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Over 4,400 breast cancer cases yearly

20 Oct 2022

  • Oncologists note nationwide lack of awareness and facilities
  BY Dinitha Rathnayake   A total of 4,447 breast cancer cases were identified in 2019, with 12 cases being reported on a daily basis and two related deaths on a daily basis, on average, the Sri Lanka College of Oncologists (SLCO) stated. Speaking to The Morning, SLCO President Dr. Nadarajah Jeyakumaran explained that if the total annual cases of 4,447 is divided by 365 days, it equals 12.1 cases per day. Breast cancer is the commonest cancer among females worldwide, and it is the same in Sri Lanka as well. In Sri Lanka, yearly, there are around 4,500 breast cancer patients who are diagnosed. Hence, each day, on average, 12 breast cancer patients are identified. The month of October is dedicated as the “breast cancer awareness month” throughout the world in order to create awareness about the risks, the need for breast self-examination, clinical examination, the availability of investigations in hospital settings, and about the fact that early detection enables effective treatment.  Those who face high risk for breast cancer are mostly women above 45 years, and also people identified with the factors including obesity, early menarche, late menopause, post-menopausal hormone replacement therapy, having the first child after 30 years, not having children, family members having breast cancer in the younger age, exposure to radiation, alcohol intake, and less physical activity.  If women conduct breast self-examination, they may be able to discover symptoms such as lumps in the breast or any abnormality in size, shape, and skin consistency, or any lumps in the armpit. In very young females, having a hard mobile lump in the breasts, usually a fibroadenoma (a solid breast lump), is a benign lesion. Still, one needs to consult a doctor to exclude breast cancer, and to try and detect such in an early stage so that one can get curative treatment with only the removal of the breast lump and thereby conserving the breast as well.  In Sri Lanka, patients are still seen coming in the very late stages even among the well educated female group. It may be purely due to shyness and not paying enough attention to their health.  In developed countries, a well-designed national breast cancer screening programme exists so that women above 45 years of age are screened with mammograms and ultrasound examinations. Many breast cancers cases are detected in the early stages and consequently, the survival rate is also very high.  Sri Lanka however lacks a national breast cancer screening programme. The non-availability of sufficient mammography facilities and the lack of female radiographers to conduct the test procedures delay setting up a national screening programme.  In Sri Lanka, on average, two breast cancer patients die on a daily basis.  Though breast cancers occurring among families is less common (5-10%), one should suspect the risk when one’s close relatives are diagnosed with breast cancer at a young age. In this instance, a genetic testing of oncogene (a mutated gene that has the potential to cause cancer) with BRCA1 and BRCA2 (two genes that are important to fighting cancer as they are tumour suppressor genes and when they work normally, these genes help keep breast, ovarian, and other types of cells from growing and dividing too rapidly or in an uncontrolled way) can be done when it meets the criteria on genetic counselling. When this oncogene is positive, they need to undergo the prophylactic removal of both breasts and could do breast reconstruction as well.   According to Dr. Jeyakumaran, at present, most of the insurance schemes are not covering breast screenings to reimburse the expenses incurred. If it is also covered by an insurance scheme and helps detect breast cancer in the early stages, they need to spend less financial reimbursement for the whole breast cancer treatment. This would be a win-win situation, and therefore, the insurance companies need to come forward to accommodate screening in the coverage scheme as quite a lot of females are in the working age group in Sri Lanka. Breast cancer is the most common cancer among females in Sri Lanka and its incidence is continuously rising. In the absence of a well established screening programme, a significant proportion of patients present with locally advanced and metastatic disease. Male breast cancer accounts for 1% of worldwide breast malignancies and is on the rise. In Sri Lanka, the figure for the same is not well known due to a lack of healthcare-seeking behaviour among men. Meanwhile, in Sri Lanka, in 2019, it was reported that 2,202 thyroid cancers were reported among females, 1,247 colon and rectal cancers, 1,114 in the cervix uteri and 988 in the uterus. According to the same report, 2,173 lip, tongue and mouth cancers were detected in males including 1,264 in the trachea, bronchus and lung, 1,260 in the colon and rectum, 1,100 in the oesophagus and 1,008 in the prostate.


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