3 delays affecting Zimbabwean women with breast cancer
CLAIM: Breast cancer is the second most common cancer affecting women after cervical cancer and accounts for 13 percent of all cancers affecting women.
SOURCE: The Herald
VERDICT: True
Imagine a 40 year old Zimbabwean woman, in Malipati village in Chiredzi, finding a lump in their breast. Do they know what to do?
The discovery of a breast lump is the beginning of a journey largely marked by delays knocking back women at every stage, according to a health organisation.
First, women delay seeking advice because of fear and ignorance of breast cancer, and the crippling costs of treatment. Next, nurses do not have the basic knowledge and skills to recognise and refer suspicious lumps. Lastly, a staggering shortage of specialist staff and equipment creates a ‘perfect storm’, delaying diagnosis and treatment further still.
The month of October is Breast Awareness Month – Pink October. It marks the world’s effort to shine the light on breast cancer.
In an article on Breast Cancer Awareness, the Herald claims that ‘breast cancer is the second most common cancer affecting women after cervical cancer and accounts for 13 percent of all cancers affecting women’.
The statistics are attributed to the Zimbabwe National Registry 2019 annual report.
The Global Cancer Observatory’s 2022 data supports this claim, showing breast cancer as the second most common cancer affecting Zimbabwean women after cervical cancer. However, it also shows an increase in the percentage of cases attributed to breast cancer – from the 2019 Zimbabwe National Registry figure of 13% to 16.1%.
According to another source, a 2023 study, breast cancer is, indeed, the second most common cause of cancer-related deaths after cervical cancer in Zimbabwean women today.
The study further states that ‘with the increasingly effective detection and treatment of cervical cancer, BC is now the leading cause of cancer-related deaths in all African women’.
The impact of breast cancer is not limited to Zimbabwe, though mortality rates are higher in low income countries.
Breast cancer is the most prevailing cancer among women and it is the only cancer that is considered universal among women worldwide, though it also affects men to a lesser extent. It is now the leading cause of cancer-related deaths among women globally.
The rate of breast cancer per 100,000 women is higher in high income countries than in low income countries. However, mortality rates are high in low income countries as opposed to high income counties due to delay in seeking health care of breast cancer with poor treatment outcomes due to determinants such as disparities to access to high quality treatment, lack of facilities for breast cancer screening and poor awareness and knowledge of the disease in low income countries.
Breast cancer is a disease in which cells in the breast grow and divide uncontrollably. These abnormal cells can form a tumor, which may spread to other parts of the body.
Risk Factors:
- Age: The risk of breast cancer increases with age.
- Family History: Having a close relative with breast cancer increases your risk.
- Genetics: Certain genetic mutations can increase the risk.
- Lifestyle: Factors like obesity, alcohol consumption, and hormone replacement therapy can also increase the risk.
Symptoms:
- Lump or thickening in the breast or underarm: This is often the first sign of breast cancer.
- Changes in the breast’s shape or size
- Nipple discharge
- Dimpling, puckering, or skin irritation on the breast
- Pain in the breast
Diagnosis:
- Mammogram: An X-ray of the breast.
- Ultrasound: A sound wave test to examine the breast.
- Biopsy: A procedure to remove a sample of tissue for testing.
Treatment:
- Surgery: Removing the tumor or breast.
- Chemotherapy: Using drugs to kill cancer cells.
- Radiation Therapy: Using high-energy rays to kill cancer cells.
- Hormone Therapy: Blocking the body’s production of hormones that can fuel cancer growth.
Prevention:
- Regular Breast Exams: Conduct monthly self-exams and see a doctor for regular check-ups.
- Healthy Lifestyle: Maintain a healthy weight, limit alcohol consumption, and avoid smoking.
- Early Detection: Get regular mammograms, especially if you are at high risk.
What to look for during a breast examination:
- On the breast itself:
- Dimpling or puckering of the skin surface
- Enlarged veins
- Lump or thickening which may be painless
- Unusual rash on the nipple or breast
- Persistent pain in the breast though this is not usual
- On the nipple:
- Discharge or blood through the nipple
- Rash on the nipple or around the nipple
- Lump or thickening which may be painless
- An inverted nipple (turned in nipple)
- Change in the position of the nipple
- Lump or thickening beneath the nipple
- On the arm:
- Swelling of the upper arm
- Swelling or lump in the armpit
- You should examine your breasts monthly from the age of eighteen years onwards. The best way to do this is while standing up looking into the mirror, standing up in the shower or lying down on the bed.
- One way of breast self-examination:
- Stand before the mirror, inspect both breasts for any unusual discharge, dimpling, scaling or puckering of the skin.
- Watching in the mirror, clasp hands behind head and press head against hands. This helps to identify any changes in the shape or size as the muscles contract.
- Press hands on the hips and bend towards the front or mirror while pulling shoulders and elbows forward. The pulling of muscles helps to identify any abnormalities on the breasts.
- While in the shower, with soapy hands, lift arm and with four fingers of your right hand, gradually work from the outer edge of the breast in small circles towards the nipple. The circular movements will help identify any lumps or abnormalities.
- Following the same process use your left hand to examine the right breast.
Conclusion
Breast cancer is, indeed, the second most common cancer affecting women in Zimbabwe after cervical cancer and accounted for 13 percent of all cancers affecting women in 2019. By 2023, it accounted for 16.1%. Awareness is needed to reduce mortality and address the 3 delays – the delay in seeking advice because of fear and ignorance of breast cancer, and the crippling costs of treatment; the delay caused by nurses who do not have the basic knowledge and skills to recognise and refer suspicious lumps, and lastly, a staggering shortage of specialist staff and equipment, delaying diagnosis and treatment further still.
