Carcinoma of the breast  
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Breast cancer is one of the most common cancers (75%) in women and is unfortunately a cause of death in many women diagnosed with it. In South Africa over 60% of women present with breast cancers bigger than 5 cm, which means that a simple breast self examination is not being done by women. Breast self examination and screening mammography helps detect breast cancers at a smaller size and earlier stage.


The growth of a cancer depends upon the rate of cell division (mitosis). As stated above, the cancer starts in a single cell. This cell then divides and the two cell progeny now divides and so on. This results in an exponential growth of the tumour. This growth in the tumour mass is called the doubling time. It has been shown that it takes thirty doublings from the original cell to produce a 1cm diameter tumour that may be palpable to the fingers.


These doubling times will vary with the rate of growth of the neoplasm. Thus a thirty doubling time may take a year in a fast growing tumour (inflammatory cancer of the breast) or many years in a slow growing tumour (around five years for a well differentiated breast cancer).


Thus it generally takes a few years for a tumour to become palpable i.e. 1cm to 2cm in diameter (like a marble). Again, depending on the rate of tumour growth, it takes another year or two for the tumour to reach a diameter of 4cm - 5cm. When a tumour contains 1012 or one trillion cells, it is a large growth that is very likely to have already metastasized (spread throughout the body).

 

It should be emphasised that although breast cancer is a frightening, common and lethal disease, the following points must be remembered:

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most breast lumps are benign (only one in ten lumps on the breast are malignant)

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breast cancer occurs in about one in nine women

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breast cancer can be cured if detected early.