Company news: Early diagnosis - the key to beating breast cancer

“The good news is that advances in mammography and other medical fields have made identification and treatment of this form of cancer more effective than it has ever been before,” says Dr. Bernardo Rapoport of the Rosebank Oncology Centre in Johannesburg.

The starting point, he says, is self-examination, a process that should be undertaken at least once a month. Women should learn how to conduct self-examination effectively and then be aware of any physiological changes to the breast or any lumps found during examination and the need to seek medical advice when they notice a change in the breast.

“This process should be supported by regular annual mammograms from the age of 50 onwards. If there is a strong history of breast cancer in the family, consideration should be given to annual mammograms from the age of 30,” he says.

The most common form of breast cancer is “ductal carcinoma”, which begins in the cells lining the ducts that bring milk to the nipple and accounts for more than 75% of all breast cancers.

Lobular carcinoma begins in the milk-secreting glands of the breast but is otherwise fairly similar in its behaviour to ductal carcinoma. Other varieties of breast cancer can arise from the skin, fat, connective tissues, and other cells present in the breast.

Some women have what is known as HER2-positive breast cancer. HER2, short for human epidermal growth factor receptor-2, is a gene that helps control cell growth, division and repair. When cells have too many copies of this gene, cell growth speeds up. It is believed that HER2 plays a key role in turning healthy cells into cancerous ones.

Also certain women with breast cancer have excessive HER2, and are therefore considered HER2-positive. Research suggests that women with HER2-positive breast cancer have a more aggressive disease and a higher risk of recurrence than those who have HER2 negative breast cancer.

“HER2 positive cancer is aggressive and has a tendency to spread rapidly and responds poorly to treatment. HER2 positive patients are candidates for treatment with hormonal blockers on top of conventional chemotherapy,” Dr. Rapoport said.

“There is only one way to find if a lump is benign or cancerous and that is through a biopsy - a process whereby a sample of the tumour is taken through a needle being inserted in the breast.”

From the point where a lump is detected and found to be cancerous, the options for treatment need to be decided. This would include various combinations of surgery, radiation therapy, chemotherapy, and hormone therapy.

The standard surgical procedure for breast cancer was once radical mastectomy — total removal of the breast and the surrounding fat, muscle, and lymph nodes. However this is now undertaken in only very rare cases.

Where a mastectomy is still involved, it involves removing the breast and some underarm lymph nodes. In many cases women who choose a mastectomy can usually have breast reconstruction at the same time as surgery.

For many women whose breast cancer is detected early and is still localised, lumpectomy (the removal of the cancerous lump and the lymph nodes under the arm) is now the preferred treatment. Good candidates for lumpectomies are women who have tumours that are less than five centimetres in size. This includes about 80 percent of all women with breast cancer.

The selection of therapy is usually influenced by the age, menopausal status of the patient, stage of the disease, amongst others.

“Chemotherapy and radiation therapy are still the most common forms of treatment for breast cancer,” Dr Rapoport said.

“Chemotherapy involves giving the patient a course of powerful anti-cancer drugs that destroy cancer cells by interfering with their ability to reproduce. The need for chemotherapy depends on the stage of cancer and an assessment of all the other risk factors described in the pathology report following surgery. Side effects include nausea and hair loss.”

“Hormonal chemotherapy is another option. When a patient's pathology report shows that the tumour tested “oestrogen-receptor positive”, the patient may be a candidate for this special type of hormonal therapy. Most patients take this drug for a five-year period. It is orally prescribed and is taken daily,” he added.

Radiation therapy is almost always recommended after the performance of a lumpectomy to destroy any cancer cells left behind and to prevent local recurrences in the breast.

“Without radiation therapy, the odds of a local recurrence increase by about 25 percent. These recurrences may be the forerunners of cancer spreading to other parts of the body, especially when they occur within the first three years after surgery.”

Radiation can cause side effects such as fatigue for a few weeks during the end of treatment and after treatment. Reddening, darkening and thickening of the breast may also occur and last for weeks or longer.

“Today, many more women than ever before are breast cancer survivors. The key to making the odds greater in your favour is being aware of the symptoms. Taking time to find out more about breast cancer, conducting regular self-examinations and ensuring that medical help is sought when something untoward is found are critically important,” Dr Rapoport concluded.

Issued by Magna Carta

Kailas Bergman
011 784 2598

On behalf of:
Pfizer South Africa
Solly Mabotha
Public Relations Manager