Dr. Gideon Assan is the author
I will always remember Thursday, 21st April, 2021, for two reasons:
First, the following day was my younger brother’s birthday and I spent all evening talking to him on phone in what was to be a very hilarious conversation.
The second reason, and perhaps the more momentous of the two, was how the teary eyes and vividly apprehensive look of an innocent adolescent girl got tattooed on my brain all day.
There she was, right in front of me in Consulting Room 2, looking unhappy, gloomy and lachrymose as though someone had told her she was going to die tomorrow.
Well yes, someone had actually told Maame Adwoa (not her real name) that she was going to die soon; she had a lump in her left breast and that was certainly the beginning of breast cancer.
“The misinformation out there is sickening”
I took my time to explain to her some fundamental information about breast cancer. It is this information that I want to share with you and many others with the hope that at least one more person does not join the queue that leads to the gate of misinformation.
First of all, not all breast lumps are cancerous.
In fact, the statistics tells us that about 70-80% of all breast lumps biopsied are not cancerous. One of such non cancerous lumps is fibroadenoma. They occur most frequently in women between 18 and 35years and account for nearly all breast lumps in women under 25. Three key characteristics of these lumps are that they are usually not painful, they are usually very small in size and they move swiftly in the breast when felt between the fingers (reason why they are also referred to as breast mouse)
Considering Maame Adwoa’s age and nature of lump, what she had was most likely fibroadenoma and not breast cancer as she was made to believe.
Another lump very much unlikely to be cancerous is called the breast cyst, a fluid-filled sac that develops in the breast tissue. They often happen in women nearing menopause, mostly between the ages of 35 and 50. Breast cyst will usually disappear after menopause. The cysts often enlarge and become sore just before your period.
So Ms. Frempong-Boakye, a 45year old woman complains about a sudden feeling of lump in her breast that becomes engorged and quite painful especially when she is nearing her menses. She admits that the size of the lump reduces significantly and it becomes less painful after her menses. Is that the beginning of cancer? No. Should she be overly worried? No. The doctor may actually do nothing about breasts cyst except to reassure you. In any case where the pain and discomfort is disturbing, the doctor will consider draining the fluid from the breast cyst.
It is actually highly recommended that you see your doctor if you feel any lump in your breast but one thing is for sure; not all breast lumps are cancerous.
Second, breast cancer is not a death sentence.
The only very dangerous thing with breast cancer comes in not recognizing it early. Breast cancers that are caught and treated in the early stages are usually less life threatening because they more often than not, have not spread to other parts of the body. The statistics tells us that these patients have a 100% 5 year relative survival rate. Early detection of breast cancer, for which treatment is most effective, is key.
But how does one tell the changes in the breast?
Three ways to detect breast cancer early:
1) Breast self examination: This is surely one of the easiest ways to detect breast cancer. It is cost effective and convenient. It is important to pay attention to the red flags while you examine - Dramatic change in shape and or size of the breast, RED FLAG! Skin changes on the breast, RED FLAG! Nipple retraction, RED FLAG! A feel of a lump in the breast, RED FLAG! Any form of discharge from the nipples, RED FLAG! In as much as these red flags do not necessarily mean breast cancer, there is a need for further investigations to rule in or out this disease condition.
2) Mammogram examination: A mammogram, simply put, is an X-ray picture of the breast and it may help pick up any cancer that may be developing in the breast. It will interest you to know that an abnormal mammogram does not always mean that there is cancer. A confirmatory test (breast biopsy) in most cases, is needed before this diagnosis is made with certainty. A breast biopsy is a procedure to remove a sample of breast tissue for laboratory testing where the pathologist will examine these tissues to come up with a diagnosis as to whether there is cancer or not. The importance of a regular mammogram examination cannot be overemphasized.
3) Professional examination: Doctors are equipped with the skill to examine the female breast to determine abnormalities. Visiting your doctor for regular examination is highly recommended and it is advised that you take advantage of it to ask your health care provider all the relevant questions on breast cancer.
