At present, the Philippines has the highest incidence of breast cancer in Southeast Asia, and the ninth highest in the world. With about 10,000 new cases discovered every year, the disease is already the most common form of cancer among Filipinos, having overtaken lung cancer in recent years. It accounts for 16% of all reported cancer cases in the country and nearly 30% of all female cancers.
Experts project that that three out of every 100 Filipinas will develop breast cancer in their lifetime and that, under prevailing conditions, one out of four Filipino women diagnosed with the disaeasewill die inside five years, and four out of 10 will expire within a decade. This 40% ten-year survival rate among Filipinas with breast cancer is very much lower than the 80-98% in developed countries. Is this poor survival rate from the disease among Filipinas due to poor access to expensive standard treatment modalities (i.e., surgery, chemotherapy and radiotherapy)? Only partly, says the experts.
The low survival rates for breast cancer in underdeveloped countries like the Philippines is mainly due to the lack of awareness about the disease resulting in a high proportion of women presenting with late-stage disease, and only secondarily to the lack of adequate diagnosis and treatment facilities.
Breast cancer is curable, but only if detected and treated at an early stage. And this is the reason why there is much ado about breast cancer awareness. Awareness is evidently the key to early diagnosis of the disease.
Every woman should be familiar with the signs and symptoms of breast cancer so she can seek medical consultation soonest. The most common manifestation of the disease is a mass or a lump in the breast. Other common signs and symptoms include pain and skin changes including redness and dimpling of the breast, and dimpling of, or unusual discharge from, the nipple.
Women should also be aware of the need to undergo periodic clinical breast examination and mammography, the two breast cancer screening tests that are recommended by experts. Clinical breast cancer examination refers to physical examination of the breast by a physician. Mammography, on the other hand, is simply x-ray examination of the breast, a procedure that detects breast tumors long before they can be felt by the fingers.
The latest guidelines of the American Cancer Society, which most Filipino physicians also adopt, on breast cancer screening are as follows:
• Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.
• Clinical breast exam (CBE) about every 3 years for women in their 20s and 30s and every year for women 40 and over.
• Women should know how their breasts normally look and feel and report any breast change promptly to their health care provider. Breast self-exam (BSE) is an option for women starting in their 20s.
In brief, a Filipina’s risk of dying from breast cancer can be reduced to nearly zero if she undergoes mammography, clinical breast examination and breast-self-examination as often as recommended because early detection and treatment of breast cancer almost always results in a cure.
Incidentally, Philhealth has a P 100,000-benefit package for its members and dependents with early stage breast cancer. But the package can only be availed of in any of the 20 Philhealth-contracted hospitals nationwide.
By EDUARDO GONZALES, MD