You probably know someone who had or has been diagnosed with breast cancer such as a mother, family member, a relative or a friend.  There are reported incidences of breast cancer in males but 99% are diagnosed in women.

Breast cancer takes its name from the origin of the disease; in the breast area. Often the cancer forms in the milk ducts in the nipple or in the glands that make milk (lobules) but this cancer can form in any tissues of the breast. Breast cancer is a complicated disease that covers a variety of diseases in the breast- scientist commonly call this group of diseases sub-types and these sub-types can have differing clinical outcomes.

Some of the well-established risk factors associated with breast cancer include the following:  Age is one of the most important risk factor associated with breast cancer – most women diagnosed with breast cancer are over the age of 60 years. Unfortunately, there are increasing numbers of African women being diagnosed with breast who are under the age of 50 year.

Another factor and perhaps one of the strongest risk factor for breast cancer is family history.  A woman’s chance of getting breast cancer increases if she has a family history of breast cancer such as a mother, sister or daughter is diagnosed with the disease. Family predisposition can arise from either maternal or paternal side of the family. Scientists have identified mutations in 2 genes known as BRCA1 and BRCA2, both genes encodes for proteins with a biological role in DNA repair among other functions.

Thus a damaged system for repairing DNA makes a person vulnerable to breast cancer and other cancers. Although family history is a key risk factor for breast cancer, less than 10% of all causes of breast cancer are linked to family history. Other risk factors including nulliparity (never given birth) is associated with increased risk to breast cancer. On the other hand, parity (given birth) and breastfeeding are associated with reduced risk to breast cancer.

Furthermore, women with dense or fatty breast tissues may be at increased risk of breast cancer as are women who are obese and physically inactive. And if a woman has breast cancer in one breast, her chances of getting the cancer in the other breast increases. Breast cancer is also linked to hormonal and reproductive factors.

Postmenopausal women with high levels of serum sex hormones are at an increased risk of breast cancer in comparison with women of the same age with lower serum sex hormones. The role of hormones is reflected in the observation of women who take estrogen and progestin to treat symptoms of menopause as well as hormonal induced fertility treatment increases risk of breast cancer. A longer reproductive period appears to increase risk.

Other scientific finding suggests that early onset of menstruation (before the age of 12 years) or a late start of menopause (after the age of 55 years) also increases risk of breast cancer. Other factors that may increase a woman’s risk of breast cancer includes tobacco smoke, and excess alcohol consumption.

Exposure to radiation, pesticides or other hash chemicals and poor dietary patterns that is deficient in essential micronutrients such as folic acid is associated with increased risk to breast cancer. Folic acid (folate) is an essential nutrient that is involved in copying and repairing DNA resulting in DNA, thus deficiency in folate can result in errors in DNA synthesis and cancer.

Most women with these risk factors do not develop breast cancer. In fact, most breast cancer patients do not have a family history of the disease or any clear risk factor, with the possible exception of age. Women (and men) can reduce their chances of getting breast cancer by avoiding some of these known risk factors.

Recommended lifestyle adjustment includes eating nutrient-rich diet (including fruits and vegetables and whole grains); moderate exercise, maintaining constant body weight (losing excess body weight); avoid moderate to excessive alcohol and quitting smoking.

Not all risk factors can be avoided, however. Some people may have a predisposition to breast cancer; either through familial predisposition or exposure to some environmental risk factors such as radiation or other unidentified risk factors, particularly if the exposure happened during childhood or infancy.

So even if an individual takes all the necessary precautions to avoid cancer, she may already be predisposed to developing the disease later in life. It is therefore essential for individuals with known risk factors to undertake age appropriate preventative measures such as screening.

Screening is designed to detect cancer at very early stage when a person is more likely to respond to treatment and there is a good chance for cure. Screening test including self-breast examination and clinical breast examination are useful to find lumps in the breast.

While the American Cancer Society (ACS) and other organizations advocates for the use of monthly self-breast examination as a cheap test that maybe worthwhile, other organizations such as the United States Preventative Task Force (USPTF) and the World Health Organization (WHO) recommends against teaching women for self-examinations noting that this technique has no statistically significant effect on breast cancer detection nor proven to reduce breast cancer mortality.

