Breast Cancer - Early Screening for African Women: A Necessity?

Breast cancer is the most common cancer among women worldwide, with an incidence of 1 in 8. Early detection is crucial for improving survival rates, but recommendations vary depending on the country and available resources. In Africa, where challenges related to access to technology and healthcare infrastructure are significant, specific adaptations of screening strategies are necessary.

International Recommendations

American Cancer Society (ACS):

• Recommendations: Annual mammograms starting at age 45 for women at average risk. For women at high risk, screening begins around age 30.

• Relevant Studies: Mammograms enable earlier detection and better survival, according to the Journal of Clinical Oncology.

National Comprehensive Cancer Network (NCCN):

• Recommendations: Early screening with mammograms and MRIs for women with family histories or genetic mutations.

• Relevant Studies: MRI is particularly useful for detecting anomalies in high-risk women, as shown by research published in Cancer Research.

European Society of Breast Imaging (EUSOBI):

• Recommendations: Mammograms recommended starting at age 40, with earlier screening for at-risk populations.

• Relevant Studies: Mammograms allow for earlier detection of cancers, reducing the need for aggressive treatments, according to European Radiology.

World Health Organization (WHO):

• Recommendations: Screening recommended starting at age 50 for the general population, with strategies adapted to local resources.

• Relevant Studies: Locally adapted screening programs increase effectiveness and patient survival, as shown in a review in The Lancet Oncology.

  
  

Practices and Recommendations for Africa

African Organisation for Research and Training in Cancer (AORTIC):

• Recommendations: Screening from age 40 or earlier for high-risk women, with awareness and training programs.

• Relevant Studies: AORTIC highlights the need for screening programs tailored to African realities in African Journal of Cancer.

African Breast Health Network (ABHN):

• Recommendations: Establishment of community-based screening programs, training for healthcare professionals, and improvement of screening infrastructure.

• Relevant Studies: Community programs improve access and early detection, according to Breast Cancer Research and Treatment.

Recommendations for Cameroon

In Cameroon, official guidelines from the Ministry of Public Health encourage screening starting at age 50. Efforts are also underway to develop awareness programs and improve access to mammograms in underserved areas.

Risk of Triple-Negative Breast Cancer in Africa

Triple-negative breast cancer is often more aggressive and more frequent among African women, with higher rates of diagnosis at advanced stages. A study published in Cancer Epidemiology, Biomarkers & Prevention shows a higher incidence of this cancer among women of African descent.

Recommendations for Women in Africa:

It is advised for African women, especially those with a high or family risk, to start screening earlier and to use complementary methods such as ultrasound and MRI to improve early detection and survival rates.

Screening Methods

• Mammography: The recommended method for detecting anomalies in breast tissues. It is the only test proven to reduce breast cancer mortality.

• Clinical Breast Exam: Used to detect anomalies, but less precise than mammography for early detection.

• Ultrasound (Sono): Complementary to mammography for evaluating detected masses, often more accessible in low-resource settings.

• Magnetic Resonance Imaging (MRI): Recommended for high-risk women, it is more precise but also more expensive and less accessible.

  
  

Conclusion

Breast cancer screening in Cameroon must be flexible and adapted to local constraints while integrating best international practices. Women should discuss with their doctor to develop a personalized screening plan based on their individual risk and available resources. Education, awareness, and improving access to tests remain key elements to improving health outcomes.

Stay informed and take care of yourselves.

Sincerely,

Dr. Sandra Yene Amougui