Similar to most developed countries, breast cancer is the most common cancer among women in Slovenia, with every fifth new cancer case in women being breast cancer.
Breast cancer is not exclusively a disease of women, as one to two percent of those affected are men. The mortality rate for women with breast cancer is slowly decreasing, mainly due to the detection of smaller tumors and high-quality treatment that is becoming increasingly tailored to the individual woman and her cancer. The organized national screening program Dora, which launched on April 21, 2008, will certainly contribute to the detection of smaller, non-palpable changes. Pink October is the global breast cancer awareness month.
Every year, 87,000 women die from breast cancer in the European Union, and around 400 in our country. According to the Cancer Registry of Slovenia, 1,255 women and 12 men fell ill in 2010. That year, 421 women and seven men died from breast cancer. In 2016, the number of cases was even higher: 1,386 women and 14 men. In the same year, 384 women (a lower number than in 2010!) and 8 men died from breast cancer.
The national DORA program is a screening mammography for the early detection of cancer and precancerous breast changes, organized by the Institute of Oncology in cooperation with the Ministry of Health and the Health Insurance Institute of Slovenia. The goal of the DORA program is to reduce breast cancer mortality among the screened population by 25 to 30 percent; however, the program’s success depends on at least 70 percent of women responding to the invitation for imaging.
The problem is also that women often say we don’t know how to perform a proper monthly breast self-examination correctly, so we simply don’t do it. In Slovenia, we have many health education tools prepared to help us with this issue:
Self-examination – Breast Test – click1
Self-examination in photos – Europa Donna – click2
Self-examination – ZAdojke – click 3
And nowadays, when various mobile apps are very trendy, there is also a mobile app on the Breast Test website – Trust your hands for breast health.
To help with regular monthly examinations, a mobile app and the Breast Test website are also available. The app includes an up-to-date menstrual calendar that reminds users to perform an exam each month, and it also features simple instructions and visual materials demonstrating the self-examination process. The app is available for free in mobile app stores (App Store, Google Play, Windows Phone Store), and it can also be downloaded to your phone via the website: breast-test.com, where a web version of the menstrual calendar with self-exam reminders and a guide to the procedure is also available.
Prevention
Primary cancer prevention involves identifying cancer risk factors and minimizing exposure to these factors as much as possible. We strive for this on one hand through education and training on how people should act to reduce their risk of cancer, and on the other hand through legislation.
2. Secondary prevention
This means early cancer detection. Treatment for most cancers is more successful if they are caught early. Therefore, it is important for people to know the early signs of various types of cancer.
Breast cancer is a highly curable disease if detected early enough. The recommendation of the Association of Slovenian Cancer Societies for early breast cancer detection is:
- – breast self-examination (a woman should start checking her breasts regularly at age 20 and continue doing so throughout her life),
- – clinical examination (a woman should have one every three years between the ages of 20 and 40. If not before, you can use this opportunity to have your gynecologist teach you how to perform a self-exam correctly),
- – clinical examination with mammography at any suspicion of disease activity in the breast (to be performed at the doctor’s discretion),
– clinical examination with mammography if risk factors are present (a woman should have this from age 40 onwards; some recommend such an exam every year or every year and a half),
– clinical examination with mammography after age 50 (a woman without risk factors should have this every two years) (Borštnar et al., 2006; Kumar, 2001).
Self-examination is the only successful weapon that every woman holds in her own hands. And what are the real signs we need to look out for?
- bloody discharge from the nipple,
- change in the color of the skin on the breasts (orange-peel texture, redness),
- inverted nipple or other indentations on the breast,
- a painless lump in the breasts.
- Lymph nodes under the armpit may also be enlarged.
Screening tests are available for detecting certain types of cancer, which can determine if people who do not yet have any symptoms have cancer or its precursor stages.
In Slovenia, we have organized screening for three cancer locations:
- national program ZORA – for detecting precancerous changes of the cervix for women between 20 and 64 years of age every 3 years
- national program DORA – mammography for women between 50 and 69 years of age every two years
- national program SVIT – fecal occult blood test for detecting colorectal cancer for men and women between 50 and 69 years of age, every two years
3. Tertiary prevention
This includes quality treatment, which contributes to reducing cancer mortality. New treatment methods have significantly improved the success of treating certain cancers, such as testicular cancer and childhood leukemias. Survival rates for patients with breast, ovarian, and colon cancer are improving. There is also an increasing focus on the quality of life for patients.
National Cancer Control Program (DPOR)
At the end of December 2012, the website www.dpor.si was launched, where you can find a lot of important information about cancer. Today, cancer is the leading cause of death in Slovenia, having overtaken cardiovascular diseases. Cancer is increasingly becoming a curable chronic disease. 30% of all cancers could be prevented if we lived healthily and followed expert recommendations.
You can find out more about this on the National Cancer Control Program website. You will also find out which health institutions in Slovenia treat specific types of cancer.
ZORA The national program for the early detection of precancerous cervical changes is intended for women aged between 20 and 64.
More information: zora.onko-i.si
SVIT The national program for screening and early detection of precancerous changes and colorectal cancer is intended for men and women aged 50 to 69.
More information: www.program-svit.si
Palmers created TheCancerBra, the first bra with breast cancer, to remind women of the necessity of regular self-examination. #TheCancerBra #SelfExamine #Palmers In the video, they remind us that we actually only pay attention to our breasts when buying bras. If we performed breast self-exams every day, many lives could be saved.
Read more: Unusual illnesses happen to everyday people
