Doctor talks Breast Cancer Awareness

EXCLUSIVE:

With October being Breast Cancer Awareness Month, the Herald spoke to a medical oncologist to find out more about this cancer.

Medical Oncologist at Lenmed Randfontein Private Hospital Dr Dineo Tshabalala, said breast cancer is the most common cancer detected in women worldwide and is the second most common cause of death among women in the world.

“It can start as a new painful lump in the breast; a change in the skin surface of the breast like nipple retraction, redness of the breast skin, unusual bloody discharge from the nipple or sudden itchiness of the breast”.

She explained confirmation of breast cancer is by doing a mammogram in women with older breasts or a ultrasound of the breast in younger women, and a biopsy of the breast mass is done which will be sent to a pathologist to confirm the diagnosis of breast cancer.

There are different types of breast cancer:

• Luminal type breast cancer is the most common diagnosed breast cancer, accounting for 70% of diagnosed breast cancers. Luminal A breast cancer is a type of breast cancer which usually occurs in older females older than the age of 55 years (it’s a very slow growing cancer that takes longer to spread to other organs and is less responsive to chemotherapy). Luminal B breast cancer is a more aggressive type of breast cancer compared to Luminal A and has a propensity to spread to other organs quicker. It can actually present already metastasised “spread “ to other organs. Luminal B breast cancers are more commonly present in younger female patients and has a more aggressive behaviour.

• HER2 positive breast cancer which is an aggressive type of breast cancer, and accounts for 20–25% of breast cancers diagnosed. This type of breast cancer also has a tendency to present already metastasised or has a potential to metastasise or recur once treated.

• Triple negative breast cancer is the most lethal and aggressive type of breast cancer, it accounts for 15% of breast cancers diagnosed. The survival at the moment is very dismal for this type of breast cancer. It presents already metastasised in 70% of patients. It has such an aggressive behaviour that it can even grow and progress on chemotherapy. It commonly presents in young black African women than other nationalities and is associated with the Breast Cancer (BRCA) gene mutation. More work and research needs to be done to better understand this type of breast cancer.

She explained that breast cancer commonly occurs with increasing age, however they are seeing an increased rise in breast cancer occurring in younger female patients. Women 50 years and older are at increased risk of developing breast cancer. However more women younger than 45 are presenting with a diagnosis of breast cancer.

“There are certain risk factors that are leading to earlier presentation of women with breast cancer such as; a family history of breast cancer or other associated cancers; ovarian cancer, pancreas cancer, prostate cancer (these are commonly related to the familial BRCA1/2 gene which is a gene mutation that causes increased risk of developing these cancers in families carrying this gene); conditions that increase inflammation in the body ‘chronic inflammatory state’. Other risk factors are HIV (a lot of young patients that are presenting with breast cancer have HIV infection without a family history of breast cancer or other associated cancer), diabetes and autoimmune conditions. Certain drugs and treatments such as previous chemotherapy, previous radiation to the chest cavity are also risk factors.”

She explained that breast cancer is indeed curable if caught early enough as it can be surgically removed and the patient can be cured of the breast cancer. Breast cancer does not necessarily hurt, however it can be painful depending on the stage of presentation. The inflammatory type of breast cancer tend to present more with a painful breast and any of the aggressive types of breast cancers mentioned above will present as inflammatory type breast cancer.

According to Dr Tshabalala, women should look and monitor their breast daily as the take a shower and examine the breasts for any abnormalities like is the size the same, is the colour the same, is the breast painful to touch, is there a new lump.

How to do a breast self-examination:

• You have to move your four fingers in circular movements dividing the breast into 4 quadrants and feeling for any abnormal mass or pain. It’s also important to feel in the armpits as breast cancer can also start or move to the armpit.

• If there’s any suspicion of an abnormality, the best next step is to present to the primary healthcare facility which will refer you for a mammography or ultrasound of the breast and biopsy to diagnose or exclude breast cancer.

She confirmed that breast cancer can occur in men and commonly these men will come from families with a strong family history of breast or associated familial cancers.

“It accounts for 1% of breast cancer diagnosis in men worldwide. However in central and eastern Africa male breast cancer has a slightly higher occurrence at 5%, this is mainly due to some hereditary syndromes like Klinefelter’s syndrome, other conditions that increase the estrogen level in men.”

Dr Tshabalala stated that regular checking of the breast is important as it can help detect breast cancer early and we know early detection saves lives. Early detection leads to ,cure.