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FAYOHI'S BLOG

Welcome to our blog, here you will find informative and educative write-ups on important Global health issues. Please feel free to send us your contributions via contact@fayohi.org OR info@fayohi.org.

PINK October - Breast Cancer Awareness Month

 

The month of October every year, since the early 1980s has been devoted to breast cancer awareness - with the primary aim of circulating health information about the disease to the general public.

Cancer is a broad term for a class of non-communicable disease characterised by abnormal cell growths that invade healthy tissues in the body. According to the Non-Communicable Disease Alliance, over 3 million women die of cancer each year - with breast cancer being the most prevalent, followed by lung, colorectal, cervical and stomach cancers. Statistics show that globally, 1 in 8 women will be diagnosed with the disease in their lifetime; and despite the rarity, breast cancer also affects men [less than 1% of all breast cancer cases develop in men and only 1 in 1,000 men will be diagnosed with the disease].  

The global burden of breast cancer is significantly shifting to vulnerable populations in the developing countries - currently about 50% of breast cancer cases and 58% of deaths occur in these parts of the world; and it is predicted that 1.7 million new cases of the disease will be diagnosed by 2020, with the majority being in these developing countries.

In spite of this growing burden, breast cancer (and all other cancers), continue to receive low public health priority in Africa. A report by the World Health Organisation on sub-Saharan Africans revealed low survival rates [less than 40%], explained mainly by the lack of early detection programmes, resulting in high proportion of women presenting with late-stage disease, as well as by the lack of adequate diagnosis and treatment facilities.

A large number of Nigerians are unaware of the magnitude of this disease and the effect it will have on the generations to come. Emphatically, leading advocacy groups like the Breast Cancer Association of Nigeria (BRECAN) – a non-profit NGO galvanizing action against breast cancer and improving the lives of many patients/survivors who would have succumbed to the disease due to ignorance and lack of support; consistently aim towards enlightening the general public on the seriousness of the disease.

We at the Family and Youth Health Initiative (FAYOHI) support the National Breast Cancer Coalition (NBCC) deadline targeted for January 1, 2020 by committing to change the conversation towards an end to Breast Cancer, because a healthier nation is possible…

 

What is Breast Cancer?

Breast cancer is characterised by the growth of a tumour – a mass of abnormal tissue - which can either be benign (non-cancerous) or malignant (cancerous) cells.

 

  • Benign tumours are generally not aggressive, and can be removed in circumstances of excessive growth to subside pain and complications.

 

  • On the contrary, Malignant Tumours are cancerous and aggressive because they invade and damage surrounding cells. In situations of delayed detection, the tumour eventually becomes metastatic, spreading to other parts of the body through the lymph system forming a secondary tumour. In an ideal situation, the detection of breast cancer is followed by a biopsy to determine the severity and aggressiveness of the cancer cells for adequate treatment plans.

 

An understanding of the symptoms of breast cancer is crucial for early detection, diagnosis and treatment of the disease. Highlighted below are the major signs of this ailment.

 

Symptoms and Diagnosis of Breast Cancer:

The symptoms of breast cancer vary widely – from lumps to swelling to skin changes – or in particular predicaments, no symptoms at all. Every Nigerian man and woman should know the major signs and symptoms of breast cancer, which when coupled with monthly breast self-exams will ease the identification process while promoting early detection plans. These include:

 

A change in how the breast or nipple feels:

  • Nipple tenderness, lump or thickening in or near the breast/underarm area.

  • A change in skin texture or enlargement of the pores in the skin of the breast (often described as Peau D’orange – similar to an orange peel’s texture).

  • A lump in the breast. Although not all lumps are cancerous.

 

A change in the breast or nipple appearance:

  • Unexplained swelling or shrinkage of the breast (especially if one-sided only).

  • Dimpling anywhere on the breast.

  • Recent asymmetry of the breast (it is common for women to have one breast slightly larger than the other, any recent asymmetry should be checked).

  • Nipple that is turned slightly inward or inverted.

  • Skin of breast, areola and nipple that becomes scaly, red or swollen displaying the Peau D’orange.

 

Any nipple discharge:

  • Particularly clear or bloody discharge. It is important for non-breastfeeding women to go for a breast exam if they notice any milky discharge from the nipples.

