Targeting Breast Cancer

A proactive approach to screenings and limiting risk factors can help you combat breast cancer which is one of the more treatable cancers if caught early. Breast cancer is now leading cancer in women and will affect 1 in 28 South Africans in their lifetimes. This figure is even higher in urban communities in South Africa, where the incidence is as high as 1 in 8 according to National Health Laboratory statistics.

While breast cancer cannot be prevented, there are important steps to take to find breast cancer early, even before it causes symptoms, and before it has a chance to spread. Preventive routine breast care involves monthly breast self-exams (BSE), yearly clinical breast exams and mammograms on the appropriate schedule. Finding problems early gives you the best chance of successful treatment.

All women should get to know how their breasts normally look and feel – the size, shape, color, etc. Doing a monthly BSE can help you notice changes more easily.

Visit your General Practitioner for a clinical breast exam if you notice any of the following:

- A hard lump developing in the breast or armpit, typically painless and occurring on one side only.

- A change in the size or shape of the breast, including indentation, prominent veins or skin loss.

- Changes in the skin such as hardening, dimpling, bumps, redness, heat or an orange peel-like appearance.

- Changes in the nipple such as retraction, the secretion of unusual discharge or a rash around the nipple area.

- The most common sign of breast cancer in men is a firm, non-painful mass located just below the nipple. There may not be other associated symptoms.

- These signs and symptoms don’t necessarily mean cancer – 80% of breast lumps are completely harmless - but you should always report any concerning changes to your doctor.

Who is at risk of developing breast cancer?

Every woman is potentially at risk of getting breast cancer and men can get breast cancer too. However, there are certain factors that would put women in a higher risk category. The risk factors include:

Non-controllable risk factors

- Being a woman: Women are 100-times more likely to develop breast cancer than men. For all males, the lifetime risk of getting breast cancer is about 1 in 788.

- Race/ethnicity: White women are slightly more likely to develop breast cancer than black, colored, and Asian women.

- Dense breast tissue: Women with dense breast tissue (as identified on a mammogram) have more glandular tissue and less fatty tissue, and have a higher risk of breast cancer.

- Age: Older age is the main risk factor for most cancers. The risk of breast cancer increases as one gets older, however, 1 out of 8 invasive breast cancers are found in women younger than 45.

- Family history: Breast cancer risk is higher among women whose close blood relatives have this disease. Having a parent (mother or father), sibling, child or maternal grandmother with breast cancer approximately doubles a woman's risk.

- Inherited risk such as harmful changes in the BRCA1 or BRCA2 gene: In some families with gene mutations, the lifetime risk of breast cancer can be as high as 80%.

Family history might be top-of-mind when considering breast cancer risk, but the reality is that about eight out of 10 women diagnosed with breast cancer have no hereditary mutations and no family history of breast cancer. Breast cancer can affect any woman, regardless of her genes or whether anyone in her family has had breast cancer.

A range of other life decisions can increase risk, such as not having children, giving birth after age 30, not breastfeeding, using birth control, and hormone therapy after menopause.

Risk factors that can be managed

- Excessive alcohol use: Alcohol use has a strong link to increased breast cancer risk.

- Being overweight: The link between weight and breast cancer is complex. Being overweight or obese increases the risk of breast cancer, especially in post-menopausal women who have not used hormone replacement therapy.

- No or little exercise: Women who exercise four or more hours a week have a lower risk of breast cancer.

As frightening as a cancer diagnosis is, the good news is that medical advances and early screening and diagnosis result in more women surviving and beating cancer with less aggressive and invasive treatments.

Talk with a healthcare provider about your breast cancer risk to decide on the best preventive care plan for you.

Sources and references: www.cansa.co.za; www.rssa.co.za, www.cancer.gov