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Breast cancer awareness [Courtesy, Freepik] Every year in October, the world joins hands to raise awareness on breast cancer. This year's theme is 'Keeping Her in the Picture', a plea for everyone to keep an eye on the well-being of the women in their lives. According to the Ministry of Health (MoH), breast cancer is the second leading cause of all cancer deaths, accounting for 12.5 per cent of the cancer burden. According to Globocan 2018 statistics, the incidence of breast cancer in Kenya is estimated at 40.3 per 100,000, with a mortality rate of 17.8 per 100,000. The annual incidence of breast cancer in Kenya is approximately 12.5 per cent of new cancer cases and the annual mortality is approximately 7.7 per cent of all cancer deaths. "Breast cancer does not have a single, specific cause, but several factors can contribute to its development. These include genetic mutations (such as BRCA1 and BRCA2), hormonal factors (such as exposure to oestrogen), family history, age and lifestyle factors such as obesity and alcohol consumption," Says Dr Catherine Nyongesa, a clinical/radiation oncologist. She explains that there are no specific causes of breast cancer, although there are factors that can lead to breast cancer. Dr Nyongesa says breast cancer can manifest itself in a variety of ways and that recognising early warning signs is important for timely intervention. Understanding the risk factors can help individuals take steps to reduce their risk of developing breast cancer. "The risk increases with age, with most cases occurring in women over 50, family history of breast cancer can increase the risk, and finally certain genetic mutations, such as BRCA1 and BRCA2, increase susceptibility," she says. She adds that hormone replacement therapy, obesity and excessive alcohol consumption and smoking can contribute to breast cancer. She says maintaining a healthy lifestyle, considering genetic testing if you have a family history, limiting alcohol intake, avoiding smoking and finally regular exercise and a balanced diet while maintaining a healthy weight are some of the ways to reduce the risk of breast cancer. "Contrary to a common misconception, men can get breast cancer. Although it's much less common in men than in women, it's important to be aware. Approximately 1 in 833 men will be diagnosed with breast cancer in their lifetime," she says. She advises people to be on the lookout for a lump in the breast or underarm or changes in breast size or shape (noticeable changes or asymmetry between the breasts). Others include unexplained persistent pain in the breast or nipple area or dimpling or puckering of the breast skin. "Breast Cancer Awareness Month is a reminder to prioritise regular screening, spread awareness and support ongoing research to combat this disease. Together, we can make a difference in the fight against breast cancer," says Nyongesa. Dr Daniel Ojuka, Breast Oncoplastic Surgeon, says treatment options depend on the stage and type of breast cancer. "Surgery can involve the whole breast or part of the breast that has a tumour. It can leave the skin with the nipple or the whole skin, or it can remove most of the skin. This skin-sparing is mainly done when you want to reconstruct immediately," says Dr Ojuka He says chemotherapy, which can be given before or after surgery, and depends on the type and stage of breast cancer. "Radiotherapy is usually given after surgery and chemotherapy, it may be omitted depending on the stage and type," he says. Ojuka says hormone therapy is given when you have over-expression of a hormone receptor, usually oestrogen. "Some of the side effects of radiotherapy are immediate, burns and fatigue are the most common side effects that patients have to deal with," he says. "Long-term cancer can also metastasise and affect other organs in the immediate area such as bones, lungs, heart." Ojuka says prevention requires a good diet to improve one's immunity. "All women should start clinical breast exams and ultrasound from the age of 35 and annual mammography from the age of 40," he advises. Ojuka wishes the government can find ways of funding screening, diagnosis and treatment of breast cancer patients.

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