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21 October 2021 | Story André Damons | Photo Supplied
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

Gender bias still rife in African Universities
2007-08-03

 

 At the lecture were, from the left: Prof. Magda Fourie (Vice-Rector: Academic Planning), Prof. Amina Mama (Chair: Gender Studies, University of Cape Town), Prof. Engela Pretorius (Vice-Dean: Humanties) and Prof. Letticia Moja (Dean: Faculty of Health Sciences).
Photo: Stephen Collett

Gender bias still rife in African Universities

Women constitute about 30% of student enrolment in African universities, and only about 6% of African professors are women. This is according to the chairperson of Gender Studies at the University of Cape Town, Prof Amina Mama.

Prof Mama was delivering a lecture on the topic “Rethinking African Universities” as part of Women’s Day celebrations at the University of the Free State (UFS) today.

She says the gender profile suggests that the majority of the women who work in African universities are not academics and researchers, but rather the providers of secretarial, cleaning, catering, student welfare and other administrative and support services.

She said that African universities continue to display profound gender bias in their students and staffing profiles and, more significantly, are deeply inequitable in their institutional and intellectual cultures. She said women find it difficult to succeed at universities as they are imbued with patriarchal values and assumptions that affect all aspects of life and learning.

She said that even though African universities have never excluded women, enrolling them presents only the first hurdle in a much longer process.

“The research evidence suggests that once women have found their way into the universities, then gender differentiations continue to arise and to affect the experience and performance of women students in numerous ways. Even within single institutions disparities manifest across the levels of the hierarchy, within and across faculties and disciplines, within and between academic and administrative roles, across generations, and vary with class and social background, marital status, parental status, and probably many more factors besides these”, she said.

She lamented the fact that there is no field of study free of gender inequalities, particularly at postgraduate levels and in the higher ranks of academics. “Although more women study the arts, social sciences and humanities, few make it to professor and their research and creative output remains less”, she said.

Prof Mama said gender gaps as far as employment of women within African universities is concerned are generally wider than in student enrolment. She said although many women are employed in junior administrative and support capacities, there continues to be gross under-representation of women among senior administrative and academic staff. She said this disparity becomes more pronounced as one moves up the ranks.

“South African universities are ahead, but they are not as radically different as their policy rhetoric might suggest. A decade and a half after the end of apartheid only three of the 23 vice-chancellors in the country are women, and women fill fewer than 30% of the senior positions (Deans, Executive Directors and Deputy Vice-Chancellors)”, she said.

She made an observation that highly qualified women accept administrative positions as opposed to academic work, thus ensuring that men continue to dominate the ranks of those defined as ‘great thinkers’ or ‘accomplished researchers’.

“Perhaps women simply make realistic career choices, opting out of academic competition with male colleagues who they can easily perceive to be systematically advantaged, not only within the institution, but also on the personal and domestic fronts, which still see most African women holding the baby, literally and figuratively”, she said

She also touched on sexual harassment and abuse which she said appears to be a commonplace on African campuses. “In contexts where sexual transactions are a pervasive feature of academic life, women who do succeed are unlikely to be perceived as having done so on the basis of merit or hard work, and may be treated with derision and disbelief”, she said.

She, however, said in spite of broader patterns of gender and class inequality in universities, public higher education remains a main route to career advancement and mobility for women in Africa.

“Women’s constrained access has therefore posed a constraint to their pursuit of more equitable and just modes of political, economic and social development, not to mention freedom from direct oppression”, she said.

Prof Mama concluded by saying, “There is a widely held agreement that there is a need to rethink our universities and to ensure that they are transformed into institutions more compatible with the democratic and social justice agendas that are now leading Africa beyond the legacies of dictatorship, conflict and economic crisis, beyond the deep social divisions and inequalities that have characterised our history”.

She said rethinking universities means asking deeper questions about gender relations within them, and taking concerted and effective action to transform these privileged bastions of higher learning so that they can fulfil their pubic mandate and promise instead of lagging behind our steadily improving laws and policies.

Media Release
Issued by: Mangaliso Radebe
Assistant Director: Media Liaison
Tel: 051 401 2828
Cell: 078 460 3320
E-mail: radebemt.stg@ufs.ac.za  
02 August 2007
 

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