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

<div><p>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.
</p><p>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.</p><p>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. </p><p><strong>A Multi-disciplinary diagnosis process</strong></p><p>The diagnosis of breast cancer is a multi-disciplinary
endeavor and involves experts in the fields of radiology and pathology.<span>  </span>It requires the involvement of trained breast
radiologist, who performs the mammogram, followed up with an ultrasound or MRI
and then perform the image guided biopsy of the suspicious lesion. That biopsy
is then reviewed by a trained breast pathologist to determine the diagnosis and
the pathologic characteristic of the tumor.</p><p><strong>Multi-disciplinary approach to treatment </strong></p><p>The treatment of confirmed breast cancer also involves a
number of expert consultants. It requires the input of an experienced breast
surgeon, the medical oncologist who will administer systemic therapy, and the
radiation therapist who may ultimately need to administer radiation.</p><p>A multi-disciplinary approach involving all three
specialists seeing the patient and reviewing the case at the same time has been
shown to provide optimal management of breast cancer.<span>  </span>This is critical since many patients may
qualify for breast conserving surgery if their tumors could be shrunk by giving
chemotherapy before surgery (neo-adjuvant chemotherapy). </p><p>The concept of a multi-disciplinary approach is new to Kenya
but has become standard practice at most major cancer centers in Europe and N.
America.<span>  </span>It is imperative that women are
given options and choices in advance of having to make a critical decision in
the management of their breast cancer. </p><p>The Aga Khan University Hospital Nairobi embarked on this
best practice by launching the Multi-Disciplinary Breast Cancer Clinic (MBC)
this July.<span>  </span>Held once a week, the clinic
is for those women diagnosed with breast cancer and awaiting a treatment plan
for the optimal management of their condition.<span> 
</span>On July 9th 2020, AKUHN launched its MBC program with 3 patients, all of
whom were recently diagnosed with breast cancer and were able to be seen by a
breast surgeon, medical oncologist and radiation therapist in one sitting. The
weekly multi-disciplinary clinic provides an environment where the patient will
receive all rounded consultation and care ensuring that they access the best
care available, for diagnosis and treatment.</p><p><em>​(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)</em></p><em>By Prof Mansoor Saleh, Chair of the Haematology-Oncology department, Aga Khan University Hospital, Nairobi</em>

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