Number one cause of death among women
CANCER is a dreaded pandemic disease. According to WHO and Global cancer statistics, the number of new cases and cancer mortality has been increasing over the last decade. Breast cancer is among the top five causes of mortality among young women in the Pacific Island countries. Global information revealed that breast cancer is the number one cause of cancer deaths among women. On the regional perspective, breast cancer is the first highest cause of death after cervical cancer in Pacific Island women. As stated by new data obtained by The Institute for Health Metrix and Evaluation (IHME) Fiji, breast cancer has accounted for 28.2 per cent of deaths in the country from 2009 to 2019.
Most of these women usually present to their hospitals with advanced breast cancer stages and almost all outcomes are poor. This is largely due to progressive change in their cultural and socio-economic status and beliefs about health and diseases like cancer. Western lifestyles and diets have shown positive association in developing breast cancers among women from these countries. At present, these countries have limited available resources or almost none for cancer care and management.
The goal of screening tests for breast cancer is to find it before it causes symptoms (like a lump that can be felt). Screening refers to tests and exams used to find a disease in people who don't have any symptoms. Early detection means finding and diagnosing a disease earlier than if you'd waited for symptoms to start.
Finding breast cancer early and getting stateof-the-art cancer treatment are the most important strategies to prevent deaths from breast cancer. Breast cancer that's found early, when it's small and has not spread, is easier to treat successfully. Getting regular screening tests is the most reliable way to find breast cancer early. The American Cancer Society has screening guidelines for women at average risk of breast cancer, and for those at high risk for breast cancer.
Breast cancers found during screening exams are more likely to be smaller and still confined to the breast. The size of a breast cancer and how far it has spread are some of the most important factors in predicting the prognosis (course and outcome) of a woman with this disease.
These guidelines are for women at average risk for breast cancer. For screening purposes, a woman is considered to be at average risk if she doesn't have a personal history of breast cancer, a strong family history of breast cancer or a genetic mutation (change in the structure of gene) known to increase risk of breast cancer (such as in a BRCA gene) and has not
The American Cancer Society recommends against MRI screening for women whose lifetime risk of breast cancer is less than 15 per cent. If MRI is used, it should be in addition to, not instead of, a screening mammogram. This is because although an MRI is more likely to detect cancer than a mammogram, it may still miss some cancers that a mammogram would detect.
Most women at high risk should begin screening with MRI and mammograms when they are 30 and continue for as long as they are in good health. But a woman at high risk should make the decision to start with her health care providers, taking into account her personal circumstances and preferences.
Although breast cancer screening cannot prevent breast cancer, it can help find breast cancer early, when it is easier to treat.
3-D mammography is a revolutionary screening and diagnostic tool that captures images of the breast in thin sections. During the procedure, the X-ray arm sweeps across the breast, capturing numerous images in a matter of seconds. 3-D imaging allows the radiologist to see inside the breast layer by layer, enhancing fine details by minimising overlapping tissue and can be done in conjunction with a traditional 2-D digital mammogram. The new digital mammography machine exposes patients to about one-quarter less radiation than traditional film mammograms.
3-D mammography offers additional benefits, including:
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Detects 41 per cent more invasive cancers
Reduces biopsies and callbacks for a second look by 40 per cent
Takes an image in four seconds
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Safety
Every screening test has benefits and risks, which is why it's important to talk to your doctor before getting any screening test.
Conclusion
According to WHO and Global cancer statistics, there is a steady increase in the incidence of cancer and cancer-related mortality worldwide, breast cancer being the number one cause among women. In Pacific Island countries, breast cancer is the leading cause of cancer deaths among women followed by cervical cancer. Studies showed that breast cancer has accounted for 28.2 per cent of deaths in the country from 2009 to 2019. And, most of the cases present at a late stage and have poor prognoses. Early diagnosis is the mainstay of treatment of cancer that can only be achieved by regular mammographic screening.
■ DR SIVASELVAM SIVAKUMAR