‘Take Action’ Phase 2

Breast Cancer

Breast cancer is the most commonly diagnosed cancer in the world.[1] The more we learn about this pervasive disease, the clearer it becomes that breast cancer is not one disease, but many. We recognize there is still more work to be done to improve the outlook for people living with breast cancer, including those with metastatic HR+, HER2-, triple negative and BRCA-mutated breast cancers as well as those with early-stage disease who may be at an elevated risk of recurrence.

Global and Africa and Middle East Incidence

  • Worldwide, breast cancer is the most common invasive cancer in women, with more than 2 million women impacted annually
  • While rare, men can also be diagnosed with breast cancer. For men, the lifetime risk of breast cancer is about 1 in 833[2]
  • According to the Globocan 2020 study, breast cancer impacts over 247,000 people across Africa and the Middle East (AfME)

 About Metastatic Breast Cancer

Metastatic breast cancer (MBC) is the most advanced stage of breast cancer. It occurs when cancer spreads to other parts of the body, such as the lung, brain, liver, and bones.[3]

  • Compared with global, more patients in our region reach a late or advanced breast cancer stage due to the lack of national screening programs and awareness campaigns
  • Over the last decade, many new treatments were approved, which significantly controlled disease progression and improved patients’ quality of life

 How is MBC diagnosed?[4]

Finding breast cancer at an early stage means that a healthcare provider can begin treatment earlier in the course of the disease.  Should a patient discover a lump or any other signs and symptoms of breast cancer during self-examination or otherwise, a healthcare provider should conduct a complete physical examination. Any suspected signs of breast cancer should be followed up with a screening mammogram.

Should breast cancer be suspected by your medical advisor, further tests will be conducted as necessary. Your healthcare provider will use these tests to diagnose and check to see if the cancer has spread to other parts of the body.

Among the subsequent tests used to diagnose breast cancer include:

  • Imaging tests such as diagnostic mammograms (like screening mammograms but more images of the breast are taken)
  • Ultrasounds
  • MRIs

Imaging tests are helpful for suggesting if cancer is present, but only a biopsy can provide a definite diagnosis. During a biopsy, a healthcare provider removes small pieces of breast tissue using a needle or an incision and exams it under a microscope to see if cancer cells are present.

‘Take Action’ Against Breast Cancer – Check Yourself

Thanks to advances in science and breakthroughs in medical treatments, today, breast cancer can often be cured if diagnosed at an early stage. Over the last three decades, awareness of breast cancer has grown considerably, and with educational initiatives and funding for research, today, patients are more empowered than ever before.

Unfortunately, however, each year, more than 247,000 women are diagnosed with breast cancer across Africa and the Middle East[5], making the disease the most common and invasive cancer among females.

Furthermore, a growing number of those cases are being diagnosed at a later stage once cancer cells have spread to other organs.

Together with prevention, treatment, and access to diagnostics, early detection could save between 2.4 and 3.7 million lives each year.[6]

Why ‘Take Action’?

On Breast Cancer Awareness Month and beyond, ‘Take Action’ month-long campaign calls on healthcare professionals, caregivers, communities, organizations, and media across Africa and the Middle East (AfME) to support patients in fighting the deadly disease that impacts over two million women annually as per the World Health Organization (WHO)

The ‘Take Action” campaign focuses on a set of messages that provide a call to action for the community:

For healthcare professionals:

Each case is unique, especially for those fighting MBC. Healthcare providers and nurses can employ technologies per their respective approvals to have open conversations and support patients who might feel overwhelmed, powerless, and isolated during these challenging times.

For the public:

‘Take Action’ to take early detection seriously and help friends and families by encouraging regular self-examination and conversations with their doctors.

Who Should Get Checked?[7]

Certain risk factors can increase a woman’s chance of developing breast cancer. These include:

  • Age. Most breast cancers are found in women over age 50.
  • Certain genetic mutations. Women who inherit mutations (changes) to certain genes (for example, BRCA1 and BRCA2) are at higher risk.
  • Getting periods before age 12 or starting menopause after age 55. This causes exposure to certain hormones for longer periods, which slightly increases the risk for breast cancer.
  • Having dense breasts. Dense breasts have more connective tissue than fatty tissue. This can make it harder to see tumours on a mammogram.
  • Family history. Having a first-degree relative (mother, sister, or daughter) or more than one family member on either the mother’s or father’s side who have had breast cancer increases a woman’s risk.

How to Perform a Self-Examination for Signs of Breast Cancer?

Most women diagnosed with breast cancer do not have any signs or symptoms of the disease. However, there are sometimes changes in the breast that a woman may notice.

