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Breast cancer among South African women increasing

21 October 2021 | Story André Damons | Photo Supplied

Photo of AS copy — Prof Alicia Sherriff, head of the Department of Oncology at the University of the Free State (UFS), says Breast Cancer Awareness Month is important as continued awareness-making of the general population on the risks and signs of breast cancer are essential to ensure early diagnoses and improve the possibility of long-term survival.

Breast cancer among South African women is increasing and is one of the most common cancers among women in South Africa and at Universitas Academic Complex in the Free State, is only second to cervical cancer.

Prof Alicia Sherriff, head of the Department of Oncology at the University of the Free State (UFS), says 1.8% of breast cancer diagnoses in South Africa are made in men. At Universitas Annex, they treat on average 350-400 new breast cancer patients annually. They have not seen an increase in cancer cases in the past two years; Prof Sherriff says the COVID-19 pandemic definitely had an impact on patients accessing health care and patient referrals.

It is for this reason that Breast Cancer Awareness Month is so important since continued awareness-making of the general population on the risks and signs of breast cancer are essential to ensure early diagnoses and improve the possibility of long-term survival. Early detection is of the utmost importance, since breast cancer is treatable and curable. Awareness is critically important in all age groups and communities.

Globally, female breast cancer has now surpassed lung cancer as the leading cause of cancer incidence in 2020, with an estimated 2.3 million new cases, representing 11.7% of all cancer cases.

This is a according to an article in the American Cancer Society which also states that breast cancer accounts for one in four cancer cases in women and is the cause of deaths for one in six patients. It is the fifth leading cause of cancer mortality worldwide, with 685,000 deaths.

According to Prof Sherriff, breast cancer is the abnormal growth of breast tissue. The cause is unknown in most patients but there are some factors that increase your risk of developing breast cancer; for example familial genetic syndromes, smoking and excessive alcohol use and obesity.

“It is important to note that a person can develop breast cancer even if there is no family history or any of the above-mentioned risk factors. The risk of developing breast cancer increases with age. That said, women as young as 18 years of age have been diagnosed with breast cancer. Self-examination is important so women can be familiar with their breasts and any change will be picked up early. When you self-examine always do it at the same time of the menstrual cycle to experience an equal impact of the hormonal cycle in the female body,” says Prof Sherriff.

Breast cancer in young women

Less than 2% of patients diagnosed with breast cancer are younger than 34years of age, but it is important to realise that it can happen and if it does arise in the younger age group it tends to be more aggressive and related to genetic mutation.

“The young breast tends to be very dense and therefore more difficult to interpret on a mammogram. For females younger than 40-45 years or women with dense breast tissue, breast sonar is advised to evaluate the breast and sometimes an MRI (magnetic resonance imaging) might be requested, but this is not standard practice.

“Reproductive and hormonal risk factors to consider are: Early age at menarche, later age at menopause, advanced age at first birth, fewer number of children, less breastfeeding, menopausal hormone therapy, oral contraceptives. These factors all increase the duration of the female breast being exposed to higher levels of estrogen. Certain lifestyle risk factors (alcohol intake, excess body weight, physical inactivity) also increase the levels of hormonal exposure,” says Prof Sherriff.

Breast cancer rising

According to an article in the American Cancer Society, incidence rates of breast cancer are rising fast in transitioning countries in South America, Africa, and Asia as well as in high-income Asian countries (Japan and the Republic of Korea), where rates are historically low.

Dramatic changes in lifestyle, sociocultural, and built environments brought about by growing economies and an increase in the proportion of women in the industrial workforce have had an impact on the prevalence of breast cancer risk factors which include the postponement of childbearing and having fewer children, greater levels of excess body weight and physical inactivity, and have resulted in a convergence toward the risk factor profile of Western countries and narrowing international gaps in breast cancer morbidity.

“Some of the most rapid increases are occurring in sub-Saharan Africa. Between the mid-1990s and mid-2010s, incidence rates increased by more than 5% a year in Malawi (Blantyre), Nigeria (Ibadan), the Seychelles, and 3% to 4% a year in South Africa (Eastern Cape) and Zimbabwe (Harare). Mortality rates in sub-Saharan regions have increased simultaneously and rank now among the world’s highest, reflecting weak health infrastructure and subsequently poor survival outcomes.

