The topic of breast cancer evokes a range of emotions, from curiosity to fear to hope. The disease affects millions of women worldwide and, in rare cases, men. Unfortunately, information about breast cancer is obscured by myths and misconceptions.
According to the World Health Organization (WHO), breast cancer is a disease in which abnormal breast cells grow out of control and form tumors. If left unchecked, tumors can spread throughout the body and become fatal.
Dr Mariusz Marek Ostrowski, breast oncoplastic surgeon at the Aga Khan University Hospital, explains the seriousness of the situation in East Africa, particularly Kenya.
“Breast cancer is the most common cancer in the world. It is the most commonly diagnosed cancer here in Kenya and East Africa. Worse still, it is one of the biggest causes of death among women in East Africa,” he says.
“Here in East Africa, particularly in Kenya, the prevalence is 40 percent. This means that 40 out of 100 breast cancers, or almost half, affect very young women. I’m talking about women in their 30s and very early 40s.
Various questions come up frequently amid all this uncertainty, such as: “Is there a link between breastfeeding and breast cancer?”
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Let’s examine this topic, unlearn the myths, explore the risk factors, and understand the curious connection between breastfeeding and the fight against breast cancer.
Separate fact from fiction
Ladies, did you know that breastfeeding could be your shield against breast cancer? But the question is: is it an infallible shield?
Dr. Marek explains that breastfeeding reduces the risk of being diagnosed with breast cancer and highlights the use of statistics involving large numbers of patients, most of whom were included in studies conducted in Europe and
America.
“And when we look at the big statistics, we can see that women are having children very early, but in Europe, early that means around their twenties,” says Dr Marek. “Here, early means 12.” Yes. And if you go to Samburu, girls have their first child at 14 years old.
“Having a child in your early 20s and breastfeeding reduces the risk of developing breast cancer. So it’s true,” he says.
The complex interplay of genetics and lifestyle factors could explain why some women develop breast cancer despite early childbirth and breastfeeding. Although breastfeeding offers protective benefits, it is not guaranteed against breast cancer.
“What happens is my patients say to me, ‘Oh, but I breastfed for two years.’ I have three children. I breastfed them for two years each. And I still came to see you, and I have cancer. For what?’ We do not know it. Yes. It could be genetic,” adds Dr Marek.
Breast cancer during pregnancy and breastfeeding
“Now what is very important is that breast cancer can occur during pregnancy and also in breastfeeding women. This is not a very common problem. That’s only one in 3,000 pregnancies, or, let’s say, one in 3,000 pregnancies that suffer from breast cancer,” says Dr. Marek.
“But we see it in the clinic. We see it at least every month. We have one or two pregnant or lactating women with breast cancer,” he says.
Breast changes, including lumps and bumps and discomfort, are common during pregnancy. Often these changes are attributed to normal problems related to pregnancy and breastfeeding. However, it is crucial to investigate persistent symptoms.
“It’s not easy because the breasts are different. On ultrasounds they look different. When we examine the breasts, we notice a different sensation. It happens very often, especially when breastfeeding, that there can be mastitis (inflammation/swelling of the breast, usually caused by an infection) or some kind of infection,” emphasizes Dr. Marek.
“Infection is much more common than cancer. But if the infection does not go away after a week or two, it should be investigated.”
An aggressive form of breast cancer called inflammatory carcinoma can look like an infection, especially during pregnancy and breastfeeding. Early diagnosis is the key to successful treatment.
Debunking the myths
Myth 1: “Breast biopsies can spread cancer”
A myth that haunts conversations is that a biopsy can spread the disease. Contrary to some beliefs, the reality is different.
Dr. Marek explained that a biopsy involves taking a small sample of a mass using a specialized needle to determine whether it is benign or malignant, that is, whether it is cancerous. He further debunked the myth that biopsy can spread cancer, firmly stating that this would not be the case.
“The way the biopsy gun is made, it just goes into the mass and then it hides, just like a pen, it hides in a tube,” he notes.
“We need to know what we are removing. This is why the biopsy is very, very important,” explains Dr. Marek.
Likewise, mammograms, x-ray images of the breast, are often misunderstood.
“Why do people think CT scans spread cancer?” Or is this causing the spread? Because 80 percent of patients here in Kenya arrive very late when the virus is already widespread. So of course you think, ‘Oh, if they do the scan, it will spread,'” notes Dr. Marek.
