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Lumps in the breast are the most well-known sign of breast cancer. However, this is not the only sign or symptom you should be cautious of before seeking potentially life-saving early diagnosis and treatment, warn medical experts.

Notably, breast cancer is the most prevalent form of cancer among women both globally and in South Africa, where it represented more than a quarter of all reported female cancer cases in 2020.[1]

Dr. Gary Sopher, Director of Oncology at Novartis South Africa, therefore emphasises that while lumps are a common early sign of breast cancer, there are a range of other symptoms you need to be aware of in order to seek timely medical advice.

“First, it’s important to realise that not all lumps are cancerous, as menstruation, for example, can make the breasts feel naturally lumpy. Additionally, not all breast cancer patients have easily discernible lumps, especially as breast tissue is often quite dense in women below the age of 40 years,” he explains.

“That’s why it’s crucial to remain alert to other common signs and symptoms, and to bring these to your healthcare practitioner’s attention as soon as possible in order to prevent any delays in obtaining treatment, which can significantly improve patient outcomes.”

Breast cancer is the abnormal, malignant growth of tissue, which can form in the breast’s glands, lobules, lobes, and ducts before spreading through the blood or lymph vessels.[2]

In addition to lumps or growths in your breasts, women therefore need to be wary of other common early signs such as a constant pain in your breasts or your armpits, and any swelling or inflammation in your armpits or even your collarbone.

Additionally, keep an eye out for any changes in your skin texture such as puckering or dimpling, changes in the shape or size of your breast, nipple discharge without squeezing, changes in the nipple position or shape, inverted nipples, and rashes or redness around the nipple, he suggests.

Developments in diagnosing and treating breast cancer

Dr. Sopher states that screening by medical professionals is crucial for detecting and better managing breast cancer, and should be conducted at least every two years for women 50 years or older. Women with a higher risk of breast cancer should usually start screening activities earlier, or from the age of 40 years.

The most common type of screening test is mammography, which uses x-rays that can pick up miniscule tumours. Other methods include magnetic resonance imaging, which is used on women with a high risk of breast cancer; thermography, which uses an infrared camera to detect heat patterns; and tissue sampling.[3]

“The other important method is to perform monthly self-examinations. Not only does this help to detect any unusual lumps but can also give you a better sense of what your breasts normally look and feel like at different stages of your menstrual cycle to better identify any unusual changes,” he says.

“But because self-exams can lead to false positive diagnoses and sometimes cause unnecessary anxiety, it is recommended that women go for regular mammograms as well, and consult a medical practitioner if you have any concerns.”

Early detection is crucial as it may be possible to surgically remove the cancerous growth without the removal of the breast and nearby lymph nodes.

Other medical treatments can include IV chemotherapy, oral chemo anti-HER2 antibodies, endocrine therapies including a new class called CDK inhibitors, targeted therapies, and immunological therapies such as PD1/ PDL1 inhibitors.

Dr. Sopher notes that CDK inhibitors are a particular focus for the company in its oncological research.

“The Novartis mission really boils down to developing improved therapies which are more effective and better tolerated by patients. Right now, we’re doing particularly important work with CDK inhibitors, which block the cell cycle and inhibits cell proliferation by constraining CDK enzyme activity.”[4]

“We hope to bring these kinds of therapies, which are most often used during late-stage breast cancer treatments, to early-stage patients as well. If we can combine these therapies with surgery and radiation, we can then potentially prevent recurrences and, ultimately, offer a curative approach.”

Finally, Dr. Sopher recommends that every South African encourage their friends, loved ones, colleagues, and employees to schedule a mammogram sooner rather than later.

“We must encourage open dialogue about the value of regular and appropriate screening at the appropriate level of risk at the right time. Additionally, because many women may feel anxious about going to a screening, men should show their support and accompany them to the appointment,” he says.

“This is the perfect time to search out patient support groups such as CANSA, the Breast Health Foundation, Reach for Recovery, Meta Buddies, and the many others out there. Show your support by donating and giving your time to these groups.”

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