“The five-year age-standardised relative survival in 12 sub-Saharan African countries was 66% for cases diagnosed during 2008 through 2015, sharply contrasting with 85% to 90% for cases diagnosed in high-income countries during 2010 through 2014. The country-specific estimate was as low as 12% in Uganda (Kyadondo) and 20% to 60% in South Africa (Eastern Cape), Kenya (Eldoret), and Zimbabwe (Harare),47% comparable to 55% in the US state of Connecticut and 57% in Norway during the late 1940s,48 3 decades before the introduction of mammography screening and modern therapies,” the article reads.

Low survival rates in sub-Saharan Africa are largely attributable to late-stage presentation. According to a report summarising 83 studies across 17 sub-Saharan African countries, 77% of all stage cases were stage III/IV at diagnosis. Because organised, population-based mammography screening programs may not be cost effective or feasible in low-resource settings, efforts to promote early detection through improved breast cancer awareness and clinical breast examination by skilled health providers, followed by timely and appropriate treatment, are essential components to improving survival.

Physical symptoms and treatments

Prof Sherriff says screening (checking for disease when there are no symptoms) for breast cancer in the normal population should start at age 40-45, where possible and yearly mammogram with sonar would be preferred. If there is a strong family history with the diagnoses of breast cancer earlier screening should start five to 10 years prior to first diagnoses. Self examination is an essential component of screening.

The physical symptoms you can experience that might be indicative of breast cancer are:

- A lump in the breast which does not have to be painful

- Changes of the skin of the breast referring to dimpling, the colour, or texture

- Changes in the appearance of the nipple (areola)

- A clear or bloody discharge from the nipple

The treatment for breast cancer consists of a combination of surgery, chemotherapy, radiation therapy and hormonal therapy. The treatment is individualised based on patient and cancer factors. Some patients will need all of the above whilst others may not. It is essential that the decision on the appropriate management is made in collaboration with the patient as part of the multidisciplinary team of specialists and allied health care workers.

News Archive

Qwaqwa Campus opens: Prof. PA Mbati's speech

2005-01-22

Official welcome speech by Prof. PA Mbati for 2005 first year students held on Saturday 22nd January 2005. Program Director, The Chief Director Operations Rev. Kiepi Jaftha, Dean of Students Dr. Natie Luyt, Program Head of the Faculty of Humanities, Dr. Elias Malete, Program Head of Faculty of Natural and Agricultural Sciences, Prof. Riaan Luyt, Acting Program Head of the Faculty of Economics and Management Sciences Prof. Andries Venter, Deputy Director Student Affairs Mr. Teboho Manchu, Coordinator Finance: Mrs. Elizabeth Nchapi, Senior Librarian Mr. Stoffel Kok, Senior Magistrate Mr Saul Mohosho, SRC President Mr. Tello Motloung, members of staff, invited guests, parents, guardians, my dear students, ladies and gentlemen.

It is indeed my pleasure to welcome you to the official welcoming ceremony of the UFS-Qwaqwa Campus 2005 first year students. Our Rector and Vice Chancellor Professor Frederick has requested me to pass to you his warmest wishes and regards on this special occasion. I am confident that the orientation exercise in which you have participated has achieved the desired effect of introducing you to your new way of life here on campus, and that you are now sufficiently prepared to get on with the rigors of being a student at this University.

Following the restructuring of the higher education landscape, the Qwaqwa campus was incorporated into the University of the Free State with effect from January 1 2003 . As a consequence, Management was faced with a whole complex series of challenges including, primarily making the campus financially viable, but also ensuring that it remains relevant in it’s core business as a satellite campus of the University of the Free State in terms of its teaching, learning, research and community service responsibilities.

A whole series of strategic planning workshops were conducted last year with both internal and external stakeholders. Various important strategic objectives were flagged out, and the next level of consultation will take place soon. I know that there is a lot of eagerness, sometimes to the level of impatience to see this process completed as quickly as possible. But again on the other hand, due to the far reaching consequences of any hasty decisions, plus the need for a carefully planned process, we need to be a little more patient before the implementation of the strategic objectives is implemented. You will be kept informed as this important and critical aspect in the evolution of our campus takes place.

As a response to the need for a more effective governance model on the Qwaqwa campus, a review of the governance structure was completed towards the end of 2004 and will soon serve before the Executive of the Executive Management for approval.

Due to the importance that top management attaches to the development of an effective governance on the Qwaqwa campus, the process was facilitated by an internationally acclaimed consultant. Again the contents of the revised governance model will be made known to the campus and the broader community once it is approved.