Clinical breast examination that is a doctor’s physical examination of the breast is recommended by ACS and other organizations every 3 years for women after the age of 40 years. Yet, the USPTF and WHO says there is not enough evidence to support clinical breast examination.

Mammography, a type of x-ray test is use to find red flags in the breast such as small lesions, lumps or abnormalities in the breast tissues to identify women who maybe at risk of developing breast cancer. Mammography is proven to detect early stage of cancer; picks 95% of breast cancer at earlier stage than self-breast or clinical breast examinations. Some noted limitations with mammography include false-positives test which means unnecessary follow-up visits for mammography and biopsies as well as anxiety and stress.

False-negative mammography results means that sometimes aggressive cancer can appears even after a clear screening test. However, there is on-going controversy with routine use of mammography as to whether it improves breast cancer mortality rates, although several well-tailored international studies suggests that mammography reduced mortality in all ages. Currently, ACE recommends mammography screening for women every 1-2 years beginning at 40 years.

THE USPTF and WHO recommends screening every 2 years for women between 50-69 years and suggests no benefit of screening to women over the age of 74 years. The National Health Institute of United Kingdom recommends screening every 3 years for women between 50-70 years.

Who should get screened? Women with family history of breast cancer including BRCA1 and BRCA2 mutations, women with first degree relatives with BRCA mutations, and women who have had prior radiation therapy to the chest between the age of 10-30 years old as well as women with dense breast mass are at increased risk of breast cancer and should get screened.

In Ghana, there are no organized breast cancer screening programs such as mammography tests even though breast cancer is increasingly a public health concern.

It is critical for the Ghanaian government for the government to provide routine age-appropriate mammography screening test for ALL Ghanaian women when breast cancer can be detected at early stage and when there is a good chance for treatment and cure.

Presently, most women recommended for biopsy on the basis of clinical symptoms finds that they present with large tumor masses and most often aggressive breast cancer which may be too late for successful treatment. Ultimately the decision to screen for breast cancer should be discussed with a medical professional who should provide information about the uncertainties, risks, and potential benefits of screening in order for individuals to make informed decision about screening.

For additional reading: Cancer Causes and Controversies- understanding risk reduction and prevention (Available at Amazon.com)

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By: Dr. Bernard Kwabi-Addo (www.Epigenovix.com)

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The advice was given by the President of Breast Care International (BCI), Dr. Beatrice Wiafe Addai, during a free breast screening session for members of the Nkawkaw Diocese of the Methodist Church in the Eastern Region.

Scores of women who thronged the screening exercise as part of activities held to mark the church’s first anniversary were grateful to Dr. Wiafe and her team for the exercise.

The Eastern Region has benefited from a number of free breast screening exercises from BCI.

In 2017, BCI marked its local version of World Cancer Day in the town, and this was preceded by other programmes.

It was however not surprising that some women accompanied by relatives, swarmed the BCI team when they arrived in the area, with many giving testimonies about the organization, while others confessed they had stepped out boldly and were undergoing treatment presently.

BCI used the opportunity to educate the church members on breast cancer and the need to seek early treatment.

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By: Godwin Akweiteh Allotey/citifmonline.com/Ghana

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The study aims to describe the typical breast cancer patient journey, as well as to assess resource use, cost, and other hurdles influencing patient care in public and private hospitals in Kenya, Nigeria and Ghana.

The data will provide insight into the challenges of addressing the full spectrum of breast cancer patient care in SSA, and help identify what solutions are needed at multiple points in the patient journey. Full study data will be available in 2018.

Despite advances in management, breast cancer remains the leading cause of cancer death among women worldwide.

The burden of breast cancer disproportionately affects African countries with 5-year survival rates as low as 12% in parts of Africa, compared with almost 90% in the United States, Australia and Canada.

In addition, as many as 80% of patients in SSA are diagnosed with late-to-end stage disease when very little can be achieved in terms of curative treatment.

Limited resources also adversely impact access to care, resulting in sub-optimal management, high morbidity and mortality.

This often places breast cancer patients and their families at risk of financial hardship. Lack of financial burden data is a major obstacle to developing policies for cancer care in lower middle-income countries.

Study Design

The study will assess delays to patient care, including the delays to initiating standard of care testing (mammography, MRI, ER, HER2, chest x-ray) and to receiving these test results, as well as delays to initiation of standard of care treatment (neoadjuvant chemotherapy, breast surgery, mastectomy, biologic treatment).

