CSSL goes pink to promote awareness     By Kumudini Hettiarachchi Sri Lanka, chillingly, detects 4,500 ‘new’ cases of breast cancer among its women every year. Early detection of breast cancer prevents death and also severe illness – is the powerful message from three women surgeons this week, backed by their male colleagues.   It is to [...]

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Breast cancer – women surgeons urge early detection

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  •  CSSL goes pink to promote awareness  

Dr. Indrani Amarasinghe (with the bouquet) and (from left) CSSL President-elect, Prof. Ajith Malalasekera; CSSL members Dr. Thathya de Silva & Dr. Minoli Joseph; CSSL President, Dr. Duminda Ariyaratne; Sri Lanka Association of Surgical Oncologists’ President, Dr Rasitha Manatunga; and CSSL Secretary, Dr. Malik De Soysa at the release of the pink balloons

 

By Kumudini Hettiarachchi

Sri Lanka, chillingly, detects 4,500 ‘new’ cases of breast cancer among its women every year.

Early detection of breast cancer prevents death and also severe illness – is the powerful message from three women surgeons this week, backed by their male colleagues.  

It is to spread this message that the stately home-base of the College of Surgeons of Sri Lanka (CSSL) went pink with banners on Thursday (October 2), catching the curious gaze of drivers and passers-by along Independence Avenue in Cinnamon Gardens.

It was a first for CSSL – as many also clad in pink stood before the façade and released pink balloons. Thereafter, with surgical precision with regard to timing, they adjourned to the charming auditorium for a Breast Cancer Awareness Programme. The chief guest was Dr. (Mrs.) IndraniAmarasinghe, Consultant Surgeon who pioneered breast cancer surgery and Senior Past President of CSSL.

the Sunday Times met Consultant Cancer Surgeons, Dr. Minoli Joseph and Dr. Sandani Wijerathne, and Consultant General Surgeon, Dr. Thathya de Silva, on Monday to take a close look at breast cancer, while CSSL President Dr. Duminda Ariyaratne also gave some valuable input.

With the dual aim of the CSSL being to educate the public and health staff, it has seized the opportunity of this month being dedicated to breast cancer awareness.

Underscoring the importance of screening, Dr. Ariyaratne says the universal gold standard is a mammogram. He appealed to all women over 45 years to get a mammogram done once in two years. If breast cancer is detected, it would fast track treatment and save lives.

Pointing out that breast cancer is the “most” prevalent malignancy among women, Dr. Joseph, Dr. Wijerathne and Dr. de Silva reiterated that this is why the focus on breast health is vital.

From right: Dr. Indrani Amarasinghe; Dr. Duminda Ariyaratne; Dr. Rasitha Manatunga & Dr. Nalinda Munasinghe. Pix by Akila Jayawardena

The lifetime risk of getting hit by breast cancer is: 1 in 20 for females, the Sunday Times learns.

The risk factors for breast cancer are:

  • The biggest risk factor (99%) is being female, even though males (1%) can also be affected by this cancer.
  • Age is another – older the age, higher the risk. However, this should not be considered the norm, as recent trends are indicative of younger women also being vulnerable.

Dr. Thathya de Silva

  • Another important risk factor is family history – if a first degree relative (mother or sister) or a second degree relative (grandmother or aunt) has been affected by breast cancer. If more family members have had breast cancer and at younger ages, the higher the risk.

However, the three surgeons assure that just because there is a family history, it does not necessarily mean that a woman would get breast cancer. What is needed is diligence – consulting a doctor and getting oneself screened.

  • Women who have not had children or have had late pregnancies may also be more vulnerable.
  • Women after menopause also need to take care.

These surgeons focus on hormone replacement therapy (HRT) that is given to women who have had early menopause or a difficult peri-menopause. The important thing to remember is that the risk arises with long-term and not short-term HRT, they point out.

  • Women who have post-menopausal obesity (having too much body fat).
  • Smoking.
  • Consuming alcohol.

Some protective measures that women can take are:

Dr. Minoli Joseph

  • If having a baby, do breastfeeding for one year at least, as it is a protective factor.
  • Having a healthy and balanced diet – inclusive of carbohydrates, protein, vegetables including green-leafy vegetables and fruit.

Dr. Sandani Wijerathne

  • Exercise.

While Dr. Joseph is attached to the Colombo North Teaching Hospital, Ragama, Dr. Wijerathne is at the Kandy National Hospital and Dr. de Silva who has a special interest in breast surgery is at the Army Hospital in Colombo.

Thursday’s event was organised by the CSSL in collaboration with the Sri Lanka Society of Breast Surgeons; the Sri Lanka Association of Surgical Oncologists; and the Women in Surgery Forum – Sri Lanka.

 

 

 

Where to go to….

Women who see or feel a symptom of breast cancer can go to the surgical clinics available at all government hospitals or breast cancer clinics at many government hospitals.

Any woman at age 35 years or 45 years, can attend the well women clinics in every Medical Officer of Health (MOH) area or any woman over 35 years can go to the ‘Suwa Divi Sayanaya’ (Non-Communicable Diseases’ Clinics) held by many government hospitals.
The doctors would make an evaluation after taking the case history including details of any family members who have had breast cancer, perform a breast examination and order scanning including an ultrasound and mammogram. If necessary, a biopsy would also be taken.
Women can perform a simple 2-3 minute self-breast examination – on the 7th day from the start of the period and for those who have irregular periods or are menopausal, on the first day of each month.

The advantage of early detection of breast cancer includes a cure and the removal of only the breast part affected by the malignancy.
Research has shown that it is better to remove only the part affected as opposed to the full breast (mastectomy), Dr. Minoli Joseph, Dr. Sandani Wijerathne and Dr. Thathya de Silva point out, assuring that women need not fear chemotherapy (either in the form of oral drugs or injections) and radiotherapy which need to be done thereafter.

Chemotherapy and radiotherapy are needed to effectively prevent the spread of cancer cells which may remain after surgery. Do not worry about hair loss – it does happen, but the hair grows back again, they assure.

If all arm-pit lymph nodes have also been removed, patients are advised against using the relevant hand for repetitive work or heavy work such as carrying stuff, they say. Prevention of injury and getting injections to that arm is also important. Otherwise, swelling could occur in that arm and hand.
Another very important thing is follow-up, they add, urging women to do that without disruption.

 
Symptoms to look out forHere is advice from Dr. Minoli Joseph, Dr. Sandani Wijerathne and Dr. Thathya de Silva on how to spot the symptoms of breast cancer.
Symptoms:

  • The most common is a breast lump
  • Breast pain
  • A discharge from a nipple
  • A change in the appearance of the skin of a breast
  • Any significant change in size or shape of a breast
  • A usually normal nipple getting pulled inside
  • Any lump in the under-arm region

If any of these symptoms are seen or felt, see a doctor or go to hospital immediately, they say.

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