Eastern Mediterranean University (EMU) Dr. Fazıl Küçük Medicine Faculty academic staff member and Marmara University Medicine Faculty, Department of Internal Medicine, Medical Oncology Specialist Assoc. Prof. Dr. İbrahim Vedat Bayoğlu made a statement on the occasion of Breast Cancer Awareness Month:
“Be Aware! Do not be Shy to Touch! Early Diagnosis Saves Life!”
“Human body is composed of tissues and specialized cells which form these tissues. Cancer is a disease which occurs when an unordinary change and uncontrolled proliferation is observed within the normal characteristics of a single or multiple cell(s). Each year, more than 12 million people are diagnosed with cancer. Being on the top of the list for causes of mortality all around the world, cancer is one of the most important diseases of our era.
Breast cancer, as in the whole world, is the most frequent type of cancer observed in women in our country. One in every 8 women has the risk of getting breast cancer throughout their lifetime. The cause of the breast cancer and the factors which causes the disease are still unknown. The main risk factors for breast cancer include; being a women, advanced age, family history, early menstruation, late menopause, having the first child during advanced ages, taking external hormone supplements, being exposed to radiotherapy in breast area and having genetic mutations such as BRCA1/2.
Every year, 1.5 million women are diagnosed with breast cancer all around the world and, nearly 250 thousand women lose their lives because of the disease. Even though the data shows that breast cancer is a significantly frequent deathly disease, it can be prevented in high risk patients and can be fully treated by using the improving treatment modalities available today. Although the breast cancer incidence in Turkey has increased by 2.5 times during the last 25 years, with current protection, screening, diagnosis, treatment and medical monitoring methods, the mortality rate has been drastically decreased.
When it is diagnosed early, the success rate of treatment is high. With new treatments, success has been greatly increased in advanced stages of the disease, life expectancy has been significantly prolonged and quality of life has improved significantly. In order to increase awareness of breast cancer and the importance of early diagnosis in breast cancer, the World Health Organization has designated October every year as "Breast Cancer Awareness and Awareness Month" since 2004. Various activities and educational activities are held this month in order to attract the attention of the public to this important health problem and to increase public awareness.
The two most important concepts in breast cancer, which is an important public health problem, is prevention and early diagnosis. In primary prevention; lifestyle changes, having a healthy (rich in vegetables and fruits) diet, minimum 150 minutes of moderate activity per week (at least 10 minutes of brisk walking, such as cycling) or minimum 75 minutes of vigorous activity per week (at least 10 minutes of jogging, swimming, etc.), being at a healthy weight and staying at this weight, avoiding smoking and alcohol should be the main priority. There are studies showing that breastfeeding for 1.5 – 2 years also protects the mother from breast cancer.
Moreover, secondary prevention methods include; performing Breast Self-examination (BSE), clinical breast examination and mammography etc. along with the medical follow-up with imaging methods being the basic approach. The person should observe her own breasts in front of the mirror and try to notice early changes in shape, form and symmetry. Breast self-examination brochure can be accessed at https://hsgm.saglik.gov.tr/depo/birimler/kanser-db/yayinlar /afis ve brosur/14-_KKMM_Brosuru_1-2.pdf. Studies have shown that BSE is effective and useful in early diagnosis.
The breast cancer screening recommended steps are; between the ages of 20-40, monthly BSE and going to the doctor every two years for clinical breast examination. Between the ages of 40-69, monthly BSE, visiting a doctor once a year for clinical breast examination, and the evaluation of the breast with imaging methods such as mammography, ultrasound, etc. at regular intervals.
The most common sign of breast cancer is the feeling of a painless, growing mass in the breast. Other symptoms consist of pain in breast or nipple, changes in the skin of the breast (skin thickening, redness, dimpling, itching, crusting, orange peel appearance), changes in the nipple (Pull-inward, sensitization, irritation or structural deterioration), unilateral nipple discharge, palpable hardness-mass in the armpit, deformity of some or all of the breasts.
After diagnosis of breast cancer, treatment should be carried out by a multidisciplinary team including General Surgery - Medical Oncology - Radiation Oncology - Plastic Surgery - Radiology and support teams. The treatment of each patient differs significantly according to the characteristics of the tumor, the general condition of the patient, and other accompanying diseases. Basically, treatment includes surgery, chemotherapy, radiation therapy and hormone therapy. In recent years, targeted therapies that provide personalized treatment, in other words smart molecules, have come into use. Thanks to these drugs, significant improvement in treatment has been observed, significant increases in treatment success were achieved, and the course of the disease has completely changed. The success of current treatments is increasing day by day.
To conclude, breast cancer remains on the agenda as an important public health problem today. Considering its lethality, the difficulties in its treatment, the psychological-material-moral burden on the patient and the family, and its effects on the country's economy, public awareness and early diagnosis still play an important role in success. Raising awareness and improving public awareness about breast cancer are among the most effective methods in the fight against the disease. For this purpose, action plans and activities to raise awareness are being carried out by the Ministry of Health and many health institutions today. The most important development in the fight against breast cancer will be achieved by increasing the rate of early diagnosis. The key point in early diagnosis is BSE. For this reason, our women should not be afraid of touching and conducting self-examinations in this disease that can be completely cured but should be afraid of late diagnosis.”
References
1- T.C sağlık bakanlığı Sağlık Hizmetleri Genel Müdürlüğü Araştırma, Geliştirme ve Sağlık Teknolojisi Değerlendirme Dairesi Başkanlığı, Meme Kanseri Korunma, Tarama, Tanı, Tedavi ve İzlem Klinik Rehberi (Versiyon 1.0), Yayın No:1170, Ankara, 2020.