Notably, the study will also assess direct cost to patients, including how many pay for their cancer care out of pocket and how many are unable to complete treatment for cost reasons.

The study is a retrospective chart review conducted in three public and three private hospitals in each country, including Ghana, Kenya and Nigeria. The study aims to obtain a comprehensive two-year sample of up to 1000 anonymised patient records across all study sites. A panel of local healthcare providers will also provide qualitative information on breast cancer management to corroborate findings from quantitative analyses, and provide further contextual insights.

Update on Roche Efforts in Sub-Saharan Africa

In sub-Saharan Africa, Roche aims to improve every step of a patient’s journey by removing barriers to access quality healthcare from diagnosis through treatment. The company develops comprehensive and sustainable programs that are tailored to the specific needs of each country. Ensuring these patients have access to innovative medicines is accomplished through partnerships with key stakeholders such as governments, who share a long-term view for investment in healthcare infrastructure.

“We believe that patients in sub-Saharan Africa deserve the same treatment as everyone else,” said Markus Gemuend, Head, Sub-Saharan Africa, Roche. “When we work with partners with a genuine will to make a difference for patients is when real impact can happen.”

Key progress from 2017 includes:

In East Africa, a partnership between Roche and the Kenya Ministry of Health includes a comprehensive access program that now supports women with access to breast cancer care.

The program includes screening, state-of-the art diagnostics, healthcare infrastructure building, including the training of new oncologists and oncology nurses, and access to innovative medicine for breast cancer – all free of charge to the patient.

A similar program in Sudan has also commenced.

In French West Africa, significant progress has been made to broaden access in multiple countries. Notably, in Côte d’Ivoire, a landmark agreement with the Ministry of Health now includes access to three innovative cancer medicines with Roche and the government covering the costs of the medicines for patients.

New agreements have also been signed this year in Burkina Faso and Republic of Congo. While these are in the early stages, they are important first steps for patients in these countries.

In Nigeria, partnerships with six oncology centers of excellence across the country are now in place to facilitate access to care for breast cancer patients and increase the chances patients will start and complete treatment.

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Source: Roche

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He said “the rate at which the public identified themselves with the breast cancer awareness month has been really encouraging, and I think government must do more in the coming years to ensure the message gets to all across the country.”

Mr. Fiamor said this when the company, in collaboration with the Trust Hospital, undertook its last breast cancer screening and awareness exercise at its Tema office.

The exercise was to wrap up the breast cancer awareness creation month in October.

According to him, in 2017, the company screened about one thousand two hundred fifty people, and was hoping to hit up to about three thousand people this year.

“This year has been very impressive and we hope we shall be able to hit about three thousand people due to the high level of response rate.”

He said NDK Financial Services believes early detection and treatment is important in the fight against breast cancer hence the screening.

“Early detection and treatment is important to safeguard the well-being of our people. NDK is customer oriented financial services, and we believe that when our customers are safe, the better for us.”

The Medical Doctor in charge of the Well Woman Clinic at the Trust Hospital, Dr. Victoria Patty Newman, noted that quite a number of incidents have been recorded in this year’s breast screening, and will be checked after they are taken through the various laboratory tests.

She expressed her appreciation to the government for its role in this year’s campaign, and urged them to do more to ensure it receives the assistance it deserves.

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By: Elvis Washington/citifmonline.com/Ghana

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“Babies need their mothers’ breasts, the mothers themselves need their breasts for cosmetic and aesthetic reasons’ two of the many reasons why the breast deserves attention,” Dr Zanetor Agyemang- Rawlings, MP for Korle Klottey; and Dr Bernard Okoe Boye, MP for Ledzokuku, said in a joint statement.

The statement was read on the floor of the House by Mr Mohammed Bawa Braimah, MP for Ejura Sekyeredumase.

The statement was in commemoration of the month of October, designated since 1985, through partnership between the American Cancer Society and the Pharmaceutical Division of the Imperial Chemical Industries to promote awareness about breast cancer prevention, diagnosis and treatment.

Breast cancer is a disease condition in which the breast tissue becomes cancerous and begins to grow out of control.

