Flip through the latest issue of Gulf Weekly.
GulfWeekly is committed to enhancing cancer awareness within our community and reflected in the support given to the Bahrain ‘Think Pink’ campaign in association with World Breast Cancer Month.
In previous issues, GulfWeekly has highlighted the sentimental and emotional aspects of this disease. Today, award-winning Dr Waleed Abdul-Wahab, a Bahraini consultant working at the pioneering Franziskus Krankenhaus-Charite University, Berlin, takes a more scientific approach in a simplified manner.
Cancer is a disease that occurs when specific cells within the human body rebel against the system and start to multiply out of control until they spread and ultimately cause death.
Is breast cancer common?
If we exclude skin cancers, breast cancer is considered to be the commonest cancer detected among women. It is also the second commonest cause of cancer-related deaths among women after lung cancer.
Where in the breast does the cancer tend to develop?
During self-examination it is essential to examine the whole breast thoroughly. However, cancers are more likely to develop in certain areas of the breast more than other areas. Therefore, these areas should be examined with even greater care and attention. The diagram pictured left, illustrates where in the breast the cancers are more commonly found.
Is breast cancer known to spread to other parts of the body?
Breast cancer is notorious for its ability to spread to other parts of the body when left untreated or detected too late. Actually, it is the spread of this disease to other parts of the body that causes death. Naturally, once the cancer has spread it becomes extremely difficult and in some cases impossible to treat. Breast cancer is known to spread to the bone, brain, lungs and liver. (See above diagram)
What are the symptoms of breast cancer?
It is extremely important to be on the lookout for these symptoms because the earlier you visit a specialist the better the chances are for curing the disease.
l A lump or lumps in the breast or armpit.
l A change in the size of the breast.
l A change in the shape of the breast.
l A change in the symmetry of the breast.
l A change in the texture or color of the breast skin.
l Any changes to the nipple such as redness or inversion.
l Blood coming from the nipple.
l Pain in the nipple or breast.
Does having one of the above symptoms mean I have breast cancer?
The above symptoms should only serve as tell-tale sign. They do not mean that you definitely have this disease. As a matter of fact, it may be highly likely that no cancer will be detected but then again it is better to be safe than sorry. However, one must also keep in mind that in some cases, breast cancer exists in the abscense of any symptoms all together.
Does any lump in the breast mean it is cancerous?
The majority of breast lumps are usually harmless. However, some lumps would be more likely to be associated with cancer than others if they have certain characteristics like being firm, hard, and immobile.
Is a painful lump is more likely to be cancerous?
Usually only 10 per cent of breast cancers are associated with pain. However, a painful breast lump does not exclude the possibility of cancer.
What is the importance of self examination?
We are looking for change. Therefore, women are encouraged to conduct regular self check examination to familiarise themselves with their normal breast structure. Even though these self exams may seem trivial, they actually save lives because they aid in early detection and as a result lead to better outcomes.
When should I consult my doctor for a breast exam?
If you have detected something suspicious during the self exam or have any doubts about your examination technique, you may seek this professional help. Even when nothing is detected during self examination it is also advised to do periodic breast exams with a doctor every two to three years till the age of 50 and then annually after that.
What risk factors are associated with breast cancer?
These are broad guidelines to make you more alert and do not necessarily mean you will get the disease:
Aged above 50.
A relative with breast cancer.
Young age at onset of menstruation (below 11).
Old age at attaining menopause (above 55).
Having no children.
Having the first child late in life (above 30).
Absence of breast feeding.
High exposure to radiation.
Fat rich diet.
High alcohol consumption.
Obesity after menopause..
Hormone Replacement Therapy taken after menopause (not strongly linked).
So, if I don’t have any of the risk factors associated with breast cancer can I confidently say that I will not get it?
It is true that women who have risk factors have a higher tendency to develop it. However, in 80 per cent of women who are diagnosed no risk factors have been identified.
How worried should I be if I have a relative with breast cancer?
Well as science is progressing, we have been able to identify certain genetic patterns. One of these is a gene called BRCA 1 & 2. Having either of these in your genetic build up predisposes you to higher risks of developing breast cancer, as well as ovarian cancer for that matter.
Therefore, since genetic material is normally shared among relatives, it is only natural that women who have family members with breast cancer would also be more likely to develop the disease themselves.
What is a mammogram?
A mammogram is a special low-dose X-ray of the breast that is usually able to identify changes in the breast prior to them being felt (Screening).
In addition, a mammogram also plays an important role in assessing breast lumps to guide doctors as to whether they are cancerous or not (Diagnosing).
What happens when a lump is discovered?
At this point, your doctor wants to know if this lump is due to cancer. His examination of the breasts and armpits may give him rough idea but this will not be enough to confirm the presence or absence of cancer no matter how experienced he may be.
A mammogram can help, however, this may be of limited use because of the dense nature of the breast at a younger age. Therefore, in women under 40, a breast ultrasound is performed instead. Sometimes both these procedures are carried out.
Is an ultrasound or mammogram of the breast lump enough to diagnose whether or not it is cancer?
Although these techniques may give some suggestion of the diagnosis they still cannot completely confirm the presence or absence of cancer. In these instances a biopsy of the lump is advised.
How is a breast biopsy performed?
By using a fine needle, a specialist is able to puncture the lump and suck out cells that are later viewed under a microscope. It is with this test that we will have a more conclusive diagnosis since we are actually able to see the cancer cells under the microscope.
What treatment is available once breast cancer has been diagnosed?
Many factors have to be considered when selecting a treatment plan such as how big and in which part of the breast it is located.
Most importantly, however, is how advanced is the disease. Is it still confined to the breast or has it spread to other close or distant parts of the body? Remember, the more advanced the disease the less the opportunity for treatment. Current treatments include:
l Surgical removal of the breast.
l Chemotherapy.
l Radiotherapy.
l Hormonal blockade.
Does breast cancer only happen in women?
Breast cancer can also occur in men. It is true that it is always perceived to be a female condition but a small percentage of these cancers actually occur in men.
Is there any difference between this cancer developing in males when compared to females?
Due to the fact that this disease lacks awareness amongst men, it is usually diagnosed at a much later stage than in women. Naturally, the later the stage, the more advanced the disease and hence the more difficult it is to treat.
Is there a message to take home?
Scientists and doctors cannot work alone to fight cancer.
Even with the most up-to-date technology in the form of drugs, equipment, and techniques they are still limited in their ability to subdue this horrific disease.
However, with better public awareness it may be possible to turn the tide against cancer since science and technology stand a better chance when dealing with cancer in its early stages. Please do not underestimate the power you have in making this change possible.
Therefore, we urge you again and again to aknowledge the importance of TIME in the fight against cancer.
It is a shame to see all the lives that could have been saved had the disease been discovered earlier and it is heartbreaking to see how a family must pick up the peices and carry on after such an avoidable tragedy.
Let us put our hands together in the coming year so that we may realise a difference when it is time to commemorate Breast Cancer Awareness Month in 2008.
Can we contact you with specific questions related to this topic?
It is virtually impossible to cover this whole topic in a way to satisfy every individual situation.
Therefore, I urge you to write in if you have any specific questions related to this topic or other cancers for that matter.
I would be delighted to offer any help I can so please send in any questions to drelansari@hotmail.com.
