BREAST CANCER:

CATCHING THEM
EARLY-THE ROLE OF
FAMILY PHYSICIANS

BY DR. GODWIN YOVWIN

INTRODCUTION
 Incidence of breast cancer is on the increase
 The 2nd most common cancer
 We are beginning to see many young patients
now presenting with breast cancer
 Majority of patients in developing countries
(including Nigeria) present very late
 Prognosis is usually poor
 Double burden effects of disease and poverty –
vicious cycle of the third world
INTRODCUTION
 Often, the breast cancer patient is first seen by
either a family physician or a general
practitioner
 Patients with suspicious lump/mases should be
referred to see the surgeon
 Effective management of the patient with
breast cancer requires adequate synergy
between the surgeon and her family physician
 Delays in presentation are multifactorial;
WHY THEY PRESENT LATE
 Role of Faith based practices with it’s blame game
 Use of other cam products
 Fear of surgery with its attendant social
consequences.
 Issues of stigmatization
 Myths about breast cancer generally
 Attitude of healthcare workers- no empathy
 Inadequate/wrong information
 Bad experiences from patients who previously
presented late
 Delay at primary consultation
BREAST CANCER- AND THE PATIENT
 Threat to life so the fear of survival

 Affront to social identification and honour thus

social isolation

 A perceived long drawn and uncertain financial

battle and the fear on family cohesiveness

 The burden of care by significant “few” and

fear of possible lone journey
THE ROLE OF THE FAMILY PHYSICIAN
 Traditionally, a detailed history and a thorough
clinical examination of-course basic
investigations
 Deployment of relevant family medicine tools
for holistic assessment and management – FIFE,
family APGAR, Ecomap etc.
 Address the relevant concerns to best of your
capability – do not make promises.
 Patient centered care
 Refer the patient to the surgeon
 Continuing care and follow-up
ARE THERE CONSTRAINTS?
 Late presentation and expectation of cure.
 Financial constraints
 Fear factor - ?anonymity, ?Confidentiality ?issues
of after treatment effect etc.
 Social/relationship readjustments issues

 Health care giver’s constraints:

 Quality of care and Standardization
 Lack of precision/misleading investigation reports
 Time
OVERCOMING THE CHALLENGES

The key is the patient centered care approach

 Identify with the patient – partnering with
empathy
 Engage the “significant” individual in the family
 Continued and Coordinated care.
 Support groups and other NGOs
 Training and updating health care professionals
 Improvement on supportive
GETTING THEM EARLY: WHAT
SHOULD THE FAMILY PHYSICIAN DO?
 Health education
 Adequate information – verbal and in prints
 Early referral-letting them understand the
need for referral.
 Show empathy – this is quite an emotional
issue
 Encourage and build strong family support
 Follow up e.g. phone call
 Encourage and help with links to support
groups and NGOs
CONCLUSION
 Breast cancer is a real and on the increase. The
key to success in its management is early
detection and intervention
 No breast is immuned to it and it does not
differentiate between sex even though the
incidence is low in males
 The burden is overwhelming affecting all
spheres of family health – emotionally,
financially psychosocially and spiritually too
 It is a battle that can be and must be won with
all hands on deck
.

Thank you for

listening