Cancer emerges when mutational changes that occur in genes that regulate cell growth. The mutations allow cells to divide and multiply in an unrestrained manner.
Breast cancer refers to cancer that develops in the cells of the breasts. It is usually a breast lump or an abnormal mammogram in one or both breasts. Breast cancer stages range from early, curable breast cancer to metastatic breast cancer. Male breast cancer is not common but must be taken very seriously.
Breast cancer is ranked as the second leading cause of cancer deaths among women in the US and the most common type of cancer in the UK.
According to the World Health Organization, breast cancer is the most common cancer among women in the world as it impacts 2.1 million women every year. It also causes the greatest number of cancer-related deaths among women in the world.
In 2018, about 627,000 women died from breast cancer, which represents about 15% of all cancer deaths among women. In Kenya, breast cancer is leading cancer among women, with 34 per 100,000 women diagnosed every year.
A large number of people diagnosed with breast cancer in the country succumb to it because 70 to 80% of cancer cases are diagnosed in late stages.
There are different types of breast cancers among women and men that vary based on the type of lump developed, the specific place developed, and the nature of the cancerous cells.
- Ductal carcinoma in situ (DCIS)
- Inflammatory breast cancer
- Invasive lobular carcinoma
- Recurrent breast cancer
- Lobular carcinoma in situ (LCIS)
- Male breast cancer
- Paget’s disease of the breast
The signs and symptoms of breast cancer may include:
- A breast lump or thickening that feels different from the surrounding tissue
- Change to the skin over the breast, such as dimpling
- Pitting or redness of the skin over your breast, like the skin of an orange
- A newly inverted nipple
- Scaling, peeling, flaking or crusting of the pigmented area of the skin that surrounds the areola (nipple) or breast skin
- Change in the shape, size or appearance of a breast
- A lump or swelling in either of your armpits
- Discharge from either of your nipples that may be streaked with blood
The precise cause of breast cancer is not fully understood or discovered. Nevertheless, there are some factors recognized to increase the risk of breast cancer.
- Gene mutations: Family history of breast cancer
- Environmental factors
- Age: the older you get, the more the risk increases
- A previous benign breast lump
- A previous diagnosis of breast cancer
- Lifestyle factors such as drinking alcohol
- Being overweight, obese or tall
Note that having one or more breast cancer risk factors does not mean that you will develop breast cancer. Several women who develop the condition have no known risk factors other than just being women.
Some of the key risk factors associated with breast cancer include:
- Being female: about 95% of breast cancer cases reported in the world are among women
- Increasing age: The older you become, the higher the risk
- A personal history of breast conditions
- Cosmetic breast implants
- A personal history of breast cancer
- A family history of breast cancer
- Inherited genes that increase cancer risk
- Exposure to radiation
- Being overweight or obese
- Beginning your periods at a younger age mostly before 12 years
- Beginning menopause at an older age
- Having your first child at an older age mostly after the age of 30
- Having never been pregnant
- Postmenopausal hormone therapy that combines estrogen and progesterone
- Being an alcoholic
After examining your breast, the doctor is likely to refer you to a specialist breast cancer clinic for further tests.
The examination is a simple physical breast exam where the doctor checks of lumps or other symptoms on your breasts.
In most cases, the tests are breast screening using mammography or a biopsy.
Treatment majorly depends on the type of breast cancer, the stage, and sensitivity to hormones, patient’s age, and overall patient’s health. A patient’s preference may also play a role.
The main treatment options available for breast cancer include:
- Surgery to remove the lumps or tumors: types of surgeries include mastectomy, lumpectomy, sentinel node biopsy, axillary lymph node dissection, and reconstruction
- Radiation therapy: Controlled doses of radiation targeting the tumor destroys cancer cells
- Biological therapy or targeted drug therapy: Targeted drugs are used to destroy specific types of breast cancer. They include trastuzumab, bevacizumab, and lapatinib.
- Hormone therapy: It helps prevent recurrence in hormone-sensitive breast cancers. Some of the hormone-blocking medications include ovarian ablation or suppression, aromatase inhibitors, tamoxifen, and goserelin that suppresses the ovaries
- Chemotherapy: The doctor uses cytotoxic drugs to kill cancer cells, although this method has a high risk of recurrence or spread. However, if the tumor is large, the doctor may administer chemotherapy before using other methods to treat breast cancer. Some of the notable side effects of chemotherapy include vomiting, nausea, loss of appetite, sore mouth, fatigue, hair loss, and slightly higher susceptibility of infections.
Treatment in Kenya
Unlike developed countries, Kenya has limited treatment centers and options. The numbers of radiation centers are very few, yet they have to serve thousands of patients.
According to the Kenya Network of Cancer Organizations, the available ones are actually 4 – Kenyatta National Hospital (KNH), MP Shah, Aga Khan, and Nairobi Hospital.
The number of treatment facilities is 4 – 2 main ones and 2 limited. The human capacity for cancer treatment in the country, in the public sector, is very limited. It includes:
- 4 radiation oncologists
- 6 medical oncologists
- 4 pediatric oncologists
- 5 radiation therapy technologists
- 3 oncology nurses
- 2 medical physicists
The government of Kenya is making efforts to increase the number of treatment centers in the country. It targets to incorporate one center in each of the 47 counties in the country with most of them have already received the equipment, but treatment is yet to commence due to lack of enough human capacity.
Making changes in your daily life may minimize the risk of breast cancer. Try to:
- Ask the doctor about breast cancer screening to know when to begin screening exams and tests
- Become familiar with your breast through breast self-exam for breast awareness
- Drink alcohol in moderation, if at all
- Exercise frequently at least 3 days a week
- Limit postmenopausal hormone therapy
- Maintain a healthy weight
- Choose a healthy diet
For more information on treatment, speak to a doctor, or get access to a hospital near you through the Uzima Health App.