Receiving a diagnosis of breast cancer is hugely challenging physically, emotionally and psychologically. However, as thousands of survivors can testify, there is greater understanding of the condition and more ways of fighting it than ever before. And the chances of beating it today are reassuringly high. With October being Breast Cancer Awareness month, BeautySA rounds-up the facts and a few figures on South Africa's most prevalent form of cancer.

Cancer is the name given to the range of more than a hundred diseases occurring when abnormal cells divide uncontrollably and become able to invade other parts of the body through the blood and lymph systems. All cancers begin in cells, which are the basic building blocks of life in our bodies. In a healthy body, the many different types of cells grow and divide in a controlled way, producing more cells to replace old or damaged ones. However, the genetic material (DNA) of a cell can change to produce mutations affecting this orderly cell growth and division, and the extra cells may form a mass of tissue called a tumour.

Tumours can be benign, which means they are not cancerous, do not spread to other parts of the body, and can generally be removed with no further problems. They may also be malignant, in which case their cancerous cells can invade nearby tissues and spread to other parts of the body in a process called metastasis.

Breast cancer is a cancer that forms in the tissues of the breast, usually in the ducts (tubes that carry milk to the nipple) or the lobules (glands that make milk). Most commonly, there is no pain in the early stages. Symptoms include a lump in the breast, unusual swelling, puckering of the skin causing indentation of the nipple, a sore or rash on the nipple or a discharge from it. Any of these symptoms could have an explanation other than cancer but should be checked out by your doctor without delay.

Actually a collection of different diseases, in which the type and course of the disorder as well as its impact varies widely from patient to patient, breast cancer can affect any adult woman. It can also, more rarely, affect men. It has no specific known cause, though appears to be influenced by a combination of genetic, hormonal, nutritional and environmental conditions. From these, researchers derive 'risk factors' which may affect the likelihood of our getting breast cancer. Having a risk factor – even several risk factors – does not mean that you will get the disease, nor does not having risk factors mean that you will not get it. An estimated 65% of people who develop breast cancer are not in the 'high-risk' category.

The main risk factors for breast cancer are gender – for every hundred women who develop the disease, there will be one man; and age – incidence in women over 50 is ten times than of those aged 30. Research shows that high amounts of oestrogen, which stimulates cell production in the body, may be related to breast cancer, so women who start their periods before the age of 12 or go through menopause after the age of 55 have a higher risk, as do those who have never had children or who have them after the age of 40. Breastfeeding is thought to reduce risk. Being on HRT (hormone replacement therapy) for longer than eight years appears to increase risk slightly, though the likelihood drops to that of the general population five years after stopping the medication. Family history (a close relative who has had cancer) and genetic predisposition may play a role. Smoking, alcohol, obesity and inactivity are believed to increase risk, and if you manage these with sensible lifestyle strategies you can help reduce it.

Breast cancer cannot be spread from one person to another, and is not related to the size of the breasts. More common in urban areas and in higher socio-economic societies, it does not discriminate between racial groups – the incidence among black women worldwide is rising rapidly.

In South Africa, breast cancer is the most prevalent form of cancer in white and Asian women and second (to cervical cancer) in black and coloured women. Current figures indicate that one in every 26 women, across all race groups, is likely to get the disease. While we as yet have no way to prevent breast cancer, early detection and improvements in treatment have vastly improved the outlook for sufferers. When found before the cancer invades tissues outside the breast, the survival rate can be as high as 95%.

Being vigilant about monthly self-examination is crucial, as around 70% of cancers in the breast are discovered in this way. However, not all lumps can be detected by touch alone, and experts recommend screening by means of mammograms (breast x-rays) every two years from the age of 40 and annually from the age of 50. A mammogram can detect breast cancer up to two years before there is a lump large enough to be felt.

Treatment depends on the stage and type of the cancer, as well as on the age and health of the patient, and usually involves a combination of chemotherapy, radiotherapy and surgery. Mastectomy – the surgical removal of one or both breasts – is appropriate in only relatively few very specific cases.

For more information, contact the Cancer Association of South Africa (CANSA) on 0800 22 66 22, or visit their website.

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