Breast cancer incidence is rising rapidly and is a public health issue in Ghana with many more diagnosis anticipated in the coming years.<\/p>\n
You probably know someone who had or has been diagnosed with breast cancer such as a mother, family member, a relative or a friend.\u00a0 There are reported incidences of breast cancer in males but 99% are diagnosed in women.<\/p>\n
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.<\/p>\n
Some of the well-established risk factors associated with breast cancer include the following: \u00a0Age 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.<\/p>\n
Another factor and perhaps one of the strongest risk factor for breast cancer is family history. \u00a0A woman\u2019s 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.<\/p>\n
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.<\/p>\n
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.<\/p>\n
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.<\/p>\n
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\u2019s risk of breast cancer includes tobacco smoke, and excess alcohol consumption.<\/p>\n
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.<\/p>\n
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.<\/p>\n
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.<\/p>\n
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.<\/p>\n
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.<\/p>\n
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.<\/p>\n
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.<\/p>\n
Clinical breast examination that is a doctor\u2019s 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.<\/p>\n
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.<\/p>\n
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.<\/p>\n
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.<\/p>\n
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.<\/p>\n
In Ghana, there are no organized breast cancer screening programs such as mammography tests even though breast cancer is increasingly a public health concern.<\/p>\n
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.<\/p>\n
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.<\/p>\n
For additional reading: Cancer Causes and Controversies- understanding risk reduction and prevention (Available at Amazon.com)<\/p>\n
–
\nBy: Dr. Bernard Kwabi-Addo (www.Epigenovix.com)<\/p>\n","protected":false},"excerpt":{"rendered":"
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