“People say mammograms are bad and painful. It’s an x-ray and modern mammograms are digital, plastic and comfortable to put on the breast,” he notes.
Timing is important; Scheduling a mammogram a few days after your period starts can help reduce discomfort.
Myth 2: “One treatment fits all, and if my friend gets a certain treatment for breast cancer, I should get the same.” »
Everyone is unique; the one-size-fits-all approach doesn’t work when it comes to treatment.
“Everyone was different and each cancer could be completely different. This is why sometimes we need chemotherapy and sometimes we don’t. Sometimes we have to remove the breast. Dr. Marek says:
” Everyone is different. You know people who can’t take ibuprofen, and ibuprofen is just a simple pain reliever. We know people who cannot take paracetamol because of the side effects.
Myth 3: “Chemotherapy always causes significant hair loss, which never grows back. »
“Each of us is different and there are different types of chemotherapy. So each chemotherapy may have slightly different side effects, but the side effect that women usually worry about is, “Will I lose my hair?” said Dr. Marek. “Probably yes, during treatment, but the hair grows back. So, a year later, after the treatment, the hair came back and everything is fine. Chemotherapy can cause pain and sometimes changes to the nails. And usually, the situation improves after a year or two.
He points out that the treatment is not as scary as it seems. “My patients come back because sometimes I have to send them for chemotherapy first, and then they come back for surgery, and most of them come back and I ask them, ‘So, how was it?’
“They said, ‘I was really scared. I was really worried, but it wasn’t that bad.
Understanding risk factors
According to the WHO, certain risk factors increase the likelihood of developing breast cancer. Risk factors for breast cancer include older age, being overweight, excessive alcohol consumption, family history of breast cancer, previous exposure to radiation, reproductive factors (such as the age of first period and age of first pregnancy), smoking and postmenopausal hormone therapy. .
Notably, nearly 50 percent of breast cancer cases occur in women without any identifiable risk factors other than being female and over 40 years old.
Genes and breast cancer
“11 percent of breast cancers are of familial origin. We can prove that 11 out of 100 breast cancer patients have not only a family history but also a genetic mutation. They are carriers of genetic mutations. Dr. Marek says:
The risk of breast cancer is increased by these genetic mutations, which are frequently passed down from generation to generation. The best known example is BRCA gene mutations.
Actress Angelina Jolie revealed her BRCA1 gene mutation and opted for a preventative double mastectomy, significantly reducing her risk of breast cancer.
“Never say never. So I can’t say a hundred percent, but a person with one of these genes can develop breast cancer. But if we know, we can reduce the risk, and very often , we can reduce the risk from 89 percent to 4 percent or less, which is even lower than in the general population,” reassures Dr. Marek.
Obesity: the never friendly enemy
“Obesity increases the risk of developing, for example, breast cancer, because fatty tissues release estrogen and many breast cancers feed on estrogen,” explains Dr. Marek.
The good news is that there are ways to reduce the risk of breast cancer. It is crucial to lead a healthy lifestyle. This includes exercising frequently, knowing where your food comes from, refraining from smoking, and not consuming more alcohol than necessary.
Maintaining a healthy lifestyle, which includes a balanced diet and regular physical activity, is essential for reducing the risk of breast cancer as well as many other health problems. “We must live in good health. We need to make sure we know where our food comes from. We were talking about chemicals. We must be active. Nature wants us to be active. Our grandmothers went everywhere on foot. Dr. Marek explains: “So the body had to spend time being active and energy walking, and then energy thinking, ‘Oh, should I maybe grow a mutated cell?’
Additionally, treating persistent infections can reduce the risk of developing certain cancers; The HPV vaccine is an example of how this can be done to prevent cervical cancer.
Cervical cancer and breast cancer share similarities in terms of well-developed screening programs. Screening can detect problems years before they develop into cancer.
“Breast cancer and cervical cancer are the two biggest causes of death among women here in East Africa, Kenya. These two cancers are the subject of very developed screening programs, which means that we can detect a problem several years, even three to four years, before it becomes a cancer,” emphasizes Dr Marek.
“If we get something that’s going to turn into cancer, a lot of times a little bit of surgery ends the story. But if we give this cancer time to grow and spread, then it is surgery, chemotherapy or radiotherapy, and the treatment costs millions of shillings,” he says.
rabdi@standardmedia.co.ke
