“Don’t depend on self-examination only” – doctor urges more screening for breast cancer

General Surgeon and Consultant at the Georgetown Public Hospital Corporation (GPHC), Dr Ravi Motilall is urging women to visit their healthcare providers to get properly screened for breast cancer, noting that self-examinations alone are not sufficient.
According to the primary physician, women and in some cases, men should not solely depend on self-examinations to detect whether or not they are predisposed to cancer in the breast.
He explained that decades of research clearly show that women who have regular mammograms are more likely to have breast cancer found earlier, are less likely to need aggressive treatments like surgery to remove the entire breast (mastectomy) and chemotherapy, and are more likely to be cured when compared to women who rely on self-examinations to determine their status.
“The WHO (World Health Organisation) says it’s a good way of empowering a woman and it’s true. You are taking responsibility for your own health so you should do it but it’s not the ideal way of screening for breast cancer. Then there was talk about you seeing a physician and him examining the breast as part of screening. Well, that has also become a little bit, wanting to say, antiquated. Is that, again, even someone who’s seen so many, it’s not an ideal way. What we want to do is capture the cancer at an early stage, so none of those methods allow us to capture it early. Because unfortunately, the only way those methods can help you is if we feel something abnormal. So, the current accepted standard way of doing breast screening is a mammogram, what’s referred to as a screening mammogram,” Dr Motilall said.
In addition to maintaining a healthy diet, exercising regularly and utilising natural contraceptive methods, getting screened for breast cancer by a certified healthcare provider annually will decrease an individual’s likeliness to be diagnosed with the illness.
In fact, Dr Motilall noted that mammograms also known as an X-ray examination of the breast, has proven to be 75 per cent to 85 per cent effective for diagnosing breast cancer, given that it is easier to see tissue on mammograms.
“Because what that mammogram allows us to do is see the very early subtle changes, minute things that we can’t feel, but can be picked up on an X-ray. And then that gives us an opportunity to now classify it in terms of assessing your risk because not every breast lump means its cancer.
So, let’s not go there. What the screening method allows is for us to now categorise women who may even have a lump and say, well, this lump is not cancer. This lump is benign and there is special skill method that a radiologist or a surgeon may use that we will look at the image and say, it falls into this category. You don’t need to be worried. And see you next year for a new screening” he added.
October is Breast Cancer Awareness Month, an annual campaign to increase awareness of the disease.
In Guyana, breast cancer is the most diagnosed cancer and the second leading cause of death due to cancer in women. (WHO 2020 Report)
In fact, the Health Ministry said last year that it had diagnosed 161 persons with breast cancer. This accounted for 17 per cent of all cancers diagnosed that year.

Symptoms
Breast cancer can have several symptoms, but the first noticeable symptom is usually a lump or area of thickened breast tissue. Most breast lumps are not cancerous, but it is always best to have them checked by a doctor especially if you notice a change in the size or shape of one or both breasts, discharge from either of the nipples, a lump or swelling in either of the armpits, dimpling on the skin of the breasts and a rash on or around the nipples, among others.

Diagnosis
A thorough clinical history, along with a physical exam, helps doctors to assess patients for breast cancer, after examining the breasts; patients may be referred to breast screening by ultrasound, mammography, or taking a small sample of breast tissue to be examined under a microscope (a biopsy).

Treatment
If cancer is detected at an early stage, it can be treated before it spreads to other parts of the body. Breast cancer is treated using a combination of surgery, chemotherapy and radiotherapy.
Surgery is usually the first type of treatment, followed by chemotherapy or radiotherapy or, in some cases, hormone or targeted treatments. The type of surgery and the treatment will depend on the type of breast cancer patients present.
In a small proportion of women, breast cancer is discovered after it has spread to other parts of the body (metastatic breast cancer). Secondary cancer is not curable, so treatment aims to relieve symptoms. (G1)