Breast Cancer – Treatment, Prevention

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What is breast cancer?

Breast cancer is caused by the abnormal growth of cells, which ends up often causing tumors in the breast. Although the cancer starts from the breast, it can spread to other parts and tissues of the human body over a period of time.

Breast cancer is found more in women but can affect men too. Reported breast cancer incidents in women account for 99 percent of cases, and about a 100 times less common in men, says Dr. Bernison Boadi, Consultant Surgeon at Medifem Multi-specialist Hospital and Fertility Centre. However, only one in 1,000 men is at risk of developing breast cancer.

Dr. Boadi explained that breast cancer growth is negatively affected by the production of oestrogen.

The role of Oestrogen in the female

Oestrogen is a strong female sex hormone that regulates a number of occurrences in a woman. This hormone stimulates breast growth in adolescent girls, it helps in the thickening of the vagina, causing it to secrete mucous, and it even affects skin quality in women. More importantly, oestrogen regulates the menstrual cycle.

Let’s break it down further. At the beginning of the menstrual cycle, most women have about 30 egg follicles that ripen up and produce oestrogen. When levels of oestrogen in the blood are highest, the hypothalamus (the section of the brain responsible for the production of many of the body’s essential hormones) releases hormones that make a follicle release an egg. Therefore, if a woman is not producing enough oestrogen, ovulation becomes a challenge. It is important to note that oestrogen is produced by the ovaries and naturally declines after the woman goes through the menopause.

“This is why the breast cancer tumors are notably aggressive in young women compared to elderly women since it is the period when they tend to produce more of the said hormones for reproduction.” Said  Dr. Boadi.

 How do we identify breast cancers?

Breast cancers can be identified by their histology-microscopic study of cells- that form the cancers and this can be determined only after thorough examination by a pathologist. Lumps found in the breast on the other hand- which may confirm the presence of breast cancer in the individual, can be either malignant or non-malignant.

Malignant and Non-malignant tumours

A malignant lump/tumour is the ‘out of control’ cancerous cells that form lumps in the breast and can spread to other parts of the body often beginning from the armpit of the affected person. This lump is cancerous and needs immediate attention. Dr. Boadi explained that “the probability of curing the lump detected at an early stage is high. In fact, breast cancer is curable when detected early.  Unfortunately due to painless symptoms seen in most patients, the disease is only detected when it is advanced and is no longer curable.” Dr. Boadi added.

Non-malignant tumors, also called benign tumors, do not spread to other tissues and can be locally treated or removed through surgical operation. These are not a threat to the patient.

Treatment of Breast Cancer

Breast cancer treatments can take three modes depending on the extent of spread of the tumor or the stage of the disease. The first type of treatment mode is the local treatment, which involves the surgical removal of the tumour on a specific location and then some radiation to kill left over cancerous cells in the breast.

The second type of treatment can be referred to as a regional treatment. Regional in the sense that the tumor spread has extended beyond the breast into the axillar /armpit areas. This also involves surgery and radiation and/ or chemotherapy.

Chemotherapy involves the use of very tough drugs to kill the cancer cells. A breast cancer patient on chemotherapy is taken through 6-8 cycles of chemotherapy bouts every six weeks. The six weeks break period is to help restore the body after the negative effects of the drugs. “It is a difficult time, mentally and physically for the patient and can also be financially draining.” Dr. Boadi stated.

According to Dr. Bernison Boadi, when it gets to the regional treatment, “It is safer to assume the worst in order to give a more thorough treatment rather than thinking all is well.”

The third, the most expensive and most prolonged treatment for breast cancer consists treating the whole body of the patient based on the assumption that cancer cells have spread to other tissues of the patient and cannot be treated through a surgical operation. This systemic treatment lasts as long as 10 years. During treatment, the patient is put on drugs to balance and control cancer feeding hormones. There is referred to as hormonal therapy or immunotherapy under the systemic treatment.

Prevention of breast cancer

To avoid getting to the point where one is termed a survivor because the cancer can only be controlled with drugs, Dr. Boadi advised “patients especially women from 30 years and up should have regular breast cancer examinations.” He stated that “Because there is often no pain attributed to symptoms until the advanced stages, people tend to ignore the obvious signs until it is too late, unfortunately.”

He stated that it is advisable for any lump in the breast to be checked by a specialist and colour changes on the breast, ulcerations where sores appear around the nipples should also quickly be examined by a health professional. Sometimes discharge from the nipples other than breast milk, that looks brownish, or bloody is a sure sign.

Prevention of breast cancers is difficult but history of breast cancer in one’s genetic line is a sign of the presence of BRCA1 and BRCA2 genes. This makes one prone to breast cancers and in the western world people have undergone double mastectomy – the removal of both breasts through surgery to avoid contracting breast cancer.

“90 percent of breast cancer cases reported in Ghanaian hospitals is brought in when the disease is already advanced” says Dr. Boadi. Early detection is the best prevention because it helps take out the tumor before it spreads and the patient can be advised to remove the unaffected breast to stop the tumor from coming back.

Breast cancer is curable when detected early.