What comes to mind when you think about breast cancer? For some it’s growing tumors, for others, it’s the person suffering from the disease. For most in the health sector, whether as individuals or facilities, breast cancer is not only about the aforementioned factors, it’s also about early detection and the treatments available. Early detection should take precedence though, no? We think so. Prevention is better than cure where breast cancer is concerned.
Before we dive into early detection, let’s look at Sub-Saharan Africa (SSA) as our geographical area of focus for this piece. WHO Regional Director for Africa, Dr. Matshidiso Moeti had this to say about Breast cancer in her opening remarks for a COVID-19 press conference for World Cancer Day in February this year,
”In sub-Saharan Africa, around two out of five women who seek access to treatment for breast cancer, for example, do not receive it because they cannot afford it or the service is not available close to where they live.’’
To add to that assessment, here are some more facts about Breast Cancer in most countries in SSA;
- Breast cancer is the second most common cancer type among women, after cervical cancer
- Women with breast cancer in SSA are younger compared to those in high-income countries
- Delay between symptom onset and seeking a medical opinion is common. In sub-Saharan Africa, most breast cancer patients are diagnosed with advanced disease
- The rapid increase in breast cancer cases in sub-Saharan Africa in recent years has been attributed to a “westernization” of lifestyles that have resulted in changing of reproductive patterns (delayed age for the first birth, fewer children, and reduced breastfeeding duration) and changes in diet, alcohol intake, low physical activity, and obesity
- Screening programs for breast cancer in SSA have been less effective than in high-income countries
”In sub-Saharan Africa, around two out of five women who seek access to treatment for breast cancer, for example, do not receive it because they cannot afford it or the service is not available close to where they live.’’WHO Regional Director for Africa, Dr. Matshidiso Moeti
To put a spotlight on the last fact, why is it that screening programs are less effective in SSA? It is possible that most countries in SSA have not been able to implement and sustain screening programs due to financial, logistical, and sociocultural constraints. Though mammograms are the gold standard in breast cancer detection, the said constraints hinder the availability of mammograms in most health facilities in SSA. Therefore, in low-resource settings where mammography is unavailable, handheld ultrasound coupled with other early detection methods may offer a viable alternative.
Early Detection: Where in the World do we start?
Early breast cancer detection has a strong influence on breast cancer survival. The first steps that should be encouraged in early detection are early diagnosis in symptomatic women and screening in asymptomatic women.
Three things need to be in place to encourage early detection;
- Education and awareness of the disease and the risk factors
- Support for women in seeking healthcare
- Access to appropriate and affordable diagnostic tests and treatments
Use of Ultrasound in Breast Cancer Screening
The ultrasound device works by sends high-frequency sound waves through the breast and converts them into images on a viewing screen. An ultrasound is not used on its own as a screening test for breast cancer. It is used to complement other screening tests (breast exam, mammogram, biopsy, and MRI).
If an abnormality is seen on mammography or felt during a physical exam, ultrasounds are the best way to find out if the abnormality is a solid mass (a benign fibroadenoma or cancer) or a fluid-filled one (a benign cyst). Our butterfly handheld ultrasound would definitely come in handy in point-of-care facilities especially during breast cancer awareness month when one and all are encouraged to visit a facility and get examined for breast cancer.
If you’re under age 30, your doctor may recommend an ultrasound test before recommending mammography to evaluate a palpable breast lump. This is because most breast lumps in young women are clumps of normal glandular tissue or benign cysts.
An ultrasound device may also assist a doctor to guide biopsy needles precisely to suspicious areas in the breast. As a point of care facility, you need a handheld ultrasound. Contact us and improve the quality of healthcare you offer.
Overcoming the stigma of cancer is critical, as is public awareness of breast health and the need for timely evaluation of breast masses. Access to timely and high-quality imaging and pathologic diagnosis remains essential. Strides have been made though and multiple efforts are underway to improve access to pathological diagnosis in Sub-Saharan Africa through expanded training, telemedicine, and other approaches.
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