THE READERS’ HUB BREAST CANCER AWARENESS WITH DR FATIMA ABUBAKAR RASHEED

The first mention of cancer of any kind was a case of breast cancer documented in Egypt around 1600 BC. The Edwin Smith Papyrus, an ancient text found in 1860 in an Egyptian tomb, described eight cases of tumours or ulcers of the breast.

Breast cancer was in the early days fatal, but today technology has helped in reducing its fatality. We now have surgeries like mastectomy, where the whole breast is removed.

Breast cancer occurs mainly in women, but men can get it, too (mostly Klinefelter). Many people do not realize that men have breast tissue and that they can develop breast cancer. Breast cancer starts when cells in the tissue begin to grow out of control. These cells usually form a tumour that can be seen on an x-ray or felt as a lump.

Breast cancer is the most frequent cause of cancer death in less developed regions where 627,000 deaths have occurred in the US in 2018. In developing countries, most women do not present breast cancer cases until it reaches an advanced stage when a cure is difficult to achieve. In these cases, they receive palliation in form of pain relief.

It is therefore important women particularly become aware of the early signs of breast cancer and take precautionary measures. The major sign of Breast Cancer is body pain and a lump in some cases.

PRECAUTIONARY MEASURES (RISK FACTORS) AGAINST BREAST CANCER

A risk factor is anything that increases your chances of getting a disease, such as cancer. But having a risk factor, or even many does not mean that you are sure to get the disease. While you can’t change some breast cancer risk factors—family history and aging, for example—there are some risk factors that you can control.

RISK FACTORS YOU CAN CONTROL

Weight. Being overweight is associated with an increased risk of breast cancer, especially for women after menopause. Fat tissue is the body’s main source of estrogen after menopause when the ovaries stop producing the hormone. Having more fat tissue means having higher estrogen levels, which can increase breast cancer risk.

Diet. Studies are looking at the relationship between diet and breast cancer risk and the risk of recurrence. The Women’s Health Initiative Trial suggested that a diet very low in fat may reduce the risk of breast cancer. More research is needed in this important area for women who are interested in eating well to reduce their risk of ever getting breast cancer.

In the meantime, here’s what dietitians suggest:

  • Keep your body weight in a healthy range for your height and frame. Body Mass Index of 18.4 to 24 can help you estimate your healthy weight.
  • Eat plenty of vegetables and fruit that contain carotene and cook them in a way that it preserves the micronutrients.
  • Limit saturated fat intake to less than 10% of your total calories and your fat intake to about 30 grams per day.
  • Avoid trans fats, processed meats, and charred or smoked foods.

Exercise. Evidence is growing that exercise can reduce breast cancer risk. The American Cancer Society recommends engaging in 45-60 minutes of physical exercise 5 or more days a week.

Smoking and Alcohol consumption is associated with an increase in breast cancer risk. It limits lung and liver function in the human system.

RISK FACTORS YOU CAN’T CONTROL

Gender. Being a woman is the most significant risk factor for developing breast cancer. Although men can get breast cancer, too, women’s breast cells are constantly changing and growing, mainly due to the activity of the female hormones estrogen and progesterone. This activity puts them at much greater risk for breast cancer.

Age. Simply growing older is the second biggest risk factor for breast cancer. From age 30 to 39, the risk is 1 in 228, or .44%. That jumps to 1 in 29, or just under 3.5%, by the time you are in your 60s.

Family history of breast cancer. If you have a first-degree relative (mother, daughter, sister) who has had breast cancer, or you have multiple relatives affected by breast or ovarian cancer (especially before they turned age 50), you could be at higher risk of getting breast cancer.

Personal history of breast cancer. If you have already been diagnosed with breast cancer, your risk of developing it again, either in the same breast or the other breast, is higher than if you never had the disease.

Exposure to estrogen. Because the female hormone estrogen stimulates breast cell growth, exposure to estrogen over long periods, without any breaks, can increase the risk of breast cancer. Some of these risk factors are not under your control, such as:

  • Starting menstruation (monthly periods) at a young age (before age 12)
  • Going through menopause (end of monthly cycles) at a late age (after 55)
  • Exposure to estrogens in the environment (such as hormones in meat or pesticides such as DDT, which produce estrogen-like substances when broken down by the body)

 Pregnancy and breastfeeding. Pregnancy and breastfeeding reduce the overall number of menstrual cycles in a woman’s lifetime, and this appears to reduce future breast cancer risk. Women who have never had a full-term pregnancy, or had their first full-term pregnancy after age 30, have an increased risk of breast cancer. For women who do have children, breastfeeding may slightly lower their breast cancer risk, especially if they continue breastfeeding for 1 1/2 to 2 years. For many women, however, breastfeeding for this long is neither possible nor practical.

SIGNS AND SYMPTOMS OF BREAST CANCER

The earlier breast cancer is diagnosed, the better the chance of successful treatment. So it’s important to check your breasts regularly. Common breast cancer signs and symptoms include:

  • a lump or swelling in the breast, upper chest, or armpit – you might feel the lump but not see it
  • a change to the skin, such as puckering or dimpling
  • a change in the colour of the breast – the breast may look red or inflamed
  • a change to the nipple, for example, it has become pulled in (inverted)
  • rash or crusting around the nipple
  • any unusual liquid (discharge) from either nipple
  • changes in size or shape of the breast

SELF-BREAST EXAMINATION

Checking your breasts only takes a few minutes. There’s no special technique and you don’t need the training to check your breasts.

Check the whole breast area, including your upper chest and armpits.

Do this regularly to check for changes.

It’s as simple as TLC: Touch Look Check

  • Touch your breasts: can you feel anything unusual?
  • Look for changes: does anything look different?
  • Check any changes with your GP

It is important that after 3 years, a woman undergo a clinical examination of her breast with a doctor or a trained nurse.

Dr. Fatima Rasheed

CALL TO ACTION

  • Everyone is prone to breast cancer particularly women above 50 years of age, so they should be encouraged more to go mammography
  • Daily practice of exercise is key, reduction of 5kg can reduce the risk of Breast cancer by 4%
  • Eat low-calorie food, rich in vegetables and fruits
  • Avoid smoking and alcohol consumption
  • Take your body mass index regularly (weight in kg/height in m²), the ideal BMI is 18.5 to 24.9
  • There is a need to do more to create awareness by mobilising more women who are the most vulnerable to know the early signs and precautionary measures of Breast Cancer.

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