Breast Cancer Screening During a Pandemic

ACCORDING TO DR PRAMOD REDDY, DIRECTOR OF THE DURBAN BREAST CLINIC AND

THE SURGICAL SCREENING CLINIC, DESPITE COVID-19, BREAST CANCER SCREENING IS AS IMPORTANT AS EVER.

At the onset of the COVID-19 pandemic, • Axillary/armpit lymph glands elective medical procedures, including • It is important to remember that breast cancer screening, were largely put on hold cancers are usually painless. to prioritise urgent needs and reduce the What are the recommended mammospread of COVID-19 in health-care facilities. graphic screening guidelines? One consequence of this has been the subRisk stratifi cation for breast cancer is stantial decline in breast cancer screening. important to evaluate one’s personal risk for The shutdown of elective health services developing breast cancer. Elevated risk facduring the outbreak may have far-reaching tors include a strong family history of breast consequences on health-care provision in cancer, a personal history of a proliferaSouth Africa. There has also been a decline tive breast disorder or a previous history of in elective consultations, diagnostic biopcancer, increased breast density, and using sies, and surgical management of breast hormone replacement therapy (HRT). Obepathology. Quantifying the negative impact sity, smoking and medical co-morbidities on breast cancer screening will only be asalso contribute to risk elevation. sessed in the months to come. It is recommended that mammographic

Many patients have delayed seeking mediscreening commence at the age of 40, annucal advice due to their fears surrounding ally for high-risk females, and biennially for the potential risk for contracting COVID-19 average-lifetime risk females. during their visit to health facilities. What if there is an abnormality?

The number of mammograms, ultraIf an abnormality is identifi ed, either sounds and MRIs had signifi cantly declined clinically or radiologically, it is important to due to the lockdown, and although confi - have it assessed by a Breast Clinician. If the dence in the system is returning, it will take lesion is concerning, then a biopsy is usually months to recover from this backlog. performed by your breast surgeon, or it will

It is vitally important for women to be scheduled to be done by a radiologist. It continue with self-breast examination, to is important not to delay this intervention, ensure that one remains breast aware. The because early diagnosis is associated with concerning clinical features that require a better outcomes and cure rates. more urgent assessment include: It is important to know that most clini• A new lump (please note that this could cal facilities have taken all the necessary be solid or cystic) precautions to ensure the safety of patients • Pathological nipple discharge, which is during procedures. And remember, always a blood-stained or watery, spontaneous, wear an appropriate mask, practice social unilateral discharge. distancing and appropriate hand sanitising. • Nipple retraction (usually unilateral) Dr Pramod Reddy, Director of the Durban Breast Clinic & The • Sk in changes (o e dema /swelling Surgical Screening Clinic and Specialist Breast Surgeon. Visit or tethering) www.durbanbreastclinic.co.za for more information.