Expert answers FAQs this Breast Cancer Awareness Month

Women under the age of 62 have a 50% diagnosis of breast cancer. Interestingly, women under 45 receive 9% of all new diagnoses for breast cancer. Picture: Pexels

Women under the age of 62 have a 50% diagnosis of breast cancer. Interestingly, women under 45 receive 9% of all new diagnoses for breast cancer. Picture: Pexels

Published Oct 12, 2023


Breast cancer is on the rise. It can afflict men as well, albeit it primarily affects women. One of the most crucial tasks for the effective treatment of breast cancer is early detection.

Positive prognosis and successful treatment are possible with early diagnosis. When breast cancer is found early, almost 90% of patients live for several years after diagnosis.

The key to early detection is routine mammography and self-breast examinations.

If you seek treatment early on, you may receive more effective care, which could lessen your pain and suffering and significantly lower the number of deaths.

In South Africa, October has been declared Breast Cancer Awareness Month in response to a national campaign by both public and private health-care systems to increase public knowledge of this crippling illness among all racial and socio-economic groups.

According to Dr Helen Weber of Sanlam, although women in South Africa have a lifetime risk of 1 in 27, tremendous advancements in cancer detection and treatment nevertheless offer a great deal of hope and optimism.

Nearly half (48%) of the company’s severe illness claims for women last year were particularly tied to breast cancer, accounting for 63% of all cancer-related claims. In spite of these facts, according to Weber, yearly physicals and routine breast exams still promote the best possible outcome and prognosis.

She said in a statement: “You know your breasts best, so keep doing your checks to note any changes and flag these with your doctor early on.”

Below are some typical questions concerning breast cancer that Weber has responded to:

How frequently should women get screened for breast cancer?

Women should self-examine their breasts every month; if they have a regular cycle, they should check three to five days after the beginning of their period. If you are erratic, set aside the same time each month to analyse yourself.

There are a ton of leaflets, videos on social media and YouTube, and other resources available on how to self-check.

See your doctor for advice if you’re not sure. Keep an eye out for any new lumps, variations in the breast’s colour or shape, or discharge from the breast (if you are not nursing).

Recall that hormone fluctuations frequently cause completely natural bumps and lumps to appear; these should go away. You should consult your GP if they continue or if you have concerns.

You should have a general health screening from your doctor once a year if you’re under 50. If you’re older and have a family history of cancer or another chronic illness, this may need to be increased.

Because the breasts of younger women are usually denser, an ultrasound may be performed in addition to a mammography. A woman with a lower risk profile may require a mammogram only every two years after the age of 55.

There will be an ultrasound and mammography for ladies whose breasts are denser. Specialised magnetic resonance imaging (MRI) may be utilised if problems persist. Younger ladies with a high family history of cancer are also referred for MRI.

Why was the recommended age to begin mammograms in the US dropped from 50 to 40 years old?

Between 2015 and 2019, the US saw an average 2% annual increase in cases of breast cancer among women aged 40 to 49. As a result, the recommended age for mammograms was lowered, which will reduce the number of new cancer cases per thousand women.

The Radiological Society recommends that women begin receiving mammograms at age 40, and that is what we do in South Africa.

Is there a blood test that can identify breast cancer in women?

Though we are not there yet, this is the ideal we are aiming for. A family history combined with current genetic testing (blood test) can determine a person’s risk for breast cancer.

Abnormalities found in blood testing may point to an increased risk of ovarian or colon cancer. They cannot, however, be utilised for diagnostic purposes; a sample of the questioned tissue is required for that purpose.

Significant advancements in genetics and the characterisation of specific tumours are being made, and these developments are already saving and extending lives. Once cancer is diagnosed, people can now be much more optimistic.

Is genetic counselling appropriate for breast cancer patients?

First of all, it’s crucial to remember that the majority of breast tumours have no known hereditary cause. When you can examine a family’s whole situation, genetic counselling functions best.

A person’s positive carrier status of a deleterious variation in either the BRCA1 or BRCA2 gene, which implies an elevated risk of getting specific cancers, will be revealed by the testing.

Genetic counselling is something you should only think about after speaking with a specialist, such as your surgeon, general practitioner, or genetic counsellor. You should weigh the benefits and drawbacks before taking this test.

The CDC has also released guidelines and indications that help identify who should be tested and when, such as in the case of someone with a significant family history of pancreatic, ovarian, or breast cancer. We will also take your age into account.

Usually, testing is done on your mother or a stricken relative first. You can decide whether to take the test yourself if she tests positive for the BRCA gene, based on factors such as her age, the type of cancer she had, her age at diagnosis, and your family history.

You and your mother/family member can be profiled to provide a more complete and accurate risk assessment.

Medical assistance programmes in South Africa have several requirements that must be met before funding genetic counselling can be considered.

You should think about what you’ll do after you find out before taking the tests. Before you do so, it could be a good idea to consult a genetic counsellor.

Are prophylactic mastectomies covered by insurance?

Many do pay for prophylactic mastectomies but only in accordance with a set of contractual conditions, like a positive BRCA test result or a family history.

Which kind of risk coverage is appropriate for women?

While medical aid is crucial, gap coverage can assist with paying for cancer medications since these expenses are very high and most cancer benefits are limited.

A significant lump sum payment from severe illness coverage may help defray some of the costs of treatment; income protection and a sickness benefit might guard against prolonged absences from work.

Treatment and recuperation for breast cancer can take three to six months or more, and the average “sick leave” benefit is often limited to 30 days over the course of a three-year cycle.

How has the treatment of breast cancer progressed?

The field has made significant strides towards early detection and diagnosis of breast cancer at the molecular, immunological, and hormonal levels.

This enables us to respond to the cancer’s hormonal or immunological manifestation with extremely focused and efficient forms of treatment. In addition to radiotherapy and hormonal treatments after surgery, these tailored treatments allow us to do more breast-conserving procedures.

Additionally, we now have chemotherapeutic combinations with less side effects and less toxicity.

The prognosis improves with earlier detection, according to Weber. Screening frequently saves lives. Doing yearly tests and weekly self-checks is essential to obtaining a complete picture of your health.