Fay­ola Fras­er

The mor­tal­i­ty rate of breast can­cer in T&T has been es­ti­mat­ed at ap­prox­i­mate­ly 23 per 100,000 women, with one in nine women de­vel­op­ing breast can­cer in their life­time.

Breast Can­cer Aware­ness Month, ob­served an­nu­al­ly in Oc­to­ber, plays a cru­cial role in rais­ing aware­ness about breast can­cer, a dis­ease that af­fects mil­lions of peo­ple world­wide.

This month-long cam­paign helps to ed­u­cate the pub­lic about the im­por­tance of ear­ly de­tec­tion, which can sig­nif­i­cant­ly im­prove sur­vival rates. By pro­mot­ing reg­u­lar screen­ings and self-ex­am­i­na­tions, Breast Can­cer Aware­ness Month aims to catch the dis­ease in its ear­ly stages when it is most treat­able. This aware­ness can lead to ear­li­er di­ag­noses, bet­ter treat­ment out­comes, and ul­ti­mate­ly, save lives.

In ad­di­tion to pro­mot­ing ear­ly de­tec­tion, Breast Can­cer Aware­ness Month serves as a plat­form to sup­port those af­fect­ed by the dis­ease. It pro­vides an op­por­tu­ni­ty for sur­vivors, pa­tients, and their fam­i­lies to share their sto­ries and ex­pe­ri­ences, fos­ter­ing a sense of com­mu­ni­ty and sol­i­dar­i­ty.

This sup­port net­work can be in­cred­i­bly em­pow­er­ing, of­fer­ing emo­tion­al and prac­ti­cal as­sis­tance to those nav­i­gat­ing their can­cer jour­ney. It can al­so equip and em­pow­er breast can­cer pa­tients with the knowl­edge of the var­i­ous op­tions avail­able to them and help guide them through dif­fi­cult process­es, such as mas­tec­to­my and re­con­struc­tive surgery.

In T&T and the Eng­lish-speak­ing Caribbean, Dr Ra­jen Ram­paul, med­ical di­rec­tor of the Pink Hi­bis­cus Breast Health Spe­cial­ists, is one of the on­ly Breast and On­coplas­tic Sur­geons trained in plas­tic surgery.

His role ranges from look­ing af­ter women with sim­ple is­sues such as breast pain to screen­ing, di­ag­nos­ing, and treat­ing breast can­cer, to per­form­ing mas­tec­tomies and re­con­struct­ing women’s breasts af­ter can­cer re­moval surgery.

Ac­cord­ing to Dr Ram­paul, al­though this month is very im­por­tant, ad­vo­ca­cy should be a year-round ef­fort.

Ear­ly de­tec­tion of breast can­cer is vi­tal, as it sig­nif­i­cant­ly in­creas­es the chances of suc­cess­ful treat­ment and sur­vival. When breast can­cer is iden­ti­fied at an ear­ly stage, it is of­ten small­er and has not yet spread to oth­er parts of the body, mak­ing it eas­i­er to treat ef­fec­tive­ly.

Dr Ram­paul en­cour­ages women to have reg­u­lar screen­ings, such as mam­mo­grams, which play a cru­cial role in ear­ly de­tec­tion by iden­ti­fy­ing ab­nor­mal­i­ties be­fore even symp­toms ap­pear. Ad­di­tion­al­ly, self-ex­am­i­na­tion and aware­ness of changes in breast tis­sue can help in­di­vid­u­als no­tice po­ten­tial is­sues ear­ly on.

By catch­ing breast can­cer ear­ly, pa­tients have more treat­ment op­tions avail­able, which can lead to bet­ter out­comes and a high­er qual­i­ty of life.

Mod­ern med­i­cine can pick up breast can­cer at a very ear­ly stage. Dr Ram­paul says “stage ze­ro and stage one.” From age 25, women should be­gin check-ups, which in­volve go­ing to the doc­tor to get a breast ex­am reg­u­lar­ly.

