As part of our Breast Cancer Awareness Campaign, consultant breast surgeon Gordon Caruana Dingli wrote an article for our Expert Advice section. Further to this, he will be giving free Breast Screening consultation throughout October.
Breast cancer is the most common form of cancer in Malta, affecting more than three hundred women every year. It is increasing but mostly because the population is growing and because people are living longer. It also affects men, but only two or three every year.
The good news is that more than 80% survive breast cancer and the rate is improving, Treatment is now not only more effective but also kinder on the patient. There are now large numbers of women who survive the disease and breast cancer has become a chronic condition.
Many women find a breast lump while washing or during self-examination and some notice skin changes like dimpling or redness. Others present with bleeding from the nipple or a rash around the nipple. Larger numbers of women are finding abnormalities in their breast when they have a screen mammogram. I am often consulted by women who have relatives with breast cancer who are concerned that they may have a high risk of breast cancer.
Women who feel a lump or have other symptoms are usually stressed and it is very important for them to be seen by a surgeon in pleasant and quiet surroundings. The surgeon will take a history of the complaint and then examine the breasts. Depending on the findings and the age of the patient a mammogram, ultrasound and a biopsy will be done. These tests usually allow the surgeon to diagnose the disease and explain the diagnosis to the patient and a plan for treatment is made.
Most women with breast cancer have surgery to remove the lump and some lymph nodes under the armpit. Some will require a mastectomy but the majority will only need to have part of the breast removed. My approach is called oncoplastic surgery ie while the operation is designed to remove all the diseased breast tissue I use plastic surgery techniques to ensure a satisfactory cosmetic outcome. Even women who undergo mastectomy are offered reconstruction. Surgery is followed by other treatments under the care of an oncologist and these comprise of radiotherapy, endocrine therapy or chemotherapy. Each patient is different and the treatment is tailored to each individual.
While most breast cancers are sporadic, a minority (less than 5%) are genetic and the tendency is inherited. Young women with relatives who had breast cancer at a young age can be counselled by a geneticist and tested if indicated. If a woman does inherit the gene she can be offered risk-reduction surgery where the glands of the breast are removed and replaced by silicone implants.
Breast cancer can be effectively treated especially when caught early. I encourage all women who feel an abnormality in their breast to immediately contact their doctor who will examine them and refer on to a breast specialist if needed.
To book your Free Breast Screening Consultation with consultant breast surgeon Gordon Caruana Dingli, call us on 21 340 366 or email to firstname.lastname@example.org – appointments are given on a first-come, first-served basis.