Your questions about breast cancer

OCTOBER is Breast Cancer Awareness Month, an annual campaign to increase awareness of this disease. In keeping with this theme, we follow up on last week’s article by answering some of the questions that our readers asked.

Dr. Kulsum Jhetam, a radiologist from Mokopane, tried to address queries as broadly as possible, so that other readers with similar problems may benefit as well.

Marieka asks: I have a lump in my breast and I’m afraid it’s cancer. Should I be worried?

Dr Jhetam says: 80 to 90% (nine out of 10) of breast lumps are not cancer. The majority of breast lumps are benign, the most common is a simple fluid-filled cyst. However, one cannot tell if a lump is malignant or benign by touch alone.

All newly discovered breast lumps should be dealt with in the same way, using a triple assessment:

1. See your GP or gynaecologist as soon as possible. After examining the lump, he or she will probably book you for a mammogram (if you are older than 40) or an ultrasound (if you are younger than 40).

2. Your radiologist will do the mammogram and or ultrasound, and decide what the possibilities are. Based on the characteristics of the lump, they may decide to do a biopsy.

3. The biopsy is done in the radiologist’s rooms under local anaesthetic, and you get the results within three days.

If your lump is not cancer, you need to have a follow-up mammogram or sonar annually. This is usually the case. Don’t forget to do your monthly self-examination.

Ten percent of lumps will be cancerous, and your doctor will help you further.

Adrie vra: kan tabakrook borskanker veroorsaak?

Dr Jhetam sê: rook is defnitief ‘n risikofaktor vir baie tipe kankers. Navorsing in 2012 het gewys dat rook ook ‘n risiko vir borskanker is. Rook veroorsaak ook siektes van die hart, longe en are. As a mens ophou rook, verminder die risiko vir alle kankers en ander siektes. Na ‘n paar jaar is jou risiko dieselfde as alle ander mense wat nie rook nie.

Anonymous asks: I’ve had my breasts enlarged with silicone implants. Will a mammogram damage my implants?

Dr Jhetam says: it is very safe for women with breast implants to have mammograms.

Extra views are performed to ensure the maximum amount of breast tissue is visualised.

A sonar examination is always performed after the mammogram to assess any breast tissue that may be obscured by the implant. This is usually adequate. Doctors rarely feel that we need to see more and then we refer you for an MRI.

It is very important for women with implants to be more vigilant with their mammograms. This is because it is more difficult to feel lumps behind your implant.

Mev. Schoeman vra: ek gebruik hormone al vir 15 jaar vir menopouse-simptome. Ek hoor dat dit borskanker kan veroorsaak. Is dit die waarheid?

Dr Jhetam antwoord: Ongelukkig is dit die waarheid.

Navorsing oor die laaste 15 jaar wys dat hormone borskanker kan veroorsaak.

Vrouens met ‘n hoë risiko vir borskanker moet alternatiewe terapie gebruik. Soja-gebaseerde aanvullings word gewoonlik gebruik.

Francina asks: why are my breasts so sore? Do I have cancer?

Dr Jhetam answers: breast pain is very common. It affects two thirds of all women at some time during their reproductive years.

There are two types of breast pain:

• Cyclical pain is associated with a woman’s periods, and usually happens for a week or so before a period. It is associated with changing hormone levels during the menstrual cycle, which make the breast tissue more sensitive.

• Non-cyclical pain can occur at any time, and can be there all the time. You can have pain in one or both breasts and you may describe it as a burning, prickling or heavy.

The treatment options for cyclical and non-cyclical pain are often the same, however, non-cyclical pain is not always as easy to treat.

Simple changes in your diet and lifestyle go a long way in reducing breast pain:

• A low-fat, high fibre diet.

• Reducing intake of caffeine and alcohol.

• Increasing the amount of fresh fruit and vegetables you eat.

• Regular exercise to help maintain a healthy weight.

• Wearing a supportive and correctly fitting bra at night as well as during the day.

Medical options:

• Evening primrose oil or starflower oil supplements, which contain an essential fatty acid GLA (gamolenic acid) are known to reduce breast pain. People with epilepsy are usually advised not to take evening primrose or starflower oil.

• Anti-inflammatories are usually helpful with non-cyclic breast pain – consult your doctor.

• Hormonal therapy. This is a last resort for severe, uncontrolled pain that has not responded to the above measures. Again, consult your doctor.

Dr. Jhetam has been involved in breast imaging for over 11 years. Her practice is situated at Silverfern Office Park, 124 Thabo Mbeki Drive, Mokopane.

For any queries, contact her at (015) 491-3330 or xray@silverferngroup.co.za