So-called diseases of civilization such as cancer are on the rise in Kenya. As a result, the medical staff at Rhine Valley Hospital created a breast cancer case study for a client. The patient is 52 years old, works as a farmer and lives in a camp for displaced people in Nakuru district.

The 52-year-old Magrate is a well-known patient at Rhine Valley Hospital. She suffers from high blood pressure and takes antihypertensive medication. She lives in a camp for displaced people in Nakuru district.

The woman felt well until October 20, 2018. At the time, she felt pain in her left breast. She was then admitted to Rhine Valley Hospital and examined. She had no history of surgery or blood transfusions. She did not use drugs and did not suffer from any food allergies. Her vital signs were unremarkable.

So that she could have a mammogram of her breast, the doctor sent her to Nakuru County Referral Hospital. The findings warranted further investigation. Tissue biopsy was performed at the same institution. She showed lobular carcinoma in situ (proliferation of neoplastic cells in the lobules of the mammary gland). Consequently, Magrate had her breast amputated.

Subsequently, she was given the following medications: a broad-spectrum antibiotic as prophylaxis against infections during hospitalization. Paracetamol for pain relief, and agents to control blood pressure.


General information about cancer and breast cancer

Cancer develops when changes, mutations, occur in genes that regulate cell growth. The mutations cause the cells to divide and multiply in an uncontrolled chaotic manner. Breast cancer develops in the breast cells. Typically, the cancer forms in either the lobules or ducts of the breast. Lobules are glands that produce milk, and ducts are pathways that transport milk from the glands to the nipple. Cancer can also occur in the fatty tissue of the breast.

According to the Centers for Disease Control and Prevention, breast cancer is the most common form in women. Worldwide, about 2.1 million people were affected in 2015. Breast cancer accounted for 5 percent of all malignancies (malignant tumors) in Kenya. The cervix accounts for only the second largest number of cancers. An estimated 40`000 e cases and 28`000 deaths occur each year, making cancer the third leading cause of death.

The following types of breast cancer exist: ductal carcinoma in situ – non-invasive condition; lobular carcinoma in situ – cancer growing in milk-producing glands; invasive ductal carcinoma entering near tissues outside the milk duct; invasive lobular carcinoma – spreading to nearby tissues and organs.

Risk factors are: increasing age; alcohol consumption; dense breast tissue; gender – women are more often affected; genetic mutations; early menstruation – before the age of twelve; childbirth m older age; hormone therapy; late menopause; never being pregnant; the individual family history.

Signs and symptoms are: Breast lumps; Breast pain; Red pilled skin over the breast; Swelling of the breast; Nipple discharge (even bloody) except breast milk; Inverted nipples; Lumps under the arm.

Dieognesis methods are: Mammography – if abnormal areas are seen, additional testing is required; Ultrasound – creates an image of the tissue deep within the breast; Biopsy – suspicious tissue is taken for examination.

Breast cancer is treated: Surgical: lumpectomy -suspicious or cancerous areas are removed; mastectomy – the entire breast is removed; sentinel node biopsy – some lymph nodes (in the armpit) are removed. By means of radiotherapy: cancer cells are killed. By means of chemotherapy: drugs kill cancer cells. The method is combined with other treatments (especially surgery). Hormone therapy – The body is prevented from producing hormones that stimulate the growth of cancer cells.

Breast cancer is attempted to be prevented by: a healthy lifestyle; regular self breast palpation, regular screening; for women 40-44 years of age, optional mammogram once a year; for women 45-54 years of age, annual mammogram is recommended; women 55 years of age and older should have a mammogram every 1-2 years. If the risk is particularly high, the breast can be removed as a precaution.

Breast survival in women when detected early was 90.6 percent in 2008.