For most women, it is a difficult and sensitive subject to broach or discuss. A majority would find it hard even to talk to their husbands about it.
The tragedy, however, is that the longer the delay, the higher the chances of the problem aggravating. It could be a pain, a swelling or even a tiny lump in the breast or a slight discharge from the nipple, but many women would keep silent, embarrassed to talk about it because most of them are reluctant to go to a male doctor.
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| Dr. Samarakoon advising a patient at the clinic. |
That, however, has changed. Now if there is the slightest doubt or suspicion that something is wrong, there is a place women can go to – the Breast Clinic of the Sri Jayewardenepura General Hospital, begun just three weeks ago.
What is so special about this clinic?
This breast clinic is run by an all-women team, points out dynamic Consultant Surgeon Dr. Dilini Samarakoon who heads the team and whose brainchild it is to make the clinic a one-stop spot, without sending women from pillar to post.
Stressing that early detection is a life-saver particularly with regard to breast cancer, she says that at the clinic they offer a “triple-assessment diagnosis”. (See box for statistics)
Any breast problem would be clinically assessed by her as the surgeon, followed by a radiological investigation in the form of a mammogram and ultrasound and finally, if necessary, a biopsy. The radiologist and the pathologist are also females, while an oncologist is also available next door, under the same roof, The Sunday Times understands.
Those who come to the clinic, held every Monday from 2-4 p.m. will be under a multidisciplinary team, says Dr. Samarakoon.
The need is for women, especially those between 45-65 years old, to get themselves screened. The earlier the detection of a problem, the process of treatment is quicker and less mutilating, she says, adding that nearly 99-100% would be sensitive to the triple assessment.
The incidence of breast cancer is on the decline in some developed countries with five-year survival rates exceeding 70%, mainly due to improvements in early detection and treatment, it is learnt.
Pointing out that early diagnosis and appropriate treatment are the key to success with breast cancer care, Dr. Samarakoon says that randomized trials have shown mammographic screening helps to reduce breast cancer deaths by 25-30%. “Another benefit of screening and early detection of breast cancer is that it allows surgeons to perform more localised cosmetically acceptable surgeries, avoiding mutilating mastectomies and expensive reconstructions,” she says.
| Commonest cancer |
Breast cancer is the commonest cancer among women in Sri Lanka, accounting for 22.8% of all female cancers, according to the latest national statistics from the National Cancer Control Programme (NCCP), says Dr. Samarakoon.
It is also the commonest cancer among Sri Lankans, contributing to 12.6% of all cancers, she says pointing out that in 2000 Sri Lanka had a total of 1,324 new females diagnosed with breast cancer with an annual age standardised rate of 19.1 per 100,000 population.
“There was a 6% increase compared to the previous cancer registry data, published in 1995, indicating that breast cancer is now emerging as a major health issue in Sri Lanka,” she says, stressing that breast cancer needs to be addressed in a timely and an organised manner.
Worldwide too breast cancer is the commonest cancer affecting women with more than 1 million new patients diagnosed per year and the last few decades seeing more and more, younger females falling victim, The Sunday Times learns.
World Health Organization statistics reveal that it is the most common cause of death from cancer in women accounting for almost 400,000 deaths per year throughout the world. |
Unfortunately, in most of the developing countries, including Sri Lanka, the majority of patients seek treatment when the disease is at an advanced stage, where current treatment is of little benefit. As a result, developing countries contribute to around 250,000 of the annual breast cancer deaths, The Sunday Times understands.
Why?
“Lack of awareness, proper screening programmes and access to breast care facilities are the main reasons,” answers Dr. Samarakoon, indicating the need for a fully-empowered and multidisciplinary breast clinic.
Dealing with the situation even in Colombo, she says that there are only a few such specialised breast clinics.
Sri Jayewardenepura Hospital being a tertiary health care establishment has the necessary personnel and resources for this clinic, she says. Radiological assessment in the form of mammography and ultrasound scanning of the breasts with pathological assessment through biopsy facilities is available. It is a one-stop clinic, reducing the patients’ agony and inconvenience associated with waiting for investigations.
The other positives are the pleasant hospital environment and friendly staff, says Dr. Samarakoon, adding that to alleviate the fear and agitation relating to the possibility of being diagnosed with breast cancer, counselling and psychological support will also be provided.
The aim is to provide holistic breast care to the patient. |
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