According to the World Health Organization, breast cancer is the top cancer in women both in the developed and the developing world. This month of October, Breast Cancer Awareness Month, Crossover Kenya’s Harleen Jabbal had a chat with Dr. Mariusz Marek Ostrowski, Consultant Oncoplastic Breast Surgeon- M.P. Shah Hospital Nairobi:
HJ: In this pandemic, what is the status of Breast Cancer cases, updates, treatments possible etc?
Dr: Breast cancer is one of the most common cancers in women in Kenya. The problem in Kenya is that 80% of patients present themselves at an advanced stage, principally because there is a lack of early screening and awareness. The recent Covid-19 pandemic has made this situation worse as people are worried about going to hospitals for fear of catching the virus. Even where patients have symptoms of cancer, they are currently reluctant to consult with a medical professional. Unfortunately, cancer is still prevalent during the pandemic and it is important to present as early as possible when someone suspects there is a problem. Additionally, many patients have delayed their treatment for fear of travelling to Nairobi or other treatment centres. It is important to remember that breast clinics are working and you can book an appointment to reduce waiting times.
HJ: Breast Cancer is the leading type of cancer in Kenya, what is the current early detection process, treatment and care available in Kenya?
Dr: Early detection saves lives. This is the most important message to take home. In Kenya we have screening guidelines for breast cancer which recommend annual screening mammograms from the age of 40 up to the age of 54 and then every two years thereafter. In younger women, we also use ultrasound scans and MRI. Unfortunately, in Kenya, the screening tools are under-utilised and throughout the country we don’t perform enough screening tests. The diagnostic tools and treatment for breast cancer is available in Kenya. We have the ability to treat breast cancer, however it is vital that cancer is detected early. This leads to better outcomes at greatly reduced costs. For example, at M.P. Shah Hospital, we have a one stop breast clinic whereby most investigations are completed within a few hours and the majority of diagnostics are completed on the day with immediate results. This reduces the need for multiple visits to often different hospitals and medical professionals.
HJ: Is there a change in the age group of the current Breast Cancer cases?
Dr: Breast cancer occurs mostly in women, although it is important to remember that men can develop breast cancer as well. In Kenya, we often diagnose breast cancer 10-15 years earlier than in the Western world. Many cancer patients are diagnosed in their 30s or early 40s. The youngest breast cancer survivor I have met here was 22 years old. It is therefore crucial to understand your breasts and to investigate any skin and nipple changes, lumps and bumps.
HJ: Why does oncoplastic become necessary? What is the aftercare and effects?
Dr: Over the last years, treatment in breast cancer has improved dramatically. The breast is an important part of a woman’s identity and where possible, the oncoplastic surgeon’s aim is to safely treat the cancer and preserve the breast and its natural shape.
Where cancer is detected early, it can be cured and often we follow our patients for many years after treatment. Oncoplastic surgery means that the breast surgeon uses modern oncoplastic techniques to achieve the best possible oncological outcome after surgery and aesthetic appearance. Quite simply, this means that we use techniques to ensure that post-treatment scars will not remind the patient about their past cancer.
HJ: Is there a home-self-examination possible or what do you recommend for prevention and early detection?
Dr: It is important to know your breasts. Both you and your partner can help in identifying changes including skin and nipple changes, new lumps and bumps.
The best time to examine yourself is a few days after your period. This should be done at the same time of your monthly cycle.
To reduce the risk of all cancers, a healthy, balanced and active lifestyle is of course important. However, cancers can happen to everyone and this is why screening is a vital tool. Routine mammograms can detect cancers years before they become a lump or present with other symptoms. Where a patient has multiple mammograms taken over a few years, we can see whether there are any year on year changes and can detect problems earlier.