While speedy diagnosis and better treatment have led to a fall in breast cancer mortality rates, being breast aware is essential to enhance your chances for survival. Recently Thumbay Hospital conducted a Pink Drive which highlighted the courageous stories of real life breast cancer survivors from all walks of life. HEALTH takes a closer look at the disease.
BREAST CANCER PREVENTION
Did you know that the incidence of breast cancer is increasing world-wide? Dr. Houriya Kazim, Specialist Breast Surgeon explains that interestingly enough, the more developed countries become, the more breast cancer is seen. “In fact, researchers have reported that in the entire Middle East region, breast cancer occurs 10 years younger than we would expect and the disease tends to be much more aggressive,” she says. “We don’t know the reason for this in spite of doing all the right things to decrease our risk – having babies young, breast-feeding,
not taking Hormone Replacement Therapy and so on.” However, the good news is that even though more breast cancer cases are being diagnosed, more women are surviving. Dr. Kazim points out that around five times more women are diagnosed with breast cancer than die from it. Why it is on the rise, she explains, is probably multi-factorial related to changes in lifestyle, food, environmental toxins, genetics and so forth.
From age 20, women should check their breasts monthly. Checking your breasts for lumps or other changes is called a breast self-exam. Women should do it 5 to10 days after the first day of their period, or those who have passed menopause should do this on the same day each month. Being breast aware means familiarizing yourself with your breasts and the changes they go through during your life. You should know how your breasts look and feel normally so that you can pick up any changes quickly. With a self-exam it is important to feel all around your breasts, including underneath, at the top, around by the collar bone, and under your arms. If you do notice a change in your breasts, try
not to worry but visit your GP as soon as you can. Breast cancer can present in many ways, but it is important to remember that many changes can also be caused by benign (non-cancerous) conditions or normal changes within the breast.
RED FLAGS TO LOOK OUT FOR
• Size – if one breast becomes larger or lower than the other.
• Nipples – if a nipple becomes inverted (pulled in) or changes position or shape.
• Lumpy area or unusual thickening of tissue that doesn’t go after your period
• Rash or crusting of the nipple or surrounding area.
• Discharge from one or both nipples.
• Skin texture – puckering or dimpling.
• Swelling under the armpit or around the collarbone.
• Pain in part of the breast or armpit that is unrelated to periods.
EARLY DIAGNOSIS AND TREATMENT
Dr. Kazim explains that the best early diagnosis for breast cancer nowadays should be a combination of regular breast self-examination, an annual physical check-up by a specialist and thirdly, screening mammograms in women over the age of 40. “Screening means taking a population (in this case, women over the age of 40) with no obvious symptoms of the disease such as no pain, no lump, and no nipple discharge and using various techniques such as clinical examination, mammograms and so forth to pick the disease up at an early and treatable stage,” she explains.
HIGH RISK PATIENTS
Dr. Kazim says that high-risk women include those with a family history of breast or ovarian cancers, especially if the diagnosis was made in the premenopausal years. Also, women with a history of certain types of benign biopsies which are benign but render the patient at risk in the future. Women who have received radiation to their chest for the treatment of lymphoma or tuberculosis are also at high risk. “We design a screening program for these women on an individual basis depending on their age and age of family members at the time of diagnosis,” she says. There are some women who are at higher risk of breast cancer than the general population; these include women with several close relatives who have had breast or ovarian cancer.
For high risk women, there are several options to reduce their risk of getting the disease. “If it’s in the family, we may test them for one of the two breast cancer gene mutations,” says Dr. Kazim. If they are carrying one of these mutations, she may advise a double mastectomy and in some cases removing the ovaries as well.
Brest Friends is a doctor-led, independent not-for-profit organization for breast cancer patients and survivors. Dr. Houriya Kazim, Specialist Breast Surgeon explains, “When I decided to start the support group, the only qualifications that I brought to the task were the experience of treating breast cancer patients and my desire to help others emotionally survive the experience. I had never set up or run a support group of any kind in my life. Our support group is a place for people in similar situations to give and receive both emotional and practical support as well as to exchange information. Ladies who attend the group can expect to both learn more about their cancer and get new ideas from others who have ‘been there, done that.’