Annual breast tests advice to women from Dr Laquis

If breast cancer is detected early enough, “the prognosis is excellent” said Chairman of the Trinidad and Tobago Cancer Society, Dr George Laquis. While the most important risk factor is genetic (a family history of the disease), he said 75 percent of the breast cancers which occur sporadically in women have no known cause. “We don’t know the real cause, therefore the only approach to this disease is early detection,” Dr Laquis said. The disease is becoming more common with the prevalence dropping from one in every 11 women to one in eight.

Breast cancer was brought to the forefront at the post-Cabinet media briefing on Thursday when Minister Christine Kangaloo disclosed she went abroad for treatment — surgery, chemotherapy, and radiation. Kangaloo reported she had received a “clean bill of health” from her doctors. Breast cancer is one of the leading cancers in TT and according to the National Cancer Registry is among the three major cancer sites along with prostate, colon and rectum. These sites accounted for 45 percent of new cancers in TT for the period 1995-1999. In the report “Cancer in Trinidad and Tobago 1995-1999” compiled by the Registry, in collaboration with the Caribbean Epidemiology Centre (CAREC), it is stated, “Breast cancer was the second most common new cancer, accounting for 15.2 percent of all cancers (1,192 of the 7,834 new cases) and was the second leading site of fatal cancer (462 deaths, 10.4 percent).”

Dr Laquis said women should go for annual mammography screening from the age of 40 years.  The risk of breast cancer is greater as women age. “Doing a mammogram in people under 40 years has a low yield. We almost never find cancers in young people.”  He explained that a mammogram shows “very little” because of the density of young women’s breasts. Dr Laquis said ten percent of cancers can be missed, but with regular screening they can be caught. A mammogram would detect a cancer the size of an eraser on a pencil (about 1/8 inch), a breast examination by a physician would detect a one-inch lump and self-examination may be able to detect 1.5 inch lump. “The difference between 1/8 inch and one inch is three to five years,” Dr Laquis said.

Dr Laquis advised that a breast ultrasound should not be used as a screening test because it is a diagnostic test. “An ultrasound is an important test to determine the difference between a cyst and solid mass.” The two most common sites for breast cancer are in the lobular (milk) gland and duct. The duct is the tube where the milk flows down. It is lined with cells. The treatment for breast cancer depends on the stage of the cancer when it is diagnosed.