By Lovemore Makurirofa
October is Breast Cancer Awareness Month. Breast cancer is one of the most frequently diagnosed cancers today. It is a type of cancer that starts from cells of the breast (chest, armpit and upper arm area). In women, it usually starts in the tubes that carry milk to the nipple (ducts) and glands that make milk (lobules). The number of cases worldwide has significantly increased since the 1970s, partly attributable to the modern lifestyles (fat and alcohol intake, smoking, the changing patterns of childbearing and breastfeeding, low parity). Many people do not realise that men have breast tissue and that they can develop breast cancer. One man is expected to develop breast cancer out of every 100 women who develop the disease. This makes breast cancer more than 100 times more common in women than in men, although males tend to have poorer treatment outcomes due to delays in diagnosis.
In Zimbabwe, breast cancer is the second most common cancer in black women after cervical cancer. According to the Zimbabwe National Cancer Registry, it contributed 12.5% to the cancer burden among black women in 2013. Breast cancer also constituted 21.3% of the non-black female cancers in Zimbabwe. According to the same source, breast cancer contributed 7% to the number of deaths due to cancer in the country.
All conditions are easily managed if they are diagnosed early and if you know your HIV status. With a compromised immune system, treatment of breast cancer becomes difficult. Get tested for HIV and know your status. Get treatment early where necessary, and take medicines as prescribed by health personnel.
Risk factors of breast cancer
Studies have shown that some people are more likely to develop cancer than others. These are called at-risk groups. The behaviour, environmental factors or other things that predispose at risk groups to cancer are called risk factors. Your risk increases if you:
lAre over 40 years of age.
lHave a family history of breast cancer.
lStarted your menstrual periods early before 12 years of age and experience menopause later than usual (after 55 years), you are more at risk.
lSmoke and excessively drink alcohol (more than two drinks in men and one in women per day).
lEat a diet high in animal fat and low in fibre.
lObese or overweight.
lHave no children or had your first child after you turned 30 years (in women).
lExcessive use of hormone replacement (always consult your doctor on the use of hormones).
lExposed to radiation especially during adolescence.
lHave had cancer previously in one breast.
lConstantly endure high stress level.
Preventing breast cancer
About a third of the most common cancers, including breast cancer, can be prevented by eating a varied and healthy diet, maintaining a healthy weight and regular physical activity. It is encouraged to eat a diet containing whole foods that are naturally grown and high in fibre. It is also important to avoid refined foods and highly processed foods as they are high in fats, sugars and salts. Instead, concentrate on whole grains, legumes, fruits, vegetables, poultry and fish. Also avoid being overweight or obese by exercising regularly at least five times a week for more than 30 minutes.
Alcohol intake must be reduced (to not more than two drinks a day in men and not more than one drink in women), while tobacco smoking, sniffing or chewing are to be avoided at all cost. Also avoid chemical exposure such as pesticides. Managing stress effectively is another important aspect in the prevention of breast cancer as well as other cancers. Getting involved in relaxation classes and stress management techniques is one way of achieving this. Breastfeeding is a protective factor — this is a common practice in Zimbabwe and must be encouraged.
Signs and symptoms of breast cancer
The common symptoms of breast cancer include a lump or thickening in or near the breast or in the underarm. A mass or lump which may feel as small as a pea should be a cause for concern, especially if it is detected during regular breast self-examination. Look out for changes in the size, shape, or contour of the breast, blood-stained or clear fluid discharge from the nipple, change in the feel or appearance of the skin on the breast or nipple (dimpled, puckered, scaly, or inflamed), redness of the skin on the breast or nipple, a change in shape or position of the nipple. Other signs include the development of a marble-like hardened area under the skin, an area that is distinctly different from any other area on breast, tingling, itching, increased sensitivity, burning pain in the breast or nipples, unexplained weight loss as well as persistent fever or chills. Some of the signs and symptoms may, however, be due to other conditions. Visit your nearest health facility if you notice any of these signs and symptoms.
In Zimbabwe, breast self-examination (BSE) is encouraged since most of the lumps are discovered by the patients themselves. BSE, though simple, is an important method to enable the early detection of breast cancer which in turn improves prognosis. The cancer is likely to be found at its early stages, hence easier and cheaper to manage. The method involves the man or woman regularly looking at and feeling each breast for possible lumps, distortions or swelling. It makes one become familiar with the usual appearance and feel of one’s breasts. Getting to know one’s breasts makes it easier to become aware of any changes. Women undergoing their menstrual periods are encouraged to do breast self-examination three to five days after one’s period. Men as well as women at menopause should choose a particular day of the month when to do breast self-examination. Early detection of abnormalities gives the doctor a better chance to offer effective treatment.
lLovemore Makurirofa writes on behalf of the Cancer Association of Zimbabwe. However, both the Cancer Association of Zimbabwe and the writer will not be responsible for any damage that may arise from the views expressed in this article. This article is not meant to substitute any health advice that you may get from your health/medical practitioner.