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By Dr Dulcy Rakumakoe

Chief Executive Officer at Quadcare | Medical Doctor | Social Entrepreneur & Incubator | Keynote Speaker | Media Personality l EO Diversity Chairperson


Keep your breast healthy

Cancer prognosis is good with early detection. Can occur in both men and women, but is far more common in women.


The incidence of breast cancer among SA women is increasing. It is the most prevalent cancers amongst white and Asian women and the second-most common among black and coloured women. Early detection can lead to effective treatment and a positive prognosis.

There are two main types of breast cancer, ductal carcinoma, which starts in the tubes (ducts) that carry milk from the breast to the nipple and lobular carcinoma, which starts in the parts of the breast, called lobules, which produce milk. In rare cases, breast cancer can start in other areas of the breast. About 90% of patients survive for many years when breast cancer is detected early. Regular self-examination and mammograms are important.

Breast cancer can occur in both men and women but is far more common in women. Substantial support for breast cancer awareness and research funding has helped improve the screening, diagnosis and treatment. If you find a lump or other change in your breast, even if a recent mammogram was normal, make an appointment with your doctor for prompt evaluation. CausesIt’s not clear what causes breast cancer.

According to scientists, it occurs when some breast cells divide more rapidly than healthy cells do and continue to accumulate, forming a lump or mass. The cells may spread (metastasise) through your breast to your lymph nodes or to other parts of your body. Researchers have identified hormonal, lifestyle and environmental factors that may increase your risk.

But it’s not clear why some people who have no risk factors develop cancer, while others with risk factors don’t. It’s likely that breast cancer is caused by a complex interaction of genetic makeup and environment. It is commonly inherited. It is estimated that five to 10% of breast cancers are linked to gene mutations passed through generations.

If you have a strong family history of breast or other cancers, your doctor may recommend a blood test to help identify specific gene mutations.

Risk factors

Having one or even several breast cancer risk factors doesn’t necessarily mean you’ll develop it. The following have been associated with an increased risk of breast cancer:

  • Being female.
  • Age: Your risk of breast cancer increases as you age.
  • Personal history: If you’ve had breast cancer in one breast, you have an increased risk of develop-ing cancer in the other.
  • Family history: If your mother, sister or daughter was diagnosed with breast cancer, particularly at a young age, your risk increases. Still, the majority of people diagnosed with breast cancer have no family history of the disease.
  • Inherited genes: Certain gene mutations can greatly increase your risk of cancer, but don’t make cancer inevitable.
  • Radiation exposure: If you received radiation treatments to your chest as a child or young adult, your risk increases.
  • Obesity.
  • Beginning your period before the age of 12.
  • Beginning menopause at an older age.
  • Having your first child after the age of 30.
  • Having never been pregnant.
  • Postmenopausal hormone therapy: Medications that combine oestrogen and progesterone to treat the signs and symptoms of menopause can increase the risk of breast cancer. This decreases when women stop taking these medications.
  • Drinking alcohol.
  • Not being physically active.
  • Having dense breasts: Dense breasts have more connective tissue than fatty tissue, which can make it hard to see tumours on a mammogram.
  • Taking oral contraceptives (birth control pills): Certain forms of oral contraceptive pills have been found to raise breast cancer risk.
  • Smoking: Smoking causes a number of diseases, including breast cancer in younger, premenopausal women.

Breastfeeding can lower breast cancer risk, especially if a woman breastfeeds for longer than a year.

Diagnosing breast cancer

Breast exam. Your doctor will check both of your breasts and the lymph nodes in your armpits, feeling for lumps and other abnormalities. You can also Google self-examination videos on You-Tube. Know your breasts so you can pick up changes.

Mammogram. An X-ray of the breast is commonly used to screen for breast cancer. If an abnormality is detected, your doctor may recommend a diagnostic mammogram to further evaluate that abnormality.

Breast ultrasound:

Which uses sound waves to produce images of structures deep within the body and can determine whether a new breast lump is a solid mass or a fluid-filled cyst.

Removing a sample of breast cells for testing (biopsy). The only definitive way to make a diagnosis.

Breast magnetic resonance imaging (MRI). An MRI machine uses a magnet and radio waves to create pictures of the interior of your breast. This is the most expensive and is only done rarely.

Stages of breast cancer :

Breast cancer stages range from zero to four with zero indicating cancer that is noninvasive or contained within the milk ducts. Stage four, also called metastatic breast cancer, indicates cancer that has spread to other areas of the body. Your cancer’s stage helps determine your prognosis and the best treatment options.

Complete information may not be available until after you undergo breast cancer surgery. Tests and procedures include: blood tests, such as a complete blood count; mammogram of the other breast; MRI; bone scan; computerised tomography scan and positron emission tomography scan.

Not all women will need all of these tests and procedures. Your doctor will select the appropriate tests based on specific circumstances and taking into account your symptoms.

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