Blog #11 Breast Cancer in American and Africa

Breast cancer is the most commonly diagnosed cancer among American women, other than skin cancer. In 1975, the incidence rate for breast cancer in American women was 105 cases per 100,000 women and the mortality rate was 31 per 100,000. Radical mastectomy (a disabling and disfiguring surgery which involves the surgical excision of breast tissue and skin, underlying muscle and lymph nodes) was the treatment of choice. Clinical trials studying chemotherapy using multiple drugs and hormone treatment was in its earliest stages (National Cancer Institute). In 2007, the incidence rate for breast cancer in American women was 125 per 100,000 and the mortality rate was 23 per 100,000. Lumpectomy (preserving the breast) along with local radiation therapy was the accepted treatment for early stage cancers. Breast cancer susceptibility in several genes has been identified, leading to the opportunity for early warnings in women who carry these genes (National Cancer Institute). According to the National Cancer Institute, in 2010 there will be approximately 207,000 new cases of breast cancer diagnosed in the United States and about 40,000 American women will die from the disease. As noted above, the breast cancer incidence has increased by about 16% but the mortality rate has decreased by 26%, and life-saving therapies are more readily available. Mammography has become more sophisticated as well as more accessible. In the future, the use of cancer genomics will aid in the development of more targeted and less toxic chemotherapy treatments. This is good news for all of us. The story for women in Africa is very different. Breast cancer incidence in Africa is lower, but it when it does strike, it strikes at an earlier age and with greater virulence. The relative rarity of screening mammography and examinations results in more advanced disease once the diagnosis is made. Researchers have found that in African women, many breast cancers arise from a different type of cells than those of Caucasian women, and cancers arising from these cells have a worse prognosis, regardless of race. In Africa, most breast cancers strike women in their 40s. There is a great deal of stigma attached to a diagnosis of breast cancer in Africa, and women are often afraid of losing husband and children, and being ostracized by their communities. Common beliefs are that breast cancer is caused by unsavory personal habits such as wearing dirty clothing or tucking money inside a bra. Many African women believe if they see a doctor, their breast will be cut off and they will be dead within 2 years anyway. There is some truth in this because most cases are advanced at the time of diagnosis and often there is no follow-up treatment. Changing the course of breast cancer for African women will require massive education, overcoming common beliefs and superstitions and the development of early detection centers where mammography will be more available and affordable for African women. National Cancer Institute, 2010. Cancer Advances in Focus. http://www.cancer.gov/cancertopics/cancer-advances-in-focus/breast Science in Africa, April, 2005. Breast Cancer Findings in African Women. http://www.scienceinafrica.co.za/2005/april/breastcancer.htm