Write-up by the Breast Surgical Unit, Korle Bu Teaching Hospital
Breast cancer is the most common cancer that affects women and the most common cause of cancer deaths in Ghana. This cancer is a growth of abnormal cells in the breast and over time, when undetected, these cells could invade nearby healthy breast tissue and the lymph system in the armpit. When the cancer goes undetected and treated for an extended period, it can also spread (metastasize) to other organs such as the lungs, bone, brain and liver.
In Ghana, there were over 2000 cases of breast cancer in 2012. Only one to two percent of breast cancers are found in men. Most of the patients are between 40 and 49 years. The number of women getting breast cancer in Ghana has increased over the years and is expected to rise with changing lifestyles and increased reporting of cases.
The key to successful treatment of breast cancer lies in its early detection but unfortunately, 60 to 70 percent of Ghanaian women report to hospitals in the late stages when the cancer cells may have already spread to other parts of the body. This is what eventually leads to death.
Detection of Breast Cancer
Breast cancer can be cured and controlled but this is only possible when it is detected early through screening. It is important to understand that breast cancer does not usually start with pain, although a persistent pain at the same location should be investigated. The goal of screening tests for breast cancer is to find it before it causes symptoms (like a lump that can be felt). Screening like charity starts at home.
Women must conduct monthly breast self-examinations where the woman checks the breast herself. Doing this on a regular basis makes one familiar with her breast and any changes can be picked up early. A breast self examination is best done after your menstruation using the flat (palmar) surface of the fingers (without the thumb). One should stand in front of a mirror with hands by the side, then lifted up above the head and finally on the hips.
During all these movements, the breast is observed for any changes. Afterwards, one can lie down with one hand under the head and the opposite hand is used to examine the breast by pressing it between the fingers and the chest. Go round the entire breast and into the armpit while doing this. Finally squeeze on the nipple to check for any discharge.
The hands are then changed to examine the other side. Some people prefer to do this examination while taking a shower as it may be easier to feel lumps when the skin is wet. So instead of putting the hand under the head while lying down, it is raised up and put behind neck.
It is critical that every woman be familiar with her breasts and the changes that occur in the breast and armpit area. What to look out for would include a lump in the breast or armpit, change in the skin texture, unexplained change in the size or shape of the breast, dimpling on the breast, change in the direction of the nipple, a rash or sore on the breast, and bloody fluid from the nipple.
It is recommended that women of more than 40 years have a clinical breast examination by a qualified health practitioner every year in women. For women between 20 and 39 years this clinical breast exam must be done every three years. A screening mammogram (X-ray of the breast) should be done every one to two years from the age of 40. This detects very early cancer in the breast before it can be seen or felt. A healthy diet and lifestyle could also reduce the chances of breast cancer.
Treatment of Breast Cancer
Breast cancer is usually treated with a combination of methods; surgery, chemotherapy (cancer medications), radiotherapy (X-ray treatment) and hormonal tablets. Each person will require different combinations in different sequences. The decision as to what to use will be based on the patient, type of breast cancer and the stage of the cancer. The earlier the diagnosis is made, the better the chance of a cure. Early detection and effective treatment is the only cure for breast cancer.
Worldwide this October, in addition to increased awareness of breast cancer, women especially are being encouraged to be vigilant and get screened by a health professional. Take charge of your health by getting your breast screened regularly. If you have a close relative who has had breast cancer you may need a personalised screening plan by a specialist.
Remember, early detection and effective treatment of breast cancer save lives!
