High cost of treating painful breast lumps

A core liquid biopsy procedure in a private hospital costs about Sh28,000. For patients with benign lumps a test has to be done every six months adding to the financial and emotional toll. PHOTO| FILE

What you need to know:

  • She ignored the new painful lump for a while. ‘‘I couldn’t even touch the breast. I feared finding out that it had changed shape or become bigger,’’ she says.
  • Fibroadenomas and lipomas require a biopsy to determine whether they are malignant or benign especially if they are increasing in size. Cysts can be drained using a needle making the lump disappear.
  • A recent report by Population Reference Bureau shows that Kenyan women are having the lowest number of children in Africa, with most having about four compared to six for Burundians and Nigerians.

Rita Chwele, 37, found a little pea-like swelling on her breast one evening. This was not the first lump. About five years ago, she had undergone a surgery to remove three other lumps, which were benign.

She ignored the new painful lump for a while. ‘‘I couldn’t even touch the breast. I feared finding out that it had changed shape or become bigger,’’ she says.

After years of worrying, she decided to have the breast examined and the doctor discovered three other lumps.

‘‘I was so worried, but the doctor said I had fibrocystic breasts or lumpy breasts, which can manifest as cysts of various sizes and recurring fibroadenomas,’’ says Mrs Chwele who barely breastfed her children.

A CT-scan confirmed that she had a fibroadenoma (overgrowth of breast tissue which is a solid lump), a cyst (which has green-like fluid), and one that looked like a lymph node or scar from the previous surgery or lipoma (a collection of fatty tissue).

CORE LIQUID BIOPSY PROCEDURE

Fibroadenomas and lipomas require a biopsy to determine whether they are malignant or benign especially if they are increasing in size. Cysts can be drained using a needle making the lump disappear.

‘‘I did a very painful core biopsy procedure where the doctor inserted a needle and cut small pieces of the tumour for cancer testing. After two weeks of agony, the tests came out and all the three lumps were benign,’’ she says.

A core liquid biopsy procedure in a private hospital costs about Sh28,000. For patients with benign lumps a test has to be done every six months adding to the financial and emotional toll.

But even with the doctor’s reassurance that the lumps were non-cancerous, Mrs Chwele says she couldn’t live with the anxiety, knowing that they could still turn malignant. She had to get rid of them.

She decided to do a breast segmentation surgery to extract the lumps, a procedure that costs about Sh300,000. Because the lumps were scattered in one breast, the surgeon decided to extract them from the nipple area.

Mrs Chwele is among an increasing number of Kenyan women who are opting to have their breast lumps removed, if only to have a peace of mind.

Prof Ronald Wasike, a consultant breast specialist and surgeon for 27 years, whose breast clinic is always full, says he sees more young women seeking treatment for painless and painful lumps compared to previous years.

Women nearing menopause, who breastfed less and who have fewer children tend to have cysts or fibroadenomas.

"‘We rarely see rural women who have had five to six children and who have breast-fed each child for up to two years have lumpy breasts.

Nowadays, young women delay child-bearing and breast-feed for a shorter period,’’ he says.

KENYAN WOMEN WITH LOWEST NUMBER OF CHILDREN IN AFRICA

With most Kenyan women having fewer children, breast feeding less and delaying child-birth, they are at a high risk of getting recurrent breast lumps compared to their counterparts in other parts of Africa.

A recent report by Population Reference Bureau shows that Kenyan women are having the lowest number of children in Africa, with most having about four compared to six for Burundians and Nigerians.

An alternative would be to have fewer children and breastfeed them for a longer period of time, which will reduce likelihood of breast cancer, strengthen the bond between mother and child and boost a child’s immunity to diseases.

However, as more women get lumps, the new ways for surgically removing them through the nipple or armpit and conserving the breast promises hope.

Prof Wasike is one of the Kenyan doctors pushing for oncoplastic surgery—a concept of combining a plastic surgery with breast conservation to allow a patient’s breast have a more favourable look.

He says that over the years, mastectomy has been the surgical treatment of choice for breast cancer, but it is disfiguring.