Alarming increase in breast cancer among black women

South African doctors have seen an “alarming” increase in the incidence of breast cancer among young black women in the past few years.

The Radiological Society of South Africa this week stepped up campaigns to build awareness of the disease. The society said on Wednesday that even more alarming than the reported increase in the incidence of breast cancer was the fact that young black women had the lowest survival rates because they presented themselves to doctors too late.

Dr Carol-Ann Benn, a breast disease specialist at the Chris Hani Baragwanath Breast Care Clinic, said doctors first noticed the higher incidence of breast disease among black women two to three years ago.

Between 60 and 80% of all the patients Benn now sees at Baragwanath and at the Johannesburg Hospital clinic arrive with advanced breast cancer, which in most cases is terminal.

Many of these patients are younger than 35, said Benn. In the last 15 years, a 21% rise in the number of breast cancer patients has been reported worldwide, meaning that women the world over now have a one-in-nine lifetime risk of developing the disease.

In South Africa for example, more women die each year from breast cancer than from any other type of cancer, including even cervical cancer which was once the number one killer among the cancers.
And to further complicate the situation, the traditional technique for screening and diagnosing breast tumours—the mammogram—has remained controversial despite evidence of its effectiveness.

Although mammograms are not perfect—they miss some tumours and flag benign lumps—they can detect small tumours up to two years earlier than breast examinations, thus providing more options for treatment.

Many professionals in South Africa have, as a result, come out in support of the mammogram for women over the age of 40. According to the National Alliance of Breast Cancer Organisations (Nabco), annual screening mammography combined with annual breast examinations by a trained professional, is the best way to find breast cancer.

Dr Richard Truft, the president of the Radiological Society, said: “As one-in-9 women can expect to get breast cancer, a 45% reduction in mortality from this disease for women aged between 39 and 49, is a saving of lives that few, if any, cancer detection programmes can hope to match.”

The society’s Professor Peter Corr said that not only is it important to make South African women aware of the need for mammograms, but it is also necessary to make the tests readily available to them.

“When we look at the national picture, mammography facilities are patchy in the public hospitals. Although screening mammography is now being recommended by private practice GPs ... accessibility needs to be broadened ... on a public service level,” he said. Although self-examination is critical for women of all ages, in South Africa this is even more critical, given that the five-year survival rate among black women is 64% in comparison to white women at 80%.

Mammography screening should begin at 40 years of age, not 50 as was previously thought and all women between 40 and 50 should be screened every 12 to 18 months. Those aged between 50 and 70 should be checked annually, and those over 70, every two years. - Sapa