October is Breast Cancer Awareness Month—a time to raise awareness, encourage appropriate screening, and emphasize that early detection and timely treatment can save lives.

Breast cancer is the most common cancer among women worldwide, with approximately 2.3 million new cases diagnosed each year. In Kenya, more than 8,000 new cases are diagnosed annually, making breast cancer an important public health concern.

Modern breast cancer care combines screening, accurate diagnosis, personalized surgery, and additional treatments such as radiotherapy, chemotherapy, hormonal therapy, targeted therapy, and, for selected patients, immunotherapy.

Breast Cancer Screening

Screening recommendations depend on a woman’s age, personal and family history, genetic risk, and other individual factors.

Women should also be aware of changes in their breasts, including a new lump, nipple inversion, abnormal discharge, skin dimpling or thickening, persistent swelling, or a change in breast size or shape. Any new or persistent abnormality should be assessed promptly by a healthcare professional.

Mammography is an important screening tool and can identify small masses, architectural distortion, and microcalcifications that may not be detected by physical examination. Breast ultrasound is particularly useful for evaluating breast lumps and is often used alongside mammography, especially when further assessment is required.

Diagnosis

When a suspicious abnormality is identified, assessment commonly involves triple assessment: clinical examination, breast imaging, and tissue diagnosis.

A core needle biopsy, often performed under image guidance, is commonly used to confirm whether cancer is present. Once diagnosed, testing for tumour characteristics such as estrogen receptor (ER), progesterone receptor (PR), and HER2 status, together with the cancer’s stage and grade, helps determine the most appropriate treatment.

Multidisciplinary Care

Breast cancer treatment is best planned through a multidisciplinary team involving breast surgeons, medical and radiation oncologists, radiologists, pathologists, specialist nurses, and other healthcare professionals.

Treatment is individualized according to the cancer’s stage and biology, the patient’s overall health, and personal preferences.

Surgical Treatment

Surgery remains an important part of treatment for many patients with early-stage breast cancer. The main options are breast-conserving surgery and mastectomy, with or without reconstruction.

Sentinel lymph node biopsy can identify whether cancer has spread to the regional lymph nodes and allows many patients to avoid more extensive armpit (axillary) surgery.

Breast-conserving surgery (lumpectomy) removes the cancer with an appropriate margin of surrounding tissue while preserving most of the breast. In appropriately selected patients, breast-conserving surgery followed by radiotherapy can provide outcomes comparable to mastectomy.

A mastectomy removes most or all breast tissue and may be recommended for larger or multifocal tumours, certain recurrences, genetic or other high-risk situations, or when breast conservation is not appropriate.

Breast reconstruction may be performed immediately or at a later stage using implants, the patient’s own tissue, or a combination of techniques.

Conclusion

Breast cancer screening, awareness of breast changes, prompt investigation, accurate diagnosis, and personalized treatment are central to modern breast cancer care. Advances in breast and lymph-node surgery allow many patients to receive effective cancer treatment while preserving the breast where appropriate and minimizing unnecessary complications.

By Dr. Sameer Pandya MD, Surgical Oncology, FACS, MMED & FCS General Surgery (ECSA), FMAS, Head of Department – Surgery & Anaesthesiology, M.P. Shah Hospital, Nairobi