The Inheritance of BRCA1 and BRCA2 gene mutations increases the risk of breast cancer among women. If a woman has had a first-degree relative (mother, sister, daughter or male relative) or multiple relatives on either her maternal or paternal side, the risk is higher.

Where does breast cancer spread first?

If cancer starts in one breast and is undetected, it can easily spread to the axillary and internal mammary lymph nodes and cross over to the other breast.

What are the signs that breast cancer has spread?

One of the first signs or symptoms of breast cancer is a lump in the breast or underarm. Other signs include;

• Cysts/sacs of fluid in the breast tissue causing a feel of lumpiness.
• Thickening or swelling of part of the breast.
• Irritation or dimpling of breast skin.
• Redness or flaky skin in the nipple or breast area.
• Inverted nipple or pain around the nipple area.
• Nipple discharge other than breast milk.
• A change in the size or shape of the breast.
• Pain in any area of the breast.

If you have found that you have any of the above symptoms kindly seek medical attention right away.

Can a healthy diet help to prevent breast cancer? What foods do you recommend? What foods should I avoid?

There is no particular diet that one can follow to prevent breast cancer but one’s dietary choices can make a difference in increasing or decreasing the risk of getting the disease.

We recommend high fibre foods such as whole grains and legumes, fruits, vegetables, low dairy products and soybean-based products.

Foods that are likely to increase the risk of developing breast cancer include alcohol, added sugar, fat, red meat and processed foods.

Can breastfeeding reduce the chances of contracting breast cancer?

Yes, breastfeeding not only reduces the risk of breast cancer but also ovarian cancer. The act of breastfeeding delays the onset of menstruation after childbirth which makes the mother less exposed to hormones which increase the risk of breast cancer.

Can physical activity reduce the risk of breast cancer?

Yes, it does! Regular physical activity reduces one’s risk of becoming obese, a known risk factor for breast cancer. It is important that one maintains a healthy weight and engages in regular moderate or vigorous exercise to protect themselves from breast cancer. Research has shown that women who work out for 4 hours a week have a lower risk of getting breast cancer.

When and how often should I do a breast cancer check-up?

It is advisable that women in their 20’s and 30’s get a breast exam every 3 years and once every year when they turn 40. However, if you realize any breast changes, contact your health care provider immediately. You’re better safe than sorry!

What treatment options are available if one gets breast cancer?

If one gets breast cancer, the doctors will make treatment recommendations based on the stage of cancer. The standard treatment options may include;

• Surgery: Breast surgery can be either a lumpectomy, where the tumour is removed or a partial or modified radical mastectomy. With a lumpectomy, it is typically followed by radiation.
• Chemotherapy: Chemo is a means of treating cancer systemically and is typically recommended for those whose tumour is larger than a certain size or the cancer has spread to the lymph nodes. The thinking is that if the cancer has had the opportunity to access the rest of your body, the treatment should be systemic as well.
• Radiation therapy: Radiation therapy is typically a localized treatment option, where rapidly dividing cells are damaged. Cancer cells are very rapid dividers, so radiation is an effective option. Typically, radiation therapy is given for about six weeks, five days a week.
• Hormonal therapy: Many breast cancers are hormone-dependent. In these cancers, there are receptors on the tumour that can be filled with estrogen. The thinking is that when estrogen fills these receptors, it causes the tumour to grow. This is called estrogen-receptor-positive (ER). These cancers respond well to hormone therapy and the hormone therapy drug that will be recommended for you will depend on your menopausal status.

What are the possible side effects of cancer treatment?

• Weight loss
• Hair loss
• Radiation exposure can increase for risk for other cancers to develop.

Does Rocket Health do Breast Cancer Screening?

Rocket Health offers breast physical examinations at the clinic, 7 days a week. During the examination, our medical practitioner will give you various options for breast-care and a session on how to carry out a self-examination.

Breast Physical Examination

Self-examination of the breasts should be the main priority for every woman. If caught in the early stages of growth, you can fight the disease with the help of today’s modern medicine and technology. But once it spreads, then the breast cancer becomes a battlefield leaving you fighting for survival.

Early detection can stop this war.

Authors: Dr Priscilla Apolot and Sandra Arinaitwe