Dr Carol Benn is one of SA’s top breast specialists and the founder of Joburg’s Breast Health Foundation, an organisation dedicated to promoting breast health and educating SA women about the disease. So what does she want you to know right now?
1 Nine out of 10 lumps aren’t malignant
“Women have a one in nine lifetime risk of breast cancer, and genes are a factor in 10% of cases,” says Dr Benn. “Lumps are caused by a variety of changes in our bodies. In breasts, cysts are small bubbles that expand and decrease, while solid lumps are usually due to hormonal changes – neither necessarily indicate breast cancer. Lumps can’t change from being non-cancerous (benign) to cancerous (malignant), so once you’ve had a lump medically checked, relax!” But that doesn’t mean you shouldn’t be vigilant! Generally, you don’t need a regular mammogram between the ages of 20 and 35 unless you have a strong family history of breast cancer, but we should all get regularly checked by a doctor, and we should all do a monthly self-examination, three to five days after our periods. Get familiar with your breasts, so you notice even minor changes. “Many women believe a 2% of those cases were in women under 35.” In fact, 65% of women diagnosed with breast cancer have palpable lumps of over 5cm, which means they’ve been present long enough to grow to that size without detection! So early diagnosis through self-examinations is vital.
4 It can happen to anyone
“Some women are at a higher risk – especially those who have a close relative like a sister, mother or daughter, with breast cancer or who have had several suspicious lumps – but anyone can get breast cancer,” says Dr Benn. Contrary to the common idea that breast cancer is an older, white women’s disease, there’s been a sharp increase in the diagnosis of women under the age of 35. “Studies also show black women have a higher risk of developing breast cancer. A mixture of genetics and environmental causes are probably to blame.”
5 Happy birthday! Now get checked
One of the biggest risk factors for breast cancer is ageing. At 30, a woman has a one in 6 000 chance of developing breast cancer; by 50, this increases to one in 600. The big lesson: the older you get, the more important self-examinations and regular medical check-ups are. Also worth knowing: women who haven’t had children or have had children late in life (from 35 onwards) have a greater risk of breast cancer. But women who have breastfed reduce their risk. And 30% of women who develop breast cancer have a family history of the disease, while 60% have no risk factors at all.
6 Get a second opinion
“Identifying a cancerous lump on a scan or mammogram is largely dependent on the expertise of the person reading the films,” says Dr Benn. “If you feel a lump and you aren’t satisfied with the report, go for a second opinion and an MRI scan of the breast.” If your doctor is concerned, follow up by asking for a core needle biopsy (in which a sliver of tissue is taken) rather than an FNA(in which a sample of cells is taken). Surgical biopsies are only done in very specific circumstances and not routinely. “If you’re going this route, have the biopsy done in a radiology suite, with either mammogram or ultrasound guidance,” says Dr Benn. “This allows biopsies to be conducted more carefully, and the results are more reliable.”
7 Exercise makes a difference
“Exercise can decrease your cancer risk by 42% by helping to burn excess fat,” explains Dr Benn. Exercise is also a winner for women getting over breast cancer. A recent Spanish study showed that cancer survivors who do regular aerobic exercise and resistance training enjoy a better quality of life
than their sedentary counterparts.
8 mastectomy isn’t the only way
“A mastectomy shouldn’t be the gold standard if breast cancer is diagnosed,” says Dr Benn. “The rule is to take the cancer out with clear margins and to check the sentinel (security guard lymph node) that protects the body. After that, there are many options. For example, large-breasted women may have the cancer removed, followed by radiation and a breast reduction.”