The National Breast Cancer Foundation defines breast cancer as a group of cancer cells (malignant tumour) that starts in the cells of the breast. According to World Health Organisation (WHO), breast cancer is the most frequent cancer among women, impacting 2.1 million women each year, and also causes the greatest number of cancer-related deaths among women. In 2018, it is estimated that 627,000 women died from breast cancer, which is approximately 15 percent of all cancer deaths among women. While breast cancer rates are higher among women in more developed regions, rates are increasing in nearly every region globally. Dr. M.Y.M Habeebu, Head of department of Radiotherapy, Lagos University Teaching Hospital (LUTH), in this interview with GERALDINE AKUTU, shed more light on breast cancer, management and prevention.
What causes breast cancer?
There are several risk factors for breast cancer. These can be subdivided into Inherent and Acquired. Under Inherent factors and genetic predisposition, you have for example, women with such familial factors as BRCA 1 and BRCA 2, early menarche and late menopause, while acquired risk includes excessive intake of alcohol, sedentary lifestyle and use of contraceptives, among others.
What are the warning signs?
The list of warning signs for breast cancer are numerous, and it includes, breast lump, bloody discharge from the nipple, breast pain, discoloration of breast skin, lump in the armpit, swelling of the whole breast and dimpling of the breast skin, among others.
Who is likely to have breast cancer?
Breast cancer can affect both adult male and female. However, it is 99 times more likely to affect an adult female than male. Women with first-degree relatives with breast cancer have higher risk. Other factors are early onset of menstruation (menarche), late onset of menopause, nulliparity, multiple abortion, history of breast lumps, which may be benign and not breast feeding. The list of factors that predispose to breast cancer is exhaustive. Certain genetic predisposition like BRCA1 and 2 have also been linked to breast cancer.
What are the types and stages of breast cancer?
Breast cancer can be classified into two major categories. These are the ductal carcinoma and the lobular carcinoma. The ductal carcinoma is about four times more common, while the lobular carcinoma tends to affect the other breast more commonly after diagnosis.
What are the treatment options?
Treatment for breast cancer depends on the type and characteristics. Available treatment options include: surgery, radiotherapy, chemotherapy, hormonal therapy and targeted therapy. There are other minor treatment options like counseling.
Exactly what does radiation therapy do? How well does it work?
Radiation therapy or radiotherapy is a form of therapy that involves the use of ionising radiation like X-rays and Gamma rays to burn off cancerous cells. Radiotherapy can be classified into teletherapy and brachytherapy. Radiotherapy is a very effective therapy, which is used either with curative intent, primarily to kill the microscopic malignant cells that cannot be removed by surgery, or reduce the size of inoperably large tumours, rendering the tumours smaller and operable.
Radiotherapy can also be with palliative intent, either to reduce pain, reduce symptoms of cancer or to stop bleeding. Radiotherapy is a very effective form of cancer treatment, and when properly used will spare the normal cells, while eliminating offending cancer cells.
How many radiation treatments are required for breast cancer?
A complete treatment for breast cancer will take about a month of daily treatment of Monday to Friday per week. The exact dose depends on the practice of the particular centre.
What can be done to reduce risks of breast cancer?
To reduce the risk of breast cancer, improved lifestyle to include regular exercises, abstaining from excessive alcohol intake, breastfeeding and genetic testing.
It is also very important to perform regular screening, which is in three categories. First is the Self-Breast Examination (BSE), Clinical breast examination and Breast Imaging (either Breast Ultrasound for women, who are less than 40 years old or Mammogram for women who are up to 40 years old and above).
Breast self-examination (BSE) is a very cheap but effective form of breast screening. With this screening done regularly, even the slightest change in the breast can be easily noted and reported to an expert. Early diagnosis gives the best chance for cure, if well managed.