The state of the South African breast is not good. Mammography is not generally available to the poor and breast cancer has become the second-biggest killer of black women. There will be about 1,25-million new cases of breast cancer diagnosed this year in the world. The life-time risk for getting breast cancer is now between one in 10 and one in seven. If this disease is so common and if our population is so vulnerable, why is there such a laissez-faire attitude? Probably as a result of two important factors: lack of communication and fear.
It is not surprising that women fear breast cancer. What most women know is what their mothers and grandmothers tell them: “Breast cancer means mastectomy, radiation therapy, chemotherapy and hair loss, lost relationships with their loved ones, deformity of the female shape and even suffering and death.”
But things have changed and modern medicine has improved dramatically. Nowadays breast cancer is easily managed and a complete cure can be achieved. But this depends on early detection.
If a woman has a regular, high-quality mammogram every year from the age of 40 she will reduce the death rate from breast cancer by 38% and her life expectancy can increase by 30%. That is why many countries in the world give their women citizens regular mammograms as a constitutional right and these countries have seen significant improvements. Mammograms detect early disease, often years before a cancer grows large enough to be felt as a lump by the human hand.
The South African government does not have the budget to introduce mass screening in the population, but those who can do something should. I’d like to appeal to big business: it is an established fact that a healthy workforce is a productive one. It would be easy for large corporations, banks, factories and so on to provide extra healthcare for their employees as has been demonstrated by similar organisations in Europe.
Most South African companies do have some sort of healthcare facility and could increase awareness among their staff about breast cancer “prevention”. (Remember male staff members have wives and daughters too who might require help.) For staff members not covered by medical aid, most private mammogram centres provide a screening mammogram service at a reduced fee. Mammogram specialists can help by giving educational lectures to spread the “gospel of mammography” and reduce the fear of breast cancer.
Dr Paul Sneider is the director of the Parktown North Mammography and Bone Density Centre
Common misconceptions
“Mammograms hurt.” They do not.
“I am well.” Early breast cancer is painless and symptomless.
“There is no breast cancer in my family.” About 80% or more breast cancers are spontaneous.
“I was reassured by a doctor that my breasts are fine.” Unfortunately the human hand cannot detect early breast cancer. More than 80% of breast lumps are found by patients themselves and not by doctors.
“I found a lump, it must be cancer.” Again, more than 80% of all lumps found in the breast are benign.
“I need an operation to diagnose breast cancer.” All breast biopsies can now be done painlessly through the skin with a needle in the mammogram centre. No hospital or surgery is required for diagnosis in the vast majority of cases. — Paul Sneider