By Siyabonga Gema (HST Communications Officer)
Breast Cancer Awareness Month is celebrated each year in October to increase awareness of Breast Cancer and raise funds for research into its cause, prevention, diagnosis, treatment, and cure. Statistics by the World Health Organization (WHO) suggest that breast cancer is the most common cancer globally with around 2.3 million new cases every year. It represents one in eight cancer cases in both sexes and a quarter of all cancers in women, with 70% mortality occurring in resource constrained settings. This means that women with breast cancer and who reside in constrained settings are more likely to die, should they not be treated.
Some warning signs of breast cancer are:
- New lump in the breast or underarm (armpit).
- Thickening or swelling of part of the breast.
- Irritation or dimpling of breast skin.
- Redness or flaky skin in the nipple area or the breast.
- Pulling in of the nipple or pain in the nipple area.
- Nipple discharge other than breast milk, including blood.
- Any change in the size or the shape of the breast.
- Pain in any area of the breast.
Awareness programmes are centred around sharing information and provision of health resources for communities, especially the under-privileged. Sub-Saharan Africa continues to grapple with breast cancer in the face of an already strained public health system which lacks basic infrastructure to adequately respond to health requirements of its growing population. According to WHO, Breast cancer is the most common cancer type in women in sub-Saharan Africa, affecting 129 000 women who were newly diagnosed in 2020. In high income countries breast cancer has a good prognosis, but in sub-Saharan Africa survival is considerably lower. In this region, estimates for five-year survival are near or below 50%, i.e. one in two women diagnosed with the disease will die within five years after diagnosis. Compared to this, the five-year survival rate in the USA is one in five for black women and one in 10 for white women.
Socio-economic issues play a major role in perpetuating mortality rates, including for breast cancer patients. The lack of nutrition, access to medication, lack of funding for treatment procedures, and limited access to information all form part of the problem. Governments continue to prioritise programmes aimed at curbing these and many other challenges through partnerships of multi-sector stakeholders. In South Africa, the government provides social assistance through the social grants system. According to the South African Social Services Administration (SASSA), social grants are by far the largest facet of the social protection system in terms of the number of people covered, with 17.8 million grants paid out by SASSA on a monthly basis in the 2018/19 financial year.
The South African government developed the Breast Cancer Prevention and Control Policy in 2017, which is aimed at prioritising breast cancer awareness, prevention, treatment and care in South Africa.
The policy also entails the implementation of interdependent strategies: increasing early recognition of breast cancer, treating breast cancer more effectively, and providing timely treatment and palliative care for invasive cancer. On the other hand, health awareness and outreach programmes have proven effective for reaching people in their areas of residence, and engaging them in their home language to bridge the information barrier. The strategic partnership between the government and Non-Governmental Organisations (NGOs) who provide screening and testing services and refer patients to their nearest facilities assists in strengthening healthy systems and providing the government with insights to channel the services where they are most needed.
The Health Systems Trust (HST) recently released the South Africa Health Review (SAHR) 2023 on 1 October 2024. The SAHR contains three chapters which deal directly with breast cancer; policies, uptake of screening, and outcomes of breast cancer counselling. Key findings from the SAHR suggest that women are not participating in breast cancer screening, often due to socio-economic and cultural factors. Addressing these barriers is vital to increasing screening uptake and promoting early detection, particularly among underserved populations.
HST's Medical Officer for the Cervical Cancer Prevention, Access and Control (CCPAC) project, Dr Asanda Shabalala weighed in on the importance of raising awareness: "Breast cancer is the most common cancer among South African Women, often diagnosed too late due to limited access to screening and care, especially in rural areas. Empowering women through better awareness and expanding early detection services can save more lives and offer hope for improved outcomes.''
Communities also have an important role to play in supporting the response to breast cancer, through making use of the available information and spreading it far and wide. There is a wide range of information on signs and symptoms, self-examinations and treatment options. To access information on breast cancer, please visit:https://www.nationalbreastcancer.org/breast-cancer-awareness-month/