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Friday, 16 November 2018

Combating Breast Cancer in Nigeria; The Need for Comprehensive Screening Programs


Breast cancer is the number one cancer killer of women in Nigeria. I am very sure that many of my readers know someone that has succumbed to or is currently battling with this dreadful disease. It is my prayer that after reading this article, someone will be prompted to encourage his/her sister, mother, cousin or friend
to get the necessary life saving and routinely regular monthly self breast examination.

Definition - Breast cancer is a malignant growth that usually begins in the tissues of the breast. It is the most common cancer in women, though it can also appear in men.

Epidemiology of breast cancer in Nigeria:
Breast cancer constitute a major public health issue globally with over 1 million new cases diagnosed annual resulting in over 400,000 annual deaths and about 4.4 million women are living with the disease. It also affects one in eight women during their lives.

In Nigeria, about 1,600 women die of breast cancer annually with about 4,000 new cases recorded yearly.

In Usmanu Danfodiyo University Teaching Hospital Sokoto, about 25 women come to the clinic every Tuesday with breast pathology among them, about 15 come with advanced breast cancer that little or no benefit can be derived from any form of therapy.

Risk factors: There are many risk factors that have been associated with breast cancer. 

1. Being a female is one of the factors
that nothing can be done about. The
chances of getting the disease increases with the age of a woman.
2. A history of breast cancer in close
relatives especially in mother and
siblings.
3. Early onset of menstrual bleeding
fore the age of 12 years.
4. Reaching menopause after the age of 55 years.
5. Oral contraceptives
6. Obesity
7. Alcohol consumption
8. Cigarette smoking
9. Not having children or having your
first child after the age of 35 year.

Signs and symptoms: It is troubling to know that majority of our females ignore changes they might have noticed around their breast. This is very common in our country. These changes may include;

1. Breast lump which is usually painless that gradually or rapidly increase in size
2. Change in size or shape of the breast
3. Nipple discharge
4. Nipple retraction

It is important to know that early detection and prompt treatment is the key to surving this deadly disease.

Diagnosis and treatment: From basic breast examination to FNAC/FNAB and then to advanced genetic studies can be done to diagnose breast cancer.

Surgery, Chemotherapy, Radiotherapy and many new and advanced therapies are now available in the developed worid and they have contributed to the good prognosis seen there. Reverse is the case in our county, I call on the government to
look into this.

Factors to consider: Diagnosis is usually late in Nigeria. By the time most people show up, the cancer is already widespread. At this stage, nothing medical or surgical can be done except palliative management.

It is obvious that modern technology
cannot be made available to all women in Nigeria in an effort to increase routine breast screening however encourage our women to conduct the routine "self breast examinations" a simple step that will reveal any changes that might require attention.

For women in the cities, annual mammography and other female related screening should be done appropriately.

For women in the rural areas, integrating breast health education by a working relationship with numerous religious organizations and non profit groups will be a step in the right direction.

Conclusion: Breast cancer is a "killer". The treatment and management is a big challenge in Nigeria.

I am appealing to us all, to call our sisters, mothers, cousins, aunties, nieces, friends and ask them if they have been screened.



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