 

Besides an understanding of the symptoms of breast cancer, enlightenment on the risk factors is essential towards the prevention of the disease. Medically established risk factors associated with breast cancer are divided into genetic or environmental categories. These include:

 

Genetic Risk Factors:

 

  • Gender: 100 times more females than males get this disease.

  • Age: of invasive breast cancer cases are diagnosed after the age of 55.

  • Race: Breast cancer is diagnosed more often in Caucasian women than women of other races.

  • Family History: If a member of your family has been diagnosed with breast or ovarian cancer, the risk of the disease is higher. With an increased risk if that member of your family was diagnosed before the age of 50.

  • Genome Changes: Mutations in the BRCA1 and BRCA2 genes – which can be passed on through family generations indicate a major risk of the disease. In addition, recent research shows that mutations on the PALB2 gene also significantly increase the risk of the disease.

  • Personal history: If you have been diagnosed with the disease in one breast, there is an increased risk of being diagnosed in the other breast.

  • Menstrual and Reproductive History: Early menstruation (before the age of 12) and late menopause (after the age of 55), late childbirth and infertility all increase the risk of breast cancer.

  • Dense breast tissue: implication of having dense breast tissue increases the risk of the disease as it makes detection of lumps harder. It is important that women find out if they have dense breast tissues so they can be more vigilant.

 

Environmental Factors:

 

  • Lack of physical activity: a sedentary lifestyle with little physical activity can increase the risk of the disease.

  • Poor diet: a diet high in saturated fat, lacking in fruits and vegetables can increase the risk of breast cancer.

  • Obesity/overweight: being overweight or obese increases the risk of breast cancer, more significantly when coupled with other genetics/environmental factors.

  • Alcohol consumption: the more alcohol consumed the greater the risk of the disease.

  • Radiation to the chest: radiation therapy to the chest before the age of 30 increases the risk of breast cancer.

  • Combined Hormone Replacement Therapy: combined HRT for menopause can increase the risk of breast cancer and its detection at a more advanced stage. 

 

The above mentioned lifestyle risk factors are all conclusively avoidable. Adapting a healthier more organic lifestyle would significantly reduce the risk associated with the disease.

In contrast, statistics show that 60% - 70% of people with breast cancer have no connection to risk factors at all, and other people with risk factors will never develop cancer. Due to this correlated unpredictability, the best way to fight breast cancer is through an early detection plan – the primary approach for prevention.

 

Early Detection Plan:

The 5-year survival rate in breast cancer patients is escalated to 98% with early detection of the disease at localised stages, reducing the proportion of women presenting with late-stage (advanced) breast cancer.

Adult women are encouraged to perform a monthly Breast Self Exam (BSE); an estimated 40% of diagnosed breast cancers are detected by women who feel a lump. The importance of women being familiar with how their breasts look and feel must be emphasized so as to prevent the progression of aggressive late-stage disease. These BSEs can be performed in the shower, in front of a mirror or while lying down. However 8 out of 10 detected lumps are non-cancerous – it is vital to schedule an appointment with a healthcare professional at least once a year for a Clinical Breast Exam. This is critical as an experienced physician may notice a suspicious place that fails to register as a warning in the patients mind. This can further be examined by mammogram (usually for women 40 years and over, every 1 – 2 years), ultrasound and MRI which often show a breast lump before it can be felt.

If these further tests show a tumour, a biopsy is recommended to determine the cell-grade and stage of the disease for effective treatment plans.

There are currently various electronic Early Detection Plans for breast cancer. A reputable plan can be found on http://www.earlydetectionplan.org and I encourage all readers of this article to download and set up accounts with an aim to prevent this detrimental ailment.

 

Ultimately, awareness programmes on breast cancer are crucial for addressing this public health priority. It is important that we do not let breast cancer (and all other cancers) undermine the Millennium Development Goals. Knowledge of the disease, its symptoms, risk factors and a commitment to an early detection plan all collectively drive action for the fight against breast cancer. Without doubt Action is the foundational key to all success.  Join us in the global fight for survival.

 

 

 

Contributed By: Aisha Allamin Daggash (Program Lead, NCDs and Mental Health at FAYOHI)