Breast Cancer Awareness Month 2021

What is breast cancer?

Breast cancer is the most diagnosed cancer among women worldwide, accounting for 1 in 4 cancer cases. It is the most frequent cancer amongst both sexes and is the leading cause of death from cancer in women. The estimated 2.3 million new cases indicate that one in every 8 cancers diagnosed in 2020 is breast cancer. In 2020, there were an estimated 684,996 deaths from breast cancer, with a disproportionate number of these deaths occurring in low-resource settings.

Breast cancer cells usually form a tumour that can often be seen on an x-ray or felt as a lump. If spread outside the breast through blood vessels and lymph vessels, it becomes advanced breast cancer. When breast cancer spreads to other parts of the body (such as the liver, lungs, bones or brain), it is said to have metastasised, and is referred to as metastatic breast cancer. Although there are various diagnostic methods to detect breast cancer early – such as breast exam, ultrasound, mammography, and biopsy – there is a range of breast cancer risk factors that still need to be examined further. The causes of breast cancer remain complex, as the development of the disease can be influenced by various factors. This includes a family history of breast cancer which presents a greater chance for women who have had a mother, sister or daughter previously diagnosed with the disease to develop it too.

Here are some important facts:

Many treatment options are available. For those who have received a diagnosis, treatment will depend upon several factors, including the stage and type of breast cancer. Clinical trials are also available when deemed appropriate for the patient. Research around the world is helping to find new treatments and improve testing and coping strategies.

While treatments are available, early detection and diagnosis are key to fighting this disease. There are several ways to screen for breast cancer, including mammography, ultrasound, clinical breast exam (by a health professional), and self-breast exam. These steps aim to identify cancer before symptoms appear. To learn more about signs and symptoms, visit the World Health Organization website.

Global impact

Survival rates for breast cancer are very high when the cancer is detected early and where treatment is available. Unfortunately, 50 to 80% of breast cancer cases are diagnosed at an advanced stage in many low- and middle-income countries, when the cancer is more difficult to treat, is more expensive to do so, and is usually incurable.

Age-standardized breast cancer mortality in high-income countries dropped by 40% between the 1980s and 2020.  Countries that have succeeded in reducing breast cancer mortality have been able to achieve an annual breast cancer mortality reduction of 2-4% per year. If an annual mortality reduction of 2.5% per year occurs worldwide, 2.5 million breast cancer deaths would be avoided between 2020 and 2040.

Challenges

Survival of breast cancer for at least 5 years after diagnosis ranges from more than 90% in high-income countries, to 66% in India and 40% in South Africa. Early detection and treatment have been proven successful in high-income countries and should be applied in countries with limited resources where some of the standard tools are available. The great majority of drugs used for breast cancer are already on the WHO Essential Medicines List (EML).  Thus, major global improvements in breast cancer can result from implementing what we already know works.

Declines in breast cancer mortality rates have been reported in many high-income countries, with large decreases in European and North American countries and in Australia and New Zealand, whereas countries in transition continue to show a slight increase in mortality from breast cancer, though this appears to be slowing. The favourable trends in mortality may result from the combined effects of earlier detection (screening and increased breast cancer awareness) and a range of improvements in treatments and programs.

In Dubai, United Arab Emirates (UAE) more than 100 women with financial difficulties have received the full spectrum of breast cancer care thanks to the DHA’s Basmah initiative, which was launched in 2019. The initiative makes Dubai authorities the first government entity in the world to provide a complete spectrum of care from screening to treatment for the three types of cancer (breast, colorectal and cervical cancer) under the essential benefit health insurance plan. Prior to the scheme, cancer coverage was limited to Dh150,000. Now there are no sub-limits and coverage is unlimited. In order to make the initiative work, all approved health insurance providers in Dubai asked policyholders to pay an additional amount of Dh19 and Dh18 for cancer and hepatitis C (HCV) treatment respectively. This sum for cancer is pooled into DHA’s trust account and helps cover the additional cost of these three types of cancer treatment.

Conclusion

A plan for the diagnosis and treatment of breast cancer is a key component of any overall cancer control plan. Its main goal is to cure breast cancer patients or prolong their life considerably, ensuring a good quality of life. In order for a diagnosis and treatment programme to be effective, it must never be developed in isolation. It needs to be linked to an early detection programme so that cases are detected at an early stage, when treatment is more effective and there is a greater chance of cure. Furthermore, programmes should include an awareness-raising component, to educate patients, family and community members about the cancer risk factors and the need for taking preventive measures to avoid developing cancer.

It is obvious that a diagnosis of breast cancer causes stress to both the patient and the family caregivers. Coping strategies employed could either be problem-focused or emotion-focused. If you or a loved one has been affected by a diagnosis of breast cancer, know that options, resources, and support are readily available. Speak to your doctor or call the assistance programme for help with the anxiety, stress, and other factors that can affect you or your loved ones.