One in 28 women is affected by breast cancer in South Africa

The key to improving one’s chances of surviving breast cancer is early screening and diagnosis. It is the most common cancer among women in this country.

October is Breast Cancer Awareness Month and the Breast Imaging Society of South Africa (BISSA) urges women from the age of 40 to regularly self-examine and have mammograms every.

The National Cancer Registry states one in 28 women is affected by this cancer in the country. According to the National Health Laboratory, the prevalence in urban communities is as high as one in eight women.

“Breast cancer affects women of all ages, races and socio-economic circumstances. As frightening as a cancer diagnosis is, the good news is that modern medical advances and early screening and diagnosis lead to more patients surviving, and that patients can beat cancer with less aggressive and invasive treatment.

The need for early and accurate diagnosis simply cannot be overemphasised,” said Prof Jackie Smilg, chair of BISSA, which is a subspecialty group of the Radiological Society of South Africa (RSSA).

“Early breast cancer diagnosis reduces deaths, prolongs life expectancy, and improves quality of life. The early diagnosis by mammography also makes it possible that less extensive surgery, fewer mastectomies, and less frequent or aggressive chemotherapy are needed.”

The purpose of screening for breast cancer is to identify the disease before it causes symptoms, said Smilg, and “the gold standard remains the mammogram,” which can detect breast changes years before any physical symptoms develop.

Regular screening increases the chances that breast cancer will be identified while the tumor is still small and confined to the breast. This is important for the successful treatment and survival of the patient, as the size and extent of the spread is one of the most important factors when it comes to predicting the outcome of a diagnosis.

“Mammography, performed by radiologists, forms the foundation of early diagnosis. Regular mammograms can often help detect breast cancer at an early stage, when treatment is likely to be successful,” she said.

As with all cancer screening tests, the recommendations for breast cancer screening depend on a combination of factors, which include evidence of a risk for the condition, the benefits and potential damage that the tests may cause, as well as their costs.

“Several other imaging methods, including tomosynthesis, C-view imaging and contrast mammography, have brought a new dimension to the fight against breast cancer. Digital tomosynthesis can study various levels of breast tissue and it is now possible to create a 2D mammogram of these tomosynthesis disks. Contrast mammography, where contrast examines the vascular composition of a tumor, is a valuable tool,” explained Smilg.

In women with a significant family history of breast cancer or where special circumstances exist, a mammogram can also be followed by an ultrasound and/or a breast MRI in both screening and symptomatic examinations.

She addresses a number of myths surrounding mammography.

“There is simply no scientific evidence that the amount of radiation used in modern mammography can cause breast cancer, or pose any other danger to the body, including the thyroid gland.”

Smilg believes that women are often persuaded by this “irrational fear of radiation” to use alternative “imaging methods” – such as thermography, which uses light-emitting devices or systems that “feel” masses.

“There is no evidence that these methods have any value in the screening and detection of breast cancer compared to mammography. These methods are often performed by staff with no medical training and no training in conventional imaging methods, and can in fact do more harm by leading to delayed diagnosis and limited treatment options for breast cancer,” she said.

The RSSA and BISSA agree with the view of international organisations that allegations of overdiagnosis of breast cancer are “greatly exaggerated due to important methodological shortcomings in many studies”.

Of the 10% of women referred for an indeterminate mammogram for further testing, most simply received additional mammographic examinations or ultrasound for clarity.

Only 1-2% of women had to undergo a needle biopsy due to a screening mammogram. “The short-term anxiety that can result from an undecided test result simply cannot be weighed against the many lives saved by mammography every year. Ultimately, any undecided result requires further and deeper investigation.

Women must decide for themselves whether the short-term anxiety outweighs the risk of possibly dying from breast cancer. When it comes to dealing with a potentially life-threatening disease such as serious cancer, it makes sense to choose the most effective, decisive and effective screening technology, and it remains the mammogram,” added Smilg.

The RSSA and BISSA encourage all women to start having regular mammograms from the age of 40, and to do so annually until the age of 70, regardless of whether they have symptoms or an abnormality or not.

Women should have their breasts examined regularly for any irregularities and should undergo a clinical breast examination by their GP or gynecologist at least once a year.

Any abnormality, regardless of age or family history, requires immediate medical consultation with a healthcare professional. “Many lumps can be harmless, but it is essential that everyone is examined,” she said.

Women at high risk, usually due to a history of breast cancer in a close family member, should start with annual mammograms and MRIs five years before the age at which their family member was diagnosed with breast cancer, or from the age of 40, whichever comes first.

High risk is defined as a lifetime risk greater than 20-25%. It can be calculated by a doctor or online at:

What increases your chances of developing breast cancer?

Every woman has developed the potential for breast cancer. However, certain factors will place them in a higher risk category, including:

  • Age: The risk of developing breast cancer increases with age, but one in eight invasive breast cancers is diagnosed in women under 45.
  • Family history: Breast cancer risk is higher among women whose close blood relatives have been diagnosed with the disease. One first-degree family member (parent, brother, sister, child or grandmother) doubles a woman’s risk of developing breast cancer. With two first-degree relatives, her risk increases about threefold.
  • Personal history: A woman with cancer in one breast has a three to four times increased risk of also developing cancer in the other breast, or in another part of the same breast. It differs from a recurrence of first cancer.
    Dense breast tissue: Women with dense breast tissue (as identified on a mammogram) have more glandular tissue and less adipose tissue, and therefore a higher risk of breast cancer. Unfortunately, dense breast tissue also makes it harder for doctors to see problems on mammograms, making regular self-examination and screening even more important.
  • Overweight women or women with obesity: Research has shown in the past that obesity increases the risk of breast and other cancers. More recently, a larger study suggested that overweight and obese women diagnosed with early-stage, hormone-receptor-positive breast cancer have a higher risk of their cancer recurring (recurring) and they are less likely to develop the disease. to survive. Healthy eating habits and weight management are therefore especially important. Lifestyle factors: Excessive alcohol use, no physical activity, smoking, and diets high in saturated fats increase the risk of breast cancer.
  • Chest radiation before the age of 30: Chest radiation to treat another cancer (not breast cancer), such as Hodgkin’s disease or non-Hodgkin’s lymphoma, leads to a higher-than-average risk for breast cancer.
  • Hormonal environment: Women who have not yet had a full-term pregnancy, or who had their first child after the age of 30, have a higher risk of breast cancer compared to women who gave birth before the age of 30. Breastfeeding can lower breast cancer risk, especially if a woman is breastfeeding for more than a year. Women who start menstruating before the age of 12 have a higher risk of breast cancer later in life. The same goes for women who go through menopause when they are older than 55. Current users or those who until recently used hormone replacement therapy have a higher risk of being diagnosed with breast cancer.

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