From age 40, as the risk in­creas­es, women should en­rol in a breast screen­ing pro­gramme at a breast cen­tre and get reg­u­lar screen­ings. These screen­ings in­clude mam­mo­grams and ul­tra­sounds, as not all can­cers can be picked up by any one test. If a pa­tient is di­ag­nosed with breast can­cer, treat­ment plans should be tai­lored to that pa­tient, and op­tions of chemother­a­py, ra­di­a­tion, and mas­tec­to­my among oth­ers, can be ex­plored.

Mas­tec­tomies, coun­selling, emo­tion­al sup­port,

and feel­ing whole again

Mas­tec­to­my is a sur­gi­cal pro­ce­dure that in­volves the re­moval of one or both breasts, typ­i­cal­ly to treat or pre­vent breast can­cer. This op­er­a­tion can be a life-sav­ing mea­sure for in­di­vid­u­als di­ag­nosed with breast can­cer, es­pe­cial­ly when the can­cer is ex­ten­sive or has a high risk of re­cur­rence.

There are dif­fer­ent types of mas­tec­tomies, rang­ing from to­tal mas­tec­to­my, which re­moves the en­tire breast tis­sue, to more con­ser­v­a­tive ap­proach­es like skin-spar­ing or nip­ple-spar­ing mas­tec­tomies that pre­serve as much of the breast skin and struc­ture as pos­si­ble.

The de­ci­sion to un­der­go a mas­tec­to­my is deeply per­son­al and can be in­flu­enced by var­i­ous fac­tors, in­clud­ing the stage of can­cer, ge­net­ic pre­dis­po­si­tion, and pa­tient pref­er­ence.

Post-surgery, many pa­tients opt for re­con­struc­tive surgery to re­store the breast’s ap­pear­ance, which can be an im­por­tant step in the men­tal, emo­tion­al, and phys­i­cal re­cov­ery process.

Dr Ram­paul has pub­lished re­search along­side psy­chol­o­gist Dr Ar­i­anne Shep­herd fo­cused on the link be­tween de­pres­sion and body mu­ti­la­tion that ac­com­pa­nies mas­tec­to­my in T&T.

Ac­cord­ing to their re­search, over 80 per cent of women who un­der­went mas­tec­tomies were sub­ject to de­pres­sion, aban­don­ment by hus­bands, failed mar­riages, and bro­ken homes.

“It be­came dif­fi­cult for these women to re­turn to work or re­sume nor­mal ac­tiv­i­ties, as they suf­fered with shame,” he said, ex­plain­ing the phys­i­cal, psy­cho­log­i­cal, and psy­choso­cial im­pact of this life-chang­ing surgery.

As breasts have for a long time been an in­te­gral part of the fe­male and fem­i­nine iden­ti­ty, hav­ing breasts is far more than aes­thet­ics, as it re­lates to re­pro­duc­tion and re­la­tion­ships, while the loss of them can cause great­ly di­min­ished feel­ings of fem­i­nin­i­ty.

At the Pink Hi­bis­cus Breast Health Spe­cial­ists, women who have to grap­ple with the de­ci­sion are of­fered coun­selling and emo­tion­al sup­port as a key com­po­nent of their treat­ment pro­gramme.

Ac­cord­ing to Dr Ram­paul, “From the point of biop­sy, we en­cour­age women to bring their hus­bands, part­ners, friends, or oth­er loved ones to pro­vide them with sup­port dur­ing and af­ter­care.”

In a broad­er sense, he en­cour­ages his pa­tients not to see los­ing their breast as a hor­ror sto­ry “be­cause of our mod­ern lev­els of ser­vice and care, we can keep part of the breast or the breast shape, so women don’t feel mu­ti­lat­ed or de­formed and they know they can be whole again.”

The fight against breast can­cer re­mains a col­lec­tive ef­fort that re­quires on­go­ing aware­ness, re­search, and sup­port.

By pri­ori­tis­ing ear­ly de­tec­tion, ad­vo­cat­ing for com­pre­hen­sive care, and fos­ter­ing a com­mu­ni­ty of sup­port, we can make sig­nif­i­cant strides in re­duc­ing the im­pact of this dis­ease.

Every step tak­en, whether through ed­u­ca­tion, fundrais­ing, or per­son­al vig­i­lance, brings us clos­er to a fu­ture where the ill­ness is no longer a life-threat­en­ing con­di­tion.