COVID-19 hampered breast cancer detection

Breast cancer is one of the most common cancers among females in Sri Lanka. Annually around 3000 new cases are detected however the COVID-19 pandemic has drastically affected early detection. Speaking to Daily Mirror, Dr Sachini Rasnayake, Consultant Oncologist, revealed that in the past 3 months she had diagnosed many patients with T4 breast lesions, which is an advanced form of breast cancer. “When the cancer progresses to T4 lesions, it means that the skin and the deep muscles are also associated with the tumour. It can invade surrounding skin tissue and change the skin appearance leading to ulceration, reddening,” explained Dr Rasnayake. 

She observed that the reasons for the detection of advanced stage breast cancer varied but one of the foremost reasons was the COVID-19 pandemic. “Even though cancer treatments and screening process was done even during the peak of the pandemic, many people were afraid to walk into the hospital during the pandemic.

Therefore, they came in many months after they have detected a lump in the breast,” she said, adding that there were also patients who did not have access to professional medical services due to the lockdowns. She also noted that many patients had also not wanted to accept that it could be a cancer lesion and had tried various home remedies. 

Dr Rasnayake remarked that factors like increased stress, lack of exercise, increase in the Body Mass Index (BMI) which has also resulted due to the pandemic could also have an impact on the tumour progression. “There are certain modifiable and non-modifiable factors that affect your risk of getting cancer and its progression. Modifiable factors to prevent cancer or slow progression include maintenance of BMI, mental relaxation, regular exercise, no smoking or drinking. During the pandemic, people were more stressed and lead a sedentary lifestyle,” she noted. 
Risk factors for breast cancer:

• Early menarche 
• Late menopause 
• Hormonal treatment 
• Increased exposure to oestrogen 

Dr Rasnayake also shared that the late detection of breast cancer could lead to a significant increase of breast cancer mortality in the future. When detected early, breast cancer can be managed and even cured by treatment that does not require removal of breast. “With advanced forms, the intense and costlier treatment can lengthen life expectancy and improve quality of life. But, early detection would drastically help to change the disease outcome.” 

To reduce incidences of late detection and prevent an increase in mortality rates, she suggested that a compulsory national breast cancer programme should be implemented as the current system is opportunistic and only available for those wanting to screen themselves. “This will enable every Sri Lankan woman above the age of 30 to be screened periodically.” She also added that there should be cancer awareness programmes for OL and AL students in schools so that they could make the necessary lifestyle changes to minimize risk of cancer. “Also, it is scientifically proven that having first child before the age of 30 could reduce the risk of breast cancer,” she noted.