I am glad to report that in recognition of the need to improve the infrastructure on campus to provide a conducive learning atmosphere to our students, a total of 8.2 million rands was made available towards the end of 2004 for recapitalization of specifically our student residences and lecture venues. The first phase of the residence renovation is completed and residences C, D and E have now been officially handed over to the University by the Contractor. Among the features of the renovated residences is that they will now computer rooms, kitchenettes for cooking, and a redesigned TV room. The rooms have even been fitted with heaters. Our challenge will now be to maintain our newly acquired facilities and to ensure that they do not again deteriorate to an un-acceptable level. The second phase of renovation will start soon.

As indicated in my address during the orientation week, our obligation to you as a campus is to offer you quality training to the best of our ability, and to disseminate this knowledge to you within a conducive atmosphere worthy of good learning. On the other hand, our students have to take advantage of this opportunity to acquire the necessary skills and training in the various academic programs that we offer on campus.

We have a very simple agenda on this campus – our vision is to continuously strive to build and develop the Qwaqwa campus of University of the Free State into a truly quality institution of higher learning in our country. To develop a tradition and culture in which we are proud of who we are, and constantly and tirelessly working towards excellence in our academic programs, and other non-academic but core and important aspects in your growth and development such as sport and community service. To nurture young conscientious citizens who are aware of their duties and responsibilities. Ultimately to produce hard working young people who fully exploit their potentials, and who will serve this country with diligence when unleashed into the real world in effectively managing their roles and responsibilities in society, whether in private or government civil service.

I would like to encourage that the various stake holders of this campus, the students, academic, administrative and support staff, and our broader community, to work together in harmony for the well being of our campus. For this campus to continue to be relevant in the environment that we find ourselves, there is a need for continuous engagement of its various stake holders, and genuinely listening to each other. We must continuously and regularly keep our feelers on alert in order that we can remain relevant.

I am particularly inviting our parents and guardians, the alumni of this campus, and leaders from our community to join hands with us in seeking solutions to the various challenges that we continue to face on campus. I am open for frank and honest discourse on the best way forward for our campus.

The University of the Free State is committed in making tertiary education accessible to as many students as possible. In this regard, students who do not have the required ‘M’ score to gain entry into main stream classes are given an opportunity to study in the highly successful ‘bridging program’ in which learners are integrated with main stream students but with fewer courses to tackle in order to ensure success. This is done on the premise that such students have the potential to pursue a degree course, and that therefore within a well structured program, they can make a success of their lives.

The University is conscious of the fact that in many instances several academically deserving students fail to be admitted into university due to financial reasons. For students who are academically deserving but who because of reasons of poverty cannot pay the requisite fees, the university is able to assist such students through the National Financial Aid Scheme – commonly known as NSFAS, and University Merit Awards. Other incentives such as Sports bursaries are also available.

Please remember that it is important to balance your life on campus and the phrase ‘a healthy mind in a healthy body’ aptly describes this statement. Ensure that you participate in sport and cultural activities of this campus so that you can develop and strengthen the various God-given talents that you have been blessed with.

A second major ingredient for your success on campus is discipline and respect for rules, policies and procedures that govern the University of the Free State , and respect for your fellow students. Good discipline is a major contributory factor to success in life, and more so in your formative academic life at University. This means for example that you must attend all your lectures, complete your assignments on-time and visit the library frequently. Please manage your time wisely and responsibly. Remember that as a university student, you are basically the master and architect of your own destiny.

Think very carefully when you are confronted with difficult situations, be they negative peer pressure, or temptations to indulge in intoxicating drugs, and make the right choice.

The University has well trained personnel including a social worker, a psychologist and counselor, and members of the student affairs division under the leadership of Mr. Teboho Manchu, Deputy Director Student Affairs, who are available to assist whenever you require their help.

Today is also a special day because we have officially inaugurated the SRC President and the rest of the SRC leadership. I am sure that you all join me in congratulating the SRC for being elected to their leadership roles for 2005. Mr. SRC president and your team, please remember that you now have a huge responsibility in carrying out the aspirations of the student body on campus. I want to wish you luck and success as you champion the rights of your constituents, which I believe and trust will be compatible with management’s expectations with regard to quality teaching and learning on campus. As you are aware, Management values the input that the student leadership makes in the operational management of the affairs of this campus, and we look forward to a cordial, non-confrontational working relationship with a view of rendering un-paralleled service on campus.

Mr. Program Director, allow me to wish everyone here a successful and prosperous year. May the good Lord give us the strength and courage to overcome any obstacle that may be placed in our way in the course of our work in 2005.

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