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October has been designated breast cancer awareness month, a time where efforts are accelerated to raise awareness about the disease, highlight the importance of early identification, and recognize the signs and symptoms to watch out for.
According to the World Health Organization, 90% of early-stage breast cancers are curable, and the treatments are often able to conserve the breast.
Breast cancer is the most common cancer in women: one in 8 women will develop breast cancer during their lifetime. It is also the leading cause of cancer deaths among women.
Morocco World News (MWN) had the opportunity to speak with Professor Hachi Hafid, General Surgery Professor at the Faculty of Medicine and Pharmacy of Rabat and Head of the surgical gynecological and mammary cancer department at the National Institute of Oncology (INO).
Dr. Hafid answered some of the most common questions regarding the cancer, and gave advice for early identification and treatment.
Risk factors
According to Hafid, breast cancer is common among women between 50 to 69 years old who represent 50% of people with the disease. In recent years, it has also been affecting the younger population with 30% of cases occurring before the age of 50, 10% of which occur before the age of 35.
As explained by him, several risk factors can increase the chance of developing breast cancer, like radiation exposure.
“Radiation exposure in young patients who received chest radiotherapy to treat Hodgkin’s lymphoma have a high risk of developing breast cancer;” the professor suggests.
It has also been documented that family history of breast cancer is a risk factor. “20 to 30% of breast cancers take on a family character[with] several cases in the family,” Hafid explains.
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He goes on to detail that the presence of the cancer in a first-degree relative (parent, sibling, child) and the occurrence in an individual younger than 50 years old multiply the risk twofold.
Genetic predisposition can also raise the risk significantly. “5 to 10% of cancers are hereditary due to genetic mutations involving genes called BRCA 1 and BRCA 2 and other mutations,” Hafid says. “The presence of a mutation does not mean inevitable breast cancer, but it highly increases the risk.”
Male breast cancer
Male breast cancer is very rare, and represents around 1% of breast cancers, the professor says.
“It occurs mostly in males older than 60 years, who have relatives with breast cancer,” he said, noting that 15% of cases were associated with hereditary factors.
Screening is vital
Breast cancer screening means checking for the cancer before it causes signs and symptoms. The goal is to find it in an early stage where it may still be treated.
A national program to perform systematic mammograms for patients aged 50 to 74 years aims to diagnose small and malignant lesions that are less than 1 cm in size, Hafid explains.
According to the doctor, early detection drastically improves the prognosis of breast cancer and allows nine out of 10 patients to recover.
“Individuals with a personal or family history of breast cancer or hereditary predispositions must undergo rigorous monitoring and control because these patients are at high risk of breast cancer,” he adds.
When to undergo screening?
Hafid recommended that all women carry out a self-examination of their breasts by first inspecting the area in search of abnormalities or lesions that recently appeared such as a nodule, redness, or change in the areola. Next, self-palpation in search of hard nodules or suspicious lumps is a good step.
“Any abnormality observed or palpated should encourage the patient to consult a gynecologist,” Hafid says.
According to him, breast cancer can be suspected clinically and the diagnosis can be made after a mammogram which might reveal suspicious microcalcifications in the screening.
After the diagnosis, “advanced medical tests will be done to track the extension of the tumor,” the doctor adds.
A positive cancer diagnosis
According to Hafid, the management of a positive cancer diagnosis must be multidisciplinary in nature, bringing together the surgeon, the oncologist, and the radiotherapist. Any decisions with regards to treatment must be taken after consultation with all the specialists.
While surgery is one of the primary treatments for breast cancer, Hafid says that “conservative treatment is the option that should be advocated for if there are favorable conditions.”
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Conservative treatments have the advantage of respecting the patient’s body image and avoiding mastectomy, which can negatively impact mental health.
In certain situations when mastectomy is necessary, the patient must be offered breast reconstruction.
Radiotherapy is also often performed at the end of therapeutic sequences to strengthen local control of the disease.” the doctor explained.
Hope for the future
Breast cancer awareness campaigns are educating on the importance of regular screenings to detect cancer in its early stage. They are also helping to raise funds to finance advanced research.
“Medical oncology has been strengthened by targeted therapies and immunotherapy,” Hafid summarizes. “Radiotherapy uses innovative techniques to comfort local control and reduce sequelae.”
“Good oncological results and a good prognosis depend on early and effective screening,” he emphasizes.
