What you need to know:
- The moment you feel or see a painless lesion on your breast, don't waste even a second; run to the nearest health facility.
- Dr Dulcie Wanda: When cancer begins there is no pain, it doesn’t hurt.
- When the tumour is left to grow without intervention, it quickly mutates into metastatic cancer.
Have you ignored that painless lesion on your breast? You’re a man and you say it’s probably nothing serious. Or you’re a breastfeeding mother and you shrug it off as your breast changes due to milk production.
Well, it’s not your place to conclude otherwise. Instead, the moment you feel or see it, don't waste even a second; run to the nearest dispensary (Level 2) or health centre (Level 3) first for a clinical examination. From here, you can be referred to a sub-county hospital (Level 4) or county (Level 5) hospital for advanced screening.
Don't run first to Kenyatta National Hospital (Level 6) for screening. To get the attention of the doctors at the national referral hospital, you must have a referral letter from a public Level 3 or Level 4 hospital.
Why? Because that would be the start of cancerous tumour and the sooner it is detected, the quicker it is removed before the cells multiply fast, then break off and move to other essential parts of the body like the lungs, liver and lungs.
“Normally, when the cancer begins there is no pain, it doesn’t hurt,” explains Dr Dulcie Wanda, a clinical and radiation oncologist at Kenyatta National Hospital.
“And since there is no pain, people ignore and go about their normal lives. But remember the tumour does not wait for you to finish all your activities. It will continue to grow and might break off and go to other organs of the body”
She explains further: “Cancer is a cell that is not behaving normally. It is a cell that is not undergoing cell division and dying off. It has lost its ability to die off. It has lost its regulation of growth and development. So it's rapidly growing, dividing in an abnormal manner and having abnormal DNA within it, and with the ability to break off and invade in another area. That is what we call metastasis.”
And when the tumour is left to grow without intervention, it quickly mutates into metastatic cancer, a dangerous phase of cancer.
Dr Wanda elaborates: “The collection of the abnormal cells form a tumour and a small piece of it can break off, enter circulation and eventually go to another organ like the lung, liver and even the brain. That is what we call metastatic disease, a disease that has left the breast and attacked different organs of the body.”
“And that explains the essence of early detection. If we detect the lesion early when it is still in the breast then we have high chances of dealing with it locally and avoiding a situation where part of it breaks off and goes to other organs,” she says.
She encourages Kenyans to go to hospitals for regular check-ups rather than checking in only when they are unwell. She says with good health seeking behaviour, breast cancer can be detected at a “local level and contained locally.”
“We need to go to hospital for screening. If you’re above the age of 40, you need to go for a mammogram that is the x-ray of the breast that is able to detect very small lesions. Once detected early, we are able to remove them before they go to other organs,” she advises.
“For the women who are below the age of 40, you can have an ultrasound as an imaging modality. The reason you can’t have a mammogram below the age of 40 is because the breasts are dense and the mammogram will not be able to visualise the lesions in the breast.”
She says individuals and health professionals need to have a high suspicion index of breast cancer.
“You need to know what's normal-how your breasts look like before, during and after your menstrual cycle,” she guides.
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“ If you realise your breast has become larger than the other one, or changes on the skin like it's looking like an orange peel with dimpling, that’s something you need checked. If your nipples were all along facing out and suddenly one has pulled inward or there is a discharge coming out of your nipple, go for a clinical examination.”
She cites late presentation as a major problem blocking early detection of breast cancer.
“And it is not a late presentation in the sense that the patient has not been in hospital but because breast cancer is not high on the list of suspected diseases,” she notes.
“We treat it as an infection or mastitis, or anything other than cancer, and by the time we treat it as cancer, it has probably taken a while.”