Breast cancer is a leading disease faced by South African women with 1 in 29 women diagnosed each year. The good news is that if you detect it in its early stages you have a good chance of fully recovering.

Breast Cancer

Breast cancer is a rare disease among women under 35. Lifetime risks of developing it vary from a low of 1 in 81 in African women to a high of 1 in 13 among white women, which is similar to rates in Western countries. Age and stage at diagnosis vary considerably between the different races and populations living in South Africa.

Many different determinants such as socioeconomic, cultural, geographic accessibility to medical centres with oncology services, availability of traditional healers, and so on affect patients with breast cancer in their decisions to obtain early medical help as well as to refrain from the proposed therapeutic methods (surgery, radiotherapy and chemotherapy).

Several factors have been implicated in the development of breast cancer. Genetic influence alone account for the development of the disease in about 5-8% of cases. The genes BRCA1 and BRCA2 carry an approximately 80% lifetime risk of cancer. Other risk factors include hormonal, early menarche (age at 1^st menstrual period), late menarche, the use of hormonal therapy for more than 10years and the later a person has their first child in life.

Symptoms to Watch Out For

o    Any breast lump which is usually painless

o    A bloody nipple discharge

o    Skin changes such as tethering or nipple eczema

o    Any ulcers or unusual redness around the breast

Treatment Options Available

Surgery remains the cornerstone of breast cancer management. Over the past 25years trials have shown that early excision of the tumour (lumpectomy – surgical removal of the tumour mass) gives as good a long-term result as mastectomy (removal of the entire breast). Conservative breast surgery followed by radiotherapy is now the accepted surgical practice for early breast cancer. In some situations mastectomy is still necessary, for example, a large tumour in a small breast.

Adjuvant or additional therapy is treatment given following complete excision of the tumour in order to improve the prognosis of the patient. It is thought to work by inhibiting the growth of circulating tumour cells at distance sites. In breast cancer the common adjuvant treatments are hormone therapy or chemotherapy.

Following mastectomy, a breast reconstruction can be done either immediately or as a delayed procedure. The aim of breast reconstruction is to restore the patients’ breast shape.

What Can I Do

In order to have a good prognosis with breast cancer, early detection is very important before it spreads. It is thus essential to do Breast Self Examination (BSE) every 7-10 days after your period and have annual mammograms after age 40.

Long-term Prognosis

Education awareness campaigns, uplifting of socioeconomic conditions, access to diagnostic resources and availability of higher standards of health care should be implemented, and must be considered in an attempt to increase early detection of breast cancer and, therefore, improve long-term prognosis and survival.

This is a challenge to be fulfilled mainly in the rural and disadvantaged populations, but campaigns should be extended to all women, irrespective of their race, socioeconomic and cultural status, and place of residence.

Centres for help and support

o    CANSA support groups;

o    General Practitioners;

o    Psychological Services;

o    Local clinics;

o    Pharmacies.