Some signs and symptoms of the condition include; breast lump, lump in the armpit, change in the colour of the breast skin, bloody nipple discharge and disoriented nipple position.

Quoting World Health Organisation (WHO) figures, the makers of the statement said “a total of two thousand Ghanaians women were diagnosed in 2012 with breast cancer, … and one thousand died of the disease.”

Also, breast cancer is the second leading cause of death in Ghana with one out of every eight women with the condition dying of the disease.

Men can also get breast cancer, which appear around the pectorals, especially in the nipple and areola areas.

Drs Agyemang Rawlings and Boye regretted the loss and damage to life by the disease and called for improved early detection mechanisms to save lives.

“It is sad that due to poor early detection mechanisms, the breast that gives life is made to become the taker of life,” they bemoaned.

Nenyi George Andah, MP for Awutu Senya West, in anorther statement on the disease and the awareness creation said “Africans, according to some studies, develop the cancer some 10-15 years before Caucasian women, putting us at higher risk and therefore in need of faster intervention.

He said breast cancer is increasingly becoming a medical condition of major concern.

In Ghana, breast cancer prevalence seems to be increasing from 12.8 per cent in 1996 to 15.4 percent in 2007 per records at the Korle-Bu Teaching Hospital, the MP said adding that “over 70 percent of all cases reported in the country were in the advanced stages.

This he said may be due to the lack of awareness on the issue; cost; lack of access to routine screening mammography; social stigma and or the preference of traditional healers over doctors.

The situation of late detection often results in death due to the fact that symptoms are often ignored or unknown by individuals until the disease has fully metastasised (spread).

The number of diagnosed cases increases annually and there is an urgent need to focus attention on awareness, education and most importantly routine screening preferable mammography in order to drive early detection, treatment and ultimately reducing the prevalence and mortality rates in our society.

“We should not sit and allow Breast Cancer to continue tearing into us. Breast Cancer does not have to be death sentence, and our handicap in Ghana is early detection,” Nenyi Andah said.

With reference to Mrs Rebecca Akufo- Addo, the First Lady of the Republic, who recently launched the Breast Cancer Awareness Campaign at the Karle-Bu Teaching Hospital, Nenyi Andah stressed early detection and effective treatment as ways to make a headway in improving the sad outcomes of Ghanaians with breast cancer.

He listed risk factors that increase the likelihood of women developing the disease as age between 50-69 years, with a lesser incidence in younger women, family history, reproductive factors such as a later age at first pregnancy, inability to conceive, early onset of menses, later age of menopause amongst others can make one more susceptible to the disease.

Lifestyle habits including; reduction or limit of alcohol, avoidance of smoking, controlling one’s weight, being physically active, breast feeding, avoiding exposure to radiation and pollution reduce the risk of breast cancer.

Nenyi Andah announced that this year, the Korle-Bu Teaching Hospital has spearheaded a campaign that was targeted at helping people detect the presence of the disease at an early stage to assist in effective treatment.

“It is a commendable initiative as voluntary breast screening can help one detect the earliest stage of breast cancer where there is the absence of lumps and just calcium flecks that can be seen through a mammogram.”

He said other partner health institutions include, amongst others, the Komfo Anokye Teaching Hospital, 37 Military Hospital, Accra Regional Hospital, Nyaho Medical Centre, Ho Regional hospital, Trust Hospital, Well Woman Clinic.

The government has also taken up the initiative to put in place various programmes to introduce educative health care to all parts of the country and also train more health care professionals and specialists in early detection in order to facilitate timely treatment, thereby reducing the mortality rate.

The makers of the statement appealed to the Media to help create more awareness on the disease and urged fellow legislators to help promote and support the Pink October activities and extend the support even beyond the month until it penetrates every community.

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Source: GNA

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The walk which is in its 7^th year and aimed at increasing awareness about the disease was themed “our breasts, let’s check them.”

The event was organized by the Breast Care International (BCI) in collaboration with the Peace and Love Hospitals.

The enthusiastic walkers moved through some principal streets of Koforidua and held placards which read: “breast cancer is curable,” “breast cancer is survivable” among others.

Speaking in an interview, President of Breast Care International, and CEO of Peace and Love Hospitals, Dr. Beatrice Wiafe Addai, said, “The annual BCI Ghana Walk for the Cure has assumed a national character, attracting people from every strata of society, affirming that our awareness creation program has been embraced by all.”