Here’s how to conduct a self-examination:

Here we can include the images from the website used to derive this content

  1. Stand straight in front of the mirror, your shoulders straight, with hands-on-hips. Check for any signs of the following:[8]
  • A lump in the breast (the most common symptom of breast cancer).
  • Swelling in the entire breast or an area of it.
  • Irritation on the skin or dimpling.
  • Pain in the breast or nipple.
  • Changes in the nipple or breast skin such as redness, thickening, or scaliness.
  • A retracted (turned in) nipple or discharge from the nipple (other than breast milk).[9]
  1. Raise your arms above your head and examine your breasts once again for the same signs. Pay particular attention to any signs of fluid coming out from the nipples.
  1. Lie flat on your back and examination each breast with your opposite hand (right breast with your left hand and vice-versa). Use a smooth but firm touch, with your fingers moving over your breast in small circular motions from top to bottom and side to side. Start at the nipple and work your way out toward the edges of your breast. Cover the entire breast area, from collarbone to the top of your abdomen and your armpit to your cleavage. You can also trace your fingers up and down over your breast if you prefer – many women find this method easier.
  2. Repeat the previous step while you are standing or sitting upright.

When to Consult Your Doctor?

If you come across any signs or symptoms of cancer during your examination, you should consult with a trusted medical advisor who will conduct necessary tests.

I have been diagnosed with MBC. Now What?

While metastatic breast cancer remains incurable, if you’ve recently been diagnosed with MBC there is still cause for hope.

What kind of treatment will I have?[10]

Following diagnosis, together with your healthcare provider, you will decide on the best course of treatment. Besides considering your personal preferences, several factors will be taken into consideration by your healthcare provider to determine the best course of action – this can include:

  • Surgery—Surgeons remove a portion of the breast containing the cancer or the entire breast.
  • Chemotherapy—Medicines are given to shrink or destroy cancer cells.
  • Hormonal/endocrine therapy—Medicines are given to prevent cancer cells from getting the hormones they need to grow.
  • Biological therapy—Medicines that work with the body’s immune system to help it fight cancer cells.
  • Radiation therapy—High-energy rays are used to kill cancer cells.

Often, patients will usually have a combination of treatments.

What Can I Do?[11]

If you have metastatic breast cancer, let your healthcare team know how you want to participate in your own care. Here are some questions to consider when speaking with your doctor:

  • How much do you want to participate in the decision-making process of your treatment plan?
  • What and how much do you want to know about your prognosis?
  • Are you comfortable having discussions about your care and end-of-life planning early on?
  • Will you bring a family member or friend for support during your doctor visits?
  • Do you feel your concerns have been properly noted and addressed?
  • Have you shared your experiences and goals for therapy with your healthcare team?
  • Do you need mental health support?

Taking an active role in your treatment can help you feel empowered in managing your disease and living your life to its fullest potential.

Infographic

Please see the infographic below

Reference:

1 World Health Organization. Breast cancer now most common form of cancer: WHO taking action. https://www.who.int/news/item/03-02-2021-breast-cancer-now-most-common-form-of-cancer-who-taking-action. Accessed September 19, 2021.

2 American Cancer Society: Key Statistics for Breast Cancer in Men. https://www.cancer.org/cancer/breast-cancer-in-men/about/key-statistics.html. Accessed September 19, 2021.

3 Breastcancer.org. https://www.breastcancer.org/symptoms/types/recur_metast. Accessed September 19, 2021.

4 Pfizer website. https://www.pfizer.com/news/featured_stories/featured_stories_detail/get_the_facts_about_breast_cancer. Accessed September 19, 2021.

6 Globocan 2020. Breast Cancer Fact Sheet. https://gco.iarc.fr/today/data/factsheets/cancers/20-Breast-fact-sheet.pdf. Accessed September 21, 2021.

7 Pfizer website. https://cdn.pfizer.com/pfizercom/health/VOM_Oncology_Global_Brochure_2017.pdf. Accessed September 19, 2021.

8 Pfizer website. https://www.pfizer.com/news/featured_stories/featured_stories_detail/get_the_facts_about_breast_cancer. Accessed September 19, 2021.

9 Breastcancer.org. https://www.breastcancer.org/symptoms/testing/types/self_exam. Accessed September 19, 2021. (All four steps of self-examination taken from Breast cancer org. website and put into own words – images are there too).

10 Pfizer website. https://www.pfizer.com/news/featured_stories/featured_stories_detail/get_the_facts_about_breast_cancer. Accessed September 19, 2021.

11 Pfizer website. https://www.pfizer.com/news/featured_stories/featured_stories_detail/get_the_facts_about_breast_cancer. Accessed September 19, 2021.

12 Pfizer website. https://www.pfizer.com/news/hot-topics/what_do_you_really_know_about_metastatic_breast_cancer. Accessed September 19, 2021.