In order to understand the importance of early detection, it is vital to understand exactly what breast cancer is, writes breast cancer expert, Prof Justus Apffelstaedt.

By: Professor Justus Apffelstaedt – Associate Professor, University of Stellenbosch and Head of the Breast Clinic: Tygerberg Hospital

Breast cancer is the most common female cancer in the world and this is true for South Africa as well.

Overseas, early detection and effective treatment have transformed breast cancer from the dreaded disease that killed about half of those suffering from it, to a disease that can be managed successfully with excellent prospects for long-term survival.

South Africa is slowly learning from this success and early detection is becoming more of a focus – taking a proactive approach rather than a reactive one.

Understanding breast cancer

In order to understand the importance of early detection, it is vital to understand exactly what breast cancer is.

Breast cancer is an uncontrolled growth of the cells in the breast gland which have the capability to spread to other parts of the body via the blood stream or lymphatic channels. The most important thing to understand however, is that precursor lesions of breast cancer can be present for as long as 10-15 years before a cancer develops.

Precursor lesions of breast cancer can be present for as long as 10-15 years before a cancer develops

Once breast cancer is established, for two or three years it  is only detectable by mammography – even specialists and the woman herself will not be able to detect anything through breast examinations.

Treatment at this stage is curative in the majority of cases; however once it has developed into a lump that is detectable by the patient herself or by physical examination by a doctor, its growth is rapid and the treatment will have to be intensive and the chances for a cure decline quickly.

Breast health management regimes

Women, from as young as 20, should have a breast health management regime in place to ensure the best possibility of early detection.

Whilst there is no prevention for breast cancer, it is more likely to occur in women who:

  • Have a family history of breast cancer
  • Have not had any children or have had children late (above 25 years)
  • Have not breast-fed
  • Had an early first menstruation and late menopause
  • Abuse alcohol
  • Have a sedentary lifestyle
  • Are overweight
  • Who are on hormonal replacement therapy

Women from the ages 20-39 should know their family history of breast cancer, schedule a clinical breast examination by a healthcare professional every three years and should conduct self breast examinations monthly. Women over 40 should know about the latest advance in breast cancer treatments and technologies, should have an annual mammogram, arrange for annual clinical breast examination and should conduct breast self-examination monthly.

Steps to approach breast health

A three-step approach to breast health is needed, which includes:

  1. Breast self-examination: Examine your breasts one week after your period ends. It is easy to do and only takes a few minutes.  This way you will detect any changes in your breasts more easily.
  2. Clinical breast examination: A breast health professional will check your breasts and can demonstrate a proper technique for you to use for your self-examination.
  3. Mammography: A mammogram is a low dose X-ray of your breasts, it can detect many breast changes that are too small or too deep to feel. This is the most important part of increasing the chances of early detection.

What symptoms should I look out for?

You should look for the following symptoms during your breast health management regime:

  • Lumps of any size or thickening of breast tissue
  • Changes in the shape of the breast or persistent discomfort
  • Discharge from the nipple that is not associated with pregnancy or breast feeding

It is important to note that a lump does not necessarily mean that you have cancer. Benign lumps are common in young women, however if a lump is found a needle biopsy must be done in order to rule out cancer in women under 35. For women over 35, a mammogram, ultrasound and a needle biopsy are done.

Early detection saves lives

Most international cancer societies recommend annual mammographic screening as the best method of detecting breast cancer early.

Early detection greatly increases the chances for survival and decreases the chances of a mastectomy being necessary for treatment. Practising good breast health management regimes can drastically improve chances of early detection, which in turn, improves the long term survival of patients.