Multi-disciplinary Breast Cancer Clinic offers holistic care for the patient

Breast cancer is rising in Africa and not a day passes that we don’t hear about a friend, family member, colleague or acquaintance who has been diagnosed with breast cancer. It is a scary time in the life of any woman.

According to the World Health Organisation, breast cancer is the most frequent cancer among women, impacting 2.1 million women each year, and also causes the greatest number of cancer-related deaths among women. In 2018, it is estimated that 627,000 women died from breast cancer – that is approximately 15% of all cancer deaths among women. While breast cancer rates are higher among women in more developed regions, rates are increasing in nearly every region globally. GLOBOCAN statistics show that Africa recorded 168,690 new breast cancer cases in 2018, out of the slightly over 2 million new cases globally.

If breast cancer is found early, there are more treatment options and a better chance for survival. It is therefore important to ensure timely and accurate diagnosis.

A team approach to breast cancer care

Early detection, followed by timely diagnosis and appropriate treatment, can improve breast cancer outcomes. A multidisciplinary approach connects these steps, drawing on the expertise of different specialists to guide each patient’s care.

At Aga Khan University Hospital, Nairobi (AKUH,N), the Multidisciplinary Breast Cancer Clinic brings specialists together to help patients understand their diagnosis, explore their options and receive a personalised treatment plan.

Getting the diagnosis right

An accurate diagnosis is the foundation of treatment. Assessment includes a medical history and breast examination, with imaging such as a mammogram, ultrasound or MRI recommended according to the patient’s needs. Radiologists interpret these images and may use them to guide a biopsy, a procedure that takes a small tissue sample for testing.

A pathologist examines the sample to determine whether cancer is present and identify its characteristics. These findings help the team understand the type of breast cancer and which treatments are most likely to be effective.

Planning treatment as a team

At the Multidisciplinary Breast Cancer Clinic, breast surgeons, medical oncologists and radiation oncologists review each patient’s case together. They contribute expertise in surgery, cancer medicines and radiation treatment, helping patients understand how these treatments fit into their care.

Treatment is not the same for everyone. The recommended approach depends on the type and stage of cancer, the patient’s overall health and individual circumstances. Some patients need a combination of surgery, radiotherapy and medicines, with the sequence carefully planned around their diagnosis.

For some patients, chemotherapy given before surgery can shrink the tumour and make breast-conserving surgery possible. This procedure removes the cancer and a small amount of surrounding tissue rather than the whole breast, and is usually followed by radiotherapy. Considering these options before treatment begins is an important part of planning care.

Helping patients make informed decisions

The clinic provides an opportunity for patients to discuss their concerns, ask questions and understand the recommended treatment before making important decisions. The focus is not only on treating the cancer, but also on helping each patient feel informed and supported.

By bringing expertise and guidance together, the Multidisciplinary Breast Cancer Clinic helps patients navigate treatment with a coordinated plan and a team alongside them.

​(GLOBOCAN 2018 is an online database providing estimates of incidence and mortality in 185 countries for 36 types of cancer, and for all cancer sites combined)

By Prof Mansoor Saleh, Chair of the Haematology-Oncology department, Aga Khan University Hospital, Nairobi