Breast cancer is one of the leading causes of cancer deaths among women globally. In Zimbabwe, it is the second most common cancer among women after cancer of the cervix. According to the National Cancer Registry, 7 000 women are diagnosed with breast cancer annually.
As such, October has been dedicated yearly as Breast Cancer Awareness Month in a bid to increase awareness about the disease and to offer support for those who have been affected. In order to understand more about breast cancer, Doctors Bernadette Ndoro and Agnes Chipo Tererai from Oncocare， a cancer treatment centre in Harare were interviewed by Sharon Sigauke.
SS: What are the breast cancer subgroups?
Oncocare: We always talk about breast cancer using a singular connotation but it consists of so many subgroup types. Some of them are histological and others are on more advanced molecular characteristics. We normally classify breast cancer either as being receptor positive or HER2/neu positive and these are the molecular features.
We can also look at it from a histological point of view, this is the basal type of breast cancer where we have normal breast like breast cancer and the HER2 enriched breast cancer.
Classification of breast cancer is important when we are looking at possibilities of the cancer coming back after one’s first line of treatment. It also has predictive value because it leads us to use certain medicines that are not normally used on a daily basis.
SS: Who is more susceptible to breast cancer?
Oncocare: The risk of getting breast cancer increases as one gets older. When women turn 50 years, the risk becomes higher. Women with relatives who have breast cancer such as mothers and sisters are in the high-risk group. Their chances of getting breast cancer will be higher than any other woman. The same as in men, if there is history of breast cancer in the family, there is a possibility that they can get breast cancer although the majority of people with the disease are women. Only one percent of men get breast cancer.
There are situations when a woman is exposed to her female hormone for a long time for example when she starts menstruating at an early age (below 11 years), this is because the female hormone feeds certain types of breast cancer. Women with late menopause, women who have not had any pregnancies, women who have had fewer pregnancies and women who use the combined pill for contraception are all at a risk of getting breast cancer.
SS: What are the social and emotional factors affecting breast cancer patients?
Oncocare: Having cancer is like going on a roller coaster. At diagnosis when patients are told that they have breast cancer, usually everyone is devastated by the news. Being told they have breast cancer is devastating because of the natural history around cancers. Most people ask why it has happened to them. Their responsibilities sort of take a different dimension because they become so big. Obviously, they are going to worry about so many things in their lives and they will be anxious. Aspects such as finances, the process involved, treatment and support will have an impact on the patient.
SS: How can breast cancer patients be assisted in having a positive self image?
Oncocare: Here we should start by valuing ourselves as women. We need to take care of our own health and be concerned about issues. We need to learn to do breast self-examination and to visit clinics and hospitals to ask for help
SS: What are the effects of breast cancer treatment and medication on a woman’s fertility?
Oncocare: With treatment of any cancer, drugs and radiation therapy are given at doses that are quite high. Sometimes there can be infertility and we encourage that a woman avoids conceiving during the treatment period. They can conceive after treatment when it’s a safer period because when drugs are given, the immune system becomes weak and they can easily pick infections. Pregnancy itself demands that a woman be healthy so that she can carry through.
SS: What determines the successful treatment of breast cancer?
Oncocare: Once a woman has been diagnosed of breast cancer, we do some tests to put her particular condition into a stage (the extent to which the cancer has spread within an individual). The stage of the disease is number one factor that we take into consideration. After that we look at the characteristics we talked about in the beginning. Once we have all the information on how advanced the cancer is, we then look at whether the patient is fit for whatever treatment is recommended. We also give the patient a chance to choose how they want to be treated.
SS: What advice would you want to give to women as far as breast cancer is concerned?
Oncocare: Our major problem as far as cancer is concerned is that people are coming with very advanced diseases. Our advice would be for women to know themselves very well. They should know what risks they have in developing breast cancer or cervical cancer and to take whatever precautions so as to deter the development of cancer. As soon as they notice that something is not quite right, it is always advisable to get an explanation about what it all means than wait until it is too late. Women can start by screening themselves once a month. They can take a day to examine their breasts after their periods and they can make it a routine so that they do not forget. This will help to pick any subtle changes so that they can go and ask health professionals
For all women above 40 years of age, we would encourage that they start visiting clinics and hospitals in order to have their breasts checked and also those who are in the high-risk category should make it a must to get screened.
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