“We are riding on this national acceptance to increase our visibility, and by extension, heighten and sustain awareness about this debilitating disease, which, but for our consistency, would have needlessly destroyed several precious lives and families.”

According to the American Cancer Society, every 69 seconds a woman somewhere in the world dies from breast cancer; and a woman is diagnosed every 19 seconds.

In Ghana, breast cancer continues to occupy the first position in mortality as far as cancers are concerned.

Reports suggest that about 60% of patients report to the hospital at a late stage making it difficult to be cured.

“Breast cancer statistics would remain a scar on our conscience, if we do not collectively fight the condition as a National disaster,” Dr. Wiafe added.

The event coincided with the annual “Akwantukese” Festival of the people in the region, blending tradition with health, in an all-embracing event.

Politicians, breast cancer ambassadors, the clergy, students, teachers, farmers and civil society organizations walked in solidarity for the cure.

President of BCI was grateful to the headline sponsor, Delta Airlines and several reputable multinational organizations as well as individuals that supported the walk.

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Source: Breast Care International

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She said although other risk factors could be cited, alcohol consumption and smoking by women pose a great threat to Ghana’s fight against breast and cervical cancers, that have become leading causes of death among women, urging women to do regular examinations for early detection and cure.

She was speaking on Tuesday at Ekumfi Imuna in the Central Region, at a community health outreach programme by the Community Empowerment Network (COMENet) Ghana, an association made up of students from the Kwame Nkrumah University of Science and Technology (KNUST).

The programme dubbed ‘Promoting Healthy Communities for Sustainable Development’ offered the fishing community talks on breast and cervical cancers and family planning, as well as free breast and cervical cancer screening, HIV/AIDS counseling and testing among others.

It brought together health experts, nurses, women and men as well as school girls from basic schools at Imuna.

Partnering with the Department of Gender, Ghana AIDS Commission, Planned Parenthood Association of Ghana (PPAG), Ghana Health Service and the Ekumfi District Assembly, the group is seeking to reduce the high number of deaths among reproductive women, and the soaring teenage pregnancy at Ekumfi Imuna.

The Ekumfi District, carved out of the Mfantsiman Municipality during the era of late President Atta Mills, is plagued with poverty, a high unemployment rate, teenage pregnancy, poor health system among other unfavourable conditions.

Speaking to journalists, a member of COMNet and Central Regional Director of the Department of Gender, Thywill Eyrah Kpe, explained that, “We realized that Ekumfi is quite disadvantaged when it comes to access to health care, so we looked at the reproductive health of the community; also, we realized poverty and teenage pregnancy are high in the community, and that informed our being here.”

Figures from the 2010 Population and Housing Census on the District, show that, about four in ten of the population of Ekumfi, aged twelve and others, are married, while its General Fertility Rate of 111.3 births per 1000 women, is the ninth highest for the Central Region, and COMNet has pledged to liaise with other stakeholders to tackle these social issues in the district.

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By: Joseph Ackon-Mensah/citifmonline.com/Ghana

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The event, which is yearly organized under the leadership of Dr. Mrs. Beatrice Wiafe, CEO of Peace and Love Hospitals, will be held on October 14 this year, at the Koforidua Jackson’s Park.

Speaking at the official launching of this year’s BCI WALK FOR THE CURE, the Busumbruhene of the New Juaben Traditional Council, Nana Bugye Asante, speaking on behalf of the Traditional Council, pledged to join the walk to create awareness and help save lives.

“I must say the Chiefs in New Juaben are very happy that this year’s event is being organized here, it has coincided with this year’s celebration of Akwantu Kesei Festival and we believe it’s a blessing in disguise.”

Nana Bugye Asante added that, “on 14th October, no chief in New Juaben will put on traditional clothes, we will all be in sneakers and trainers to join the 30,000 Ghanaians who will be taking part in the walk. We want the world to know how as chiefs we cherish our women in the society, our challenges are their challenges and their concerns are ours also.”

“From here, I will be visiting all the Chiefs to rally them and get them ready for the walk, so I am pleading with the organizers to make available a number of t-shirts which will be used for the walk because we will be coming with the queen mothers.”

