“I should’ve never ignored that lump!” the patient exclaimed with sunken eyes brimming with tears. Shrieking cries then bellowed throughout the corridors as she slumped forward, face planted into weary hands. As the room deadened with silence, the patient then shakingly uttered a few unforgettable words, “I never thought it could be me, nobody in my family has it…”. Unfortunately, this patient had just received news of her crippling diagnosis of Stage IV Breast Cancer.

Cancer is documented to be the second most common cause of death in the Caribbean with Breast cancer being the most diagnosed cancer among Trinbagonian women. Cancer of the breast proves to be fatal in most cases, mainly because early symptoms of this disease are not easily noticed. The later breast cancer is detected, the lesser are the chances of survival of an individual.

Additionally, the National Cancer Institute (NCI) projects that pandemic-related delays in diagnosis and treatment disruption could result in 10,000 additional deaths from breast cancer over the next 10 years. In addition, researchers report that during the first three months of the COVID-19 pandemic, diagnostic and screening mammograms have decreased over 80%. There has also been a 50% decline in visits to primary care physicians. All these plus disruptions in diagnostic tests, lab work and delayed appointments are all likely to have an impact on cancer patients.

So, what can we do about this?

Screening Saves Lives

The most important strategy in preventing the sequelae of Breast Cancer is early Screening. The aim of screening is to detect cancer before the onset of symptoms.

Breast cancer that is diagnosed before spread (metastasis) is significantly easier to treat successfully and has higher cure rates. Regular screening allows for us to diagnose earlier and it decreases the need for aggressive treatment like chemotherapy and surgical removal of the breast (mastectomy). Early detection of breast cancer prevents deaths and improves longevity and quality of life.

Early warning signs of breast cancer

Symptoms of breast tumors vary from person to person. Some common, early warning signs of breast cancer include:

Skin changes, such as swelling, redness, or other visible differences in one or both breasts

An increase in size or change in shape of the breast(s)

Changes in the appearance of one or both nipples

Nipple discharge other than breast milk

General pain in/on any part of the breast

Lumps or nodes felt on or inside of the breast

Symptoms more specific to invasive breast cancer are:

Irritated or itchy breasts

Change in breast colour

Increase in breast size or shape (over a short period of time)

Changes in touch (may feel hard, tender or warm)

Peeling or flaking of the nipple skin

A breast lump or thickening

Redness or pitting of the breast skin (like the skin of an orange)

It is important to remember that other, benign conditions may have caused these changes. For example, changes to the skin texture on the breast may be caused by a skin condition like eczema, and swollen lymph nodes may be caused by an infection in the breast or another, unrelated illness. Seeing a doctor for an evaluation will help you determine whether something you notice is cause for concern.

Risk Factors of Breast Cancer

A breast cancer risk factor is anything that makes it more likely you’ll get breast cancer. But having one or even several breast cancer risk factors doesn’t necessarily mean you’ll develop breast cancer. Many women who develop breast cancer have no known risk factors other than simply being women.

Family History: Women who have genetic mutations such as the presence of the genes BRCA1 & BRCA2, had suffered from breast cancer or certain kinds of other cancers in the past and those who have a previous family history of breast cancer, amongst their close female or male relatives, are at an increased risk of developing breast cancer earlier.

Reproductive History: Chances of breast cancer tend to rise if a female might have undergone her menstruation before the age of 12 or her menopause after 55. The presence of more connective tissue in women with dense breasts, make it difficult to detect tumorous growth in the breasts, automatically raising the potential of developing breast cancer early on.

Medical History: Women who have undergone radiation therapy for cancers such as Hodgkin’s lymphoma, lobular carcinoma or atypical ductal hyperplasia, to the chest or breasts early-on in life, can experience an occurrence of breast cancer owing to this, as they progress in age. Hormonal medications such as oral contraceptives and birth control pills, taken without a doctor’s intervention, also increase the risk of breast cancer.

Poor Lifestyle Habits: Regular consumption of alcohol, not being physically active, smoking, consuming a diet rich in fatty food and living in an environment of constant stress and anxiety, can eventually contribute to a heightened risk of breast cancer.

Are Screening Initiatives Helpful?

Many clinics locally and globally proactively embark on Screening initiatives. Dr Jevon Rush, Chief of Staff, The Care Clinic and Medical Centre shared, “Our first initiative in 2019, identified 20% of women screened as high-risk patients for Breast Cancer, who then received further evaluations. From my perspective, screening as a public health strategy is necessary as it allows us to promptly identify unrecognised or early disease in apparently well, asymptomatic persons. This then allows for early intervention in earlier stages of disease leading to better outcomes and decreased mortality.”

Breast Cancer and Mental Health

A breast cancer diagnosis can make patients and their loved ones often feel powerless. Some things truly are outside of our control, and the associated mental health issue can be devastating. While breast cancer and mental illness may both feel like insurmountably large problems, you can take simple steps every day to feel better. Staying as active as you can, focusing on healthy habits, and reaching out to friends, family, a support group, or a faith group can all help. Knowing your risks, what are the early symptoms and the proper techniques for self-examination are all armouries to prevent the fatality of Breast Cancer.