Third, breastfeeding does not cause breast cancer.
Most women are very much aware of some advantages of breastfeeding. Does it provide good nutrients for the baby? yes. Does it increase bonding between the mother and the baby? Certainly.
What if I tell you that paramount among all the advantages of breastfeeding is the fact that it also reduces the risk of having breast cancer?
In 2014, the Journal of the National Cancer Institute published that women of African descents were at a higher risk of developing an aggressive form of breast cancer and the risk actually goes up when a woman gives birth but the good news is that breastfeeding negates this risk.
So as much as it depends on you, choose breastfeeding over any other form of feeding for your baby. However, if there is a genuine reason why you cannot breastfeed, do not stress; I am in by no means suggesting that not breastfeeding causes breast cancer.
There are actually women who have breastfed all their lives but still got breast cancer, and there are women who had no risk factors whatsoever but still had to battle with this condition. As it stands now, we are all obliged to continually screen and treat matters of breast cancer with all the urgency it deserves because the disease is no respecter of who is at risk or not.
After explaining everything to Maame Adwoa, I saw how relieved she was and that made my day.
I have learnt from Dr. Reuben Ngissah, the importance of explaining comprehensively to our patients, their conditions and the act of being nice to them- I’m glad Maame Adwoa benefited from it.
But one last thing that I didn’t tell Maame Adwoa but is absolutely important for you to know especially if you are a man reading this; men can also have breast cancer.
Yes, if you are a man, there is a need for breast self examination because although rare, you can also have breast cancer. It is normally detected as a hard lump underneath the nipple. Signs and symptoms of male breast cancer are basically the same as that of the female. Factors that increase the risk of male breast cancer include:
Older age. Like in females, the risk of breast cancer increases as you age and it is most often diagnosed in men in their 60s.
Oestrogen therapy: If for any reason, the man is taking an estrogen related therapy such as those used for prostate cancer, the risk of breast cancer is increased.
Klinefelter's syndrome: This is a genetic condition that results when a boy is born with an extra copy of the X chromosome. Men with this condition have an under developed testicles, producing less of the male hormones and more of the female hormones. This increases the risk of them developing breast cancer.
Liver disease: An abnormality of the liver such as liver cirrhosis, can reduce male hormones and increase female hormones, thereby increasing your risk of breast cancer.
Are the women still around? I believe not. Good. Since it is now a boys-boys affair here, brothers, can I take a minute to chip in why you love the breast like that. Maybe it baffles even you yourself.
Writing in a column for The Huffington Post, Larry Young, who is an expert in the area of the neuroscience of social bonding, explained that the male obsession with breasts is biological.
Apparently, men are attracted to breasts on a biological level because a good, full cleavage indicates to a man that a woman is in good health and an excellent choice to bear and raise his children.
But the researcher believes that the male attraction to a pair of boobs goes beyond this and develops during their childhood.
When a mother breastfeeds her child, the infant becomes the most important thing in the world and all her attention is focussed on the baby. The bonding chemical Oxytocin is also released into the mother’s breast milk and consumed by the baby.
This makes nursing a feel-good experience for mother and child and it forges a very important bond between the two.
Essentially then, when a man sees, touches or massages a woman’s breasts, it sparks the same series of brain events as nursing – the feel good chemical is released in the man’s brain and he is drawn to the breasts because subconsciously he remembers the feel-good experience of nursing as a child. This is what research is saying and much as it may sound weird, it offers us an explanation into why we so adore breast; it is an evolutionary urge and we just can’t help it.
Looking at all of the erotic, romantic and lascivious importance of breast to men, I think it is safe to say that when the last boob dies, that will be the end of the last man on earth.
If this singular reason won’t jolt us men into action on breast cancer; looking out for changes in the breast of our partners, reminding and supporting our partners for self examination and mammograms and raising the awareness for stakeholder effort, then I don’t know what else will scare us about breast cancer.
It is our collective effort.