breast cancer | the leading cause of cancer related deaths in women

Breast cancer is the commonest cause of cancer related deaths in women in Kenya and the world.

It also affect men but over 99% of the cases are in women.

It is more aggressive black African women.

In Kenya, it occurs more commonly in women below 50 years.

Risk Factors for breast cancer

  • Prolonged use of estrogens(some found in family planning pills)
  • Family history of breast cancer
  • Smoking and taking alcohol.
  • Obesity

Signs and symptoms

signs of bresat cancer

Initially the disease present as follows:

  • A painless  lump in the breast.
  • Nipple retraction(nipple points inwards)
  • There may be bloody discharge from the nipple.
  • skin changes like darkening and dimpling.

In late stages  symptoms are;

  • breast ulceration
  • enlarged lymph nodes, Persistent cough
  • bone pain,
  • bone fractures
  • uniform breast enlargement
  • Pain is usually a late symptom.

Tests and diagnosis 

Self breast examination

 

Imaging

For women over 40 years mammogram is recommended.

 For younger women, Ultra-sound is recommmended.

If mammogram and ultra-sound produce confusing results MRI is recommeded.

Pathology diagnosis

 Biopsy is a very effective diagnosis method.

Determination of the levels of estrogen and progestron receptor by use of immunohistochemistry.

Laboratory investigations

  • Full bood count
  • Virus for HIV
  • Liver and kidney function
  • Note: tumor markers have no role in diagnosis of breast cancer.

Staging and risk assessment

This is done to determine the size and extent of the cancer.

Treatment and management.

The choice of treatment depends on the cause and the stage of the cancer.

For Estrogen responsive breast cancer, Anti-estrogen treatment is given.

Drugs that inhibit estrogen synthesis are also used

Combination of anticancers and other treatment methods depends on the stage and extent of spread of the disease.

outcome of breast cancer

The oucome of the disease depends on the stage in which the treatment was started.

Early diagnosis leads to better outcomes and is actually curable.

If diagnosed late, it is usually incurable

 

 

 

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Dr Mathu

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