South Africans recently mourned the death of another music legend when Busi Mhlongo, 62, lost her battle with breast cancer.
Dr Carol Benn, who heads the Breast Care Centre at Joburg's Milpark Hospital, says breast cancer, the second leading cause of death in younger South African women after HIV and Aids, accounts for over 30 percent of new cancer cases in women.
But, she adds, nine out of 10 breast problems are benign and not cancer related.
Dr Vicki Schutte from Fourways says that although younger women are being diagnosed with early aggressive breast cancer today, "not every breast lump is a cancer lump".
"Many young women have a fibroadenoma, which is a lump of harmless fibrous tissue that only needs to be surgically removed if it is worrying her, or grows to be bigger than 3cm," she says.
But this does not mean that women - or men, who can also get breast cancer - can ignore a lump in their breast.
On the contrary, Benn says, they should be examined, have follow-up investigations such as a sonar or mammogram - and if necessary, a needle biopsy to confirm a diagnosis.
Successful treatment of breast cancer begins with finding breast cancer cells early and Benn encourages all women to check their breasts regularly.
"A woman who is afraid to see a doctor because the lump is either painless or because she's afraid to have it tested, risks minimising her chances of a full recovery, or she may worry unnecessarily because the lump may not be malignant," she said.
Schutte explains: "It takes on average about 90 days for a cancer cell to multiply. This means that the number of cancerous cells doubles every three months, and it usually takes about 10 years for a single cell to become a detectable lump that is the size of about 1cm."
It is standard procedure that once a lump has been found, testing for breast cancer includes a mammogram (or X-ray) followed up by a sonar and a needle aspiration biopsy if necessary.
Thermography or digital infrared thermal imaging (DITI) is a newer diagnostic tool available in South Africa.
Dr Arien van der Merwe, director of Health Stress Management in Pretoria, explains that thermography is "a heat-sensitive scanning camera that identifies cells in the body that are behaving abnormally".
"These can be malignant, inflamed or infected cells. More specifically, thermography has been found to be very useful when it comes to identifying early changes in breast tissue cells and the skin.
"Thermography is non-invasive as it simply uses a specialised heat-detecting camera to photograph the body. The colour-coded picture identifies hot and cold spots. These 'hot spots' (identified in red) indicate increased blood flow that could be a tumour with new blood vessels surrounding it. Even the smallest lumps can be found in this way," she says.
Schutte explains how thermography works: "The blood vessels surrounding cancer cells are slightly deformed and leaky, which means that the area can't respond to temperature changes as well as healthy tissue can and any area with damaged vessels will show up to be warmer."
What are the advantages of thermography over mammography?
A mammogram is basically an X-ray picture of the breast that has been pressed between two glass plates.
It should be a painless procedure, but some women find it painful - like "catching your breast in the fridge door". Benn says that this should not be the case and depends on the skill and sensitivity of the radiographer.
In the UK, routine mammograms are not done on younger women because they're not supposed to be at risk of breast cancer as much as older women. This is to their disadvantage because today younger women are getting breast cancer.
Another concern about mammograms questions their accuracy in younger women, because their breasts are dense, making it more difficult to identify anything abnormal when it is still small.
There is also some concern among the medical profession that young women should not be exposed to the radiation of a mammogram during the ovulatory phase of her cycle, because duct cells are multiplying under the influence of oestrogen at this time. According to Benn, this theory has not yet been scientifically proven.
Advantages of thermography are that it is a non-invasive procedure (the body isn't even touched), takes only about 15 minutes and there is no radiation exposure or harmful side effects.
Over the past 15 years, standardised interpretation protocols for thermography have been put in place, and the US Food and Drug Administration has approved breast thermography as an additional cancer screening procedure.
Benn agrees that thermography can be an initial or additional investigation for breast cancer, but says it can't replace a mammogram.
Schutte also emphasises the importance of follow-up investigations three months after the first thermography if it showed any abnormal cell activity.
"Otherwise thermography can be done annually for women who are at risk of getting breast cancer," she said.
Although thermography is recommended for detecting breast cancer, full-body images can be useful in identifying other medical problems such as inflammation (arthritis and fibromyalgia), infection (artery inflammation and unexplained pain) and abnormal cells in other organs.
- For more information about thermography in South Africa and where testing can be done, go to www.HeathStressWellness.com or www.diti.co.za. If you have any questions, e-mail [email protected]