Uganda Cancer Institute (UCI) specialists have highlighted poor breastfeeding as one of the major drivers for the 4,000 new breast cancer cases registered annually in the country.
This information comes amid recent findings in the 2022 Uganda Demographic and Health Survey (UDHS) report, which shows that close to 20 percent of mothers were not breastfeeding their children by 12th month, the minimum time required to optimise the benefit of breastfeeding as a preventive measure for breast cancer.
‘Breastfeeding is one of the preventive features of breast cancer, the longer you breastfeed, the lower the likelihood of breast cancer. Usually, the benefit was recorded when you breastfeed for at least a year’ Dr Naghib Bogere, a breast cancer specialist at UCI, noted.
Dr Alfred Jatho, the head of community cancer services at UCI, said men should encourage their wives to breastfeed their babies exclusively up to six months, without giving any other type of food.
‘Then, after that, continue [breastfeeding] up to two years, mixing the breast milk and food. That is the best protection you can find [against breast cancer],’ Dr Jatho added.
According to the UDHS report, by 18 months (one and a half years), more than 57 percent of mothers were no longer breastfeeding their children, meaning many mothers are not maximising the potential of this cancer prevention method.
Dr Naghib explained the link between breastfeeding and prevention of breast cancer.
‘Whenever you breastfeed, the cells in your breast mature, and when they mature and fully develop, chances of cancer forming in those cells are lower,’ he said.
He challenged the myth that if a man suckles the breast, it can reduce breast cancer risk.
‘Those changes (maturing of cells in the breast) do not come if you’re not breastfeeding a child. If you’re not nursing a child. If it is your husband sucking your breast or something of that kind, those changes do not occur,’ he added.
Dr Jatho expounded: ‘There’s no evidence yet currently that a man sucking the breast can be protective in terms of reducing breast cancer risk. The protection offered by breastfeeding your baby, it has a hormonal nature; there’s a lot of hormonal influence involved.’
‘First of all, the production of breast milk alone is influenced by certain hormones, which make other hormones, which, when they stay in you for a longer time, can make your cancer risk go down,’ he added.
He said the volume of breast milk suckled by the baby is also higher than that which the man can.
‘The volume of milk produced when a baby sucks, some babies can suck up to 1 litre of milk, which you as a man cannot, so, there’s no protection in terms of you sucking the breast of your wife,’ he explained.
Available scientific information also shows that breastfeeding lowers breast cancer risk by reducing lifetime exposure to estrogen (a hormone in the body linked to the growth of some cancer cells) and promoting the shedding of breast tissue, which can clear out potentially damaged cells.
Scientists said, hormonal changes during breastfeeding suppress ovulation, lowering estrogen levels that can fuel breast cancer growth.
The risk of breast cancer drops by 26 percent among women who breastfeed for more than 12 months, according to a 2015 meta-analysis by Ranadip Chowdhury from the Centre for Health Research and Development, Society for Applied Studies in India.
Dr Jackson Orem, the UCI director, while announcing the breast cancer awareness months at the Uganda Media Centre on Thursday, said breast cancer remains the leading cancer among women in Uganda, accounting for a large proportion of all female cancers treated at UCI.
‘Each year, Uganda records more than 4,000 new cases of breast cancer, and tragically, many women still present with the disease at advanced stages. Yet, with early detection and timely treatment, up to 90 percent of breast cancers are curable,’ Dr Orem said. He further called on the public to take advantage of available screening services in nearby health centres across the country and major facilities like UCI. He also urged women and men to perform regular breast self-examinations and report any unusual breast changes to a health facility.
Risk factors for breast cancer
Dr Orem said there are modifiable and non-modifiable risk factors for breast cancer. While the exact cause of breast cancer is not known, several factors increase a woman’s risk. Although breast cancer also affects men, over 90 percent of the cases are in women.
Dr Orem highlighted family history of breast or ovarian cancer and hormonal factors, early onset of menstruation or late menopause which might not be modifiable.
He also highlighted lifestyle factors – obesity, lack of physical activity, smoking, and alcohol consumption as some of the drivers of breast cancer. Reproductive factors include not breastfeeding, or having the first child after age 30. These risks can be prevented/modified.