On her part, the CEO of Peace and Love Hospitals, and the President of Breast Care International, Dr. Mrs. Beatrice Wiafe, showed appreciation to all who are contributing to make the walk a success.

“I must say we are impressed with what we have seen so far when we got to Koforidua. The chairman of the local organizing committee, Eric Kwakye Darfour, the Eastern Regional Minister, together with his able deputy, Joseph Tetteh, have been very helpful and we are grateful.”

“My sincere gratitude also goes to every member of the local organizing committee, you have worked tirelessly and we are proud of all of you, we will not rest until all women in the country make it a regular habit of getting breast examination for early detection and treatment. Breast Cancer can be cured, it is curable and before one can get help, then the cancer needs to be detected early, so the onus lies on us all to create massive awareness on it, breast cancer should not kill any woman again”she said.

Over 30, 000 people which includes personnel and wives of police, fire, army, immigration and prison officers, keep fit clubs, association of hairdressers, beauticians, dressmakers, driver’s unions, teacher associations and other civil societies, are all expected to take part in the BCI WALK FOR THE CURE on Saturday October 14th.

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By: Neil Nii Amatey Kanarku/citifmonline.com/Ghana

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This, according to her, will help increase the survival rate of victims in the country.

Globally, Breast cancer is the leading cancer for women, and the second leading cause of female cancer deaths.

Recent statistics by the World Health Organization indicate that, over 2000 women in Ghana get the disease and more than 1000 die from it every year.

As alarming as that may be, the organization also projects an increase in numbers in countries like Ghana.

Speaking at the launch of this year’s awareness month celebration,  Mrs Akufo-Addo assured victims of the disease of government’s support.

“If we are to make a head way in improving the sad outcomes of Ghanaians with breast cancer, we cannot ignore these two pillars.

It is therefore not surprising, that the Korle Bu Breast Surgical unit has adopted the theme: Early Detection and Effective Treatment save lives for this year’s October Breast Awareness campaign. This hospital sees over 400 new breast cancer cases every year. Most of the women report with advanced disease, after trying unproven therapies.”

Breast cancer survival in advanced countries has improved over the last few decades. The improvement has been based on two factors; with the first being early detection through effective screening, and the second being effective treatment options made possible through cancer research.

“During this month of October, there will be a lot of publicity and education about breast cancer. Clearly, the problem is late detection and delayed treatment. Effective treatment is available in this country.” she noted.

The First Lady also called on the public to disregard misconceptions about the disease as well as false claims on treatment on the internet and other social media platforms.

“There are a lot of misconceptions about the disease as a result, many women end up in the hospital after trying other treatments; by this time, their cancers are no more curable. I have been informed that over 90% of patients with early breast cancer treated in this hospital survive the disease. This figure, compares with what pertains in the advanced countries. Yet, the majority of our breast cancer patients do not survive breast cancer.”

“I encourage our women to report early and comply with treatment that has been proven to be effective.  It is important that we access proven treatment methods and educate others to do the same.”

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By: Felicia Osei/citifmonline.com/Ghana

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The two institutions share a common goal of creating awareness and educating women about breast cancer.

Head of Comforting Queens,  Afuah Anku, told the media in Kumasi that she was motivated to join the fight against breast cancer after witnessing her mother  go through diagnosis, treatment  and cure.

She was of the conviction that the disease could be contained provided public education was intensified and women heeded to the call not to patronize products and services not medically certified for treatment of the disease.

Comforting Queens raises money for the acquisition of wigs, bras, and prostheses for breast cancer patients in a bid to enhance their physical look and feel.

The Chief Executive Officer of Peace and Love Hospitals, who doubles as the President of Breast Care International (BCI), Dr. Beatrice Wiafe Addai, who received the items, commended Comforting Queens for the gesture and encouraged the public to help survivors live economically viable lives after treatment, saying the fight against breast cancer is a shared responsibility.

Dr. Wiafe, who in turn gave the items to the Peace and Love Survivors Association, (PALSA), directed that they should be given to survivors with low income backgrounds.

Dr. Wiafe said, a woman, according to statistics from the World Health Organization “dies somewhere around the globe every sixty-nine seconds from breast cancer.”

“That woman,” she continued, “could be your mother, sister, niece, wife, daughter or even friend.”

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Credit: Breast Care International

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