Breast cancer is the most commonly diagnosed cancer among women in South Africa, according to the 2023 National Cancer Registry – and men are not immune from risk, either.
“The National Cancer Registry indicates that South African women have a one-in-27 lifetime risk of developing breast cancer, and anyone can be affected although the risk is even higher for those who carry genetic mutations that predispose some families to certain types of breast cancer,” says Dr Britta Dedekind, a breast surgeon practising in Netcare Christiaan Barnard Hospital and member of the Breast Interest Group of Southern Africa.
“All women should prioritise both self-examination and visiting their doctor or clinic for a breast examination by a trained healthcare worker, as this is often where the warning signs of breast cancer are first detected,” she recommends.
Know your risk
Various factors, including family history and breast density, may increase a person’s risk of breast cancer. These should be discussed with your primary healthcare practitioner or gynaecologist to determine whether you may require earlier or more frequent screenings to manage any heightened risk more actively.
“Individuals with a family history of breast cancer before the age of 50 should start screening 10 years before their relative’s age at the onset of cancer. For those who have already been categorised as high risk, imaging may be recommended from as young as 30,” Dr Dedekind explains.
Dr Dedekind points out that an international, free online tool is available at https://ibis.ikonopedia.com/, where women can enter their relevant information for a theoretical estimate of their personal risk of developing breast cancer within the next 10 years and throughout their lifetime.
“It is important to remember that anyone can be at risk of breast cancer, and we all need to be vigilant both for the sake of our own health and for our loved ones. It is estimated that modifiable lifestyle factors, such as smoking, alcohol consumption, and dietary factors, contribute a significantly – up to 25% – towards a person’s risk for breast cancer, and together with awareness, aiming for healthier choices in our daily lives is a great starting point.”
Know your breasts
“Even in the private sector, where imaging screening tools, such as mammograms and ultrasound scans, are more readily available, there is no substitute for carefully inspecting the breasts from all sides, with arms up and arms down, standing in front of a mirror, and reclining on your back.
“Even in women with large breasts, signs of breast disease are often noticed in subtle changes early on, which can be clinically significant. It’s so important to become familiar with your breasts so that anything that looks or feels out of the ordinary can be checked by a healthcare professional as soon as possible.
“It may be tempting to ignore little signs or attribute them to something harmless, but it is not unusual for patients diagnosed with breast cancer to tell their doctors that they had been aware of something for months before making an appointment for a proper check-up. It has generally been found that the sooner breast cancer is detected, the easier it is to treat,” Dr Dedekind says.
Check your breasts in the week after your period, in a well-lit room, using the flat pad of your fingers moving in a circle radiating outward from the nipple to cover the entire breast area.
“In your visual inspection and when feeling for lumps, be sure to also examine the flat of the chest, all the way up to the collarbones and including the armpits. Any swelling, puckering, dimpling, or changes in the shape or appearance of the breast, nipple or areola should be investigated with a doctor or clinic.”
Trends and myths in imaging and treatment
Modern technology has significantly improved the experience of mammograms. Hence, the breast tissue no longer needs to be pressed as hard to achieve images for breast cancer screening, Dr Dedekind says.
“Unfortunately, the reality is that some women are diagnosed before the age of 40, so any suspicions from the patient or her healthcare practitioner should be investigated with imaging, whatever her age may be. Women with dense breast tissue may require ultrasound imaging to help detect abnormalities that are harder to see with mammography alone.
“A mammogram takes just a few moments, and it really is not painful – contrary to one of the most persistent myths in breast health,” she says.
To book a screening or doctors and specialists’ appointments conveniently according to your location and preferences at any Netcare or Netcare Medicross facility nationwide, simply call Appointmed on 0860 5555 65 during office hours or visit https://www.netcare.co.za/netcare-appointmed.
“Another myth that needs to be shattered with awareness is that having a breast problem today automatically means you will need a mastectomy. In fact, the trend in breast cancer treatment is moving toward more precise and less invasive options. Modern advances, supported by international experts, mean many patients can often avoid major surgery. The focus now is on using targeted treatments carefully to give patients better results through personalised, multidisciplinary collaboration and care.”
