As in most developed countries, breast cancer is also the most common cancer among women in Slovenia, accounting for one in five new cancer cases in women.
Breast cancer is not exclusively a women’s disease, as 1–2% of those affected are men. Mortality from breast cancer among women is slowly decreasing, mainly due to the detection of smaller tumors and high-quality treatment that is increasingly tailored to each woman and her cancer. The organized national screening program DORA, which started on April 21, 2008, will certainly help detect smaller atypical 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 Slovenia. According to the Cancer Registry of Slovenia, in 2010, 1,255 women and 12 men were diagnosed. That year, 421 women and seven men died from breast cancer. In 2016, the number of people diagnosed was even higher: 1,386 women and 14 men. In the same year, 384 women (fewer than in 2010!) and 8 men died from breast cancer.
The national program DORA is a screening mammography program for the early detection of breast 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 women in the screened population by 25–30%, and a condition for the program’s success is that at least 70% of women respond to the invitation for screening.
Another issue is that women often say we don’t know how to do a proper monthly breast self-exam, so we simply don’t do it. In Slovenia, there are many health education resources available to help with this:
Breast self-exam – Breast Test – click 1
Breast self-exam in photos – Europa Donna – click 2
Breast self-exam – ZAdojke – click 3
And nowadays, when various mobile apps are very trendy, there’s also a mobile app on the Breast Test website – Trust Your Hands for Breast Health.
To help you with regular monthly self-checks, the Breast Test mobile app and website are also available. The app includes an always up-to-date menstrual calendar that reminds users each month to do the check, and it also includes simple instructions and visual materials that explain the breast self-exam 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 you can also find a web version of the menstrual calendar with self-exam reminders and a presentation of the self-exam procedure.
Prevention
Primary cancer prevention includes identifying cancer risk factors and reducing exposure to these factors as much as possible. On the one hand, we work toward this through education and awareness about how people can reduce their cancer risk, and on the other hand through legislation.
2. Secondary prevention
This means early detection of cancer. Treatment for most cancers is more successful if they are detected early. That’s why it’s important for people to know the early signs of different types of cancer.
Breast cancer is highly curable if it is detected early enough. The recommendation of the Association of Slovenian Societies for the Fight Against Cancer for early breast cancer detection is:
- – breast self-examination (a woman should start checking her breasts regularly at age 20 and then continue throughout her life),
- – clinical examination (between ages 20 and 40, a woman should have it every three years; if not earlier, you can use that visit to have your gynecologist teach you how to do a proper self-exam),
- – clinical examination with mammography whenever there is any suspicion of changes in the breast (as determined by the doctor),
– clinical examination with mammography if risk factors are present (from age 40 onward; some recommend such an exam every year or every 18 months),
– clinical examination with mammography after age 50 (a woman without risk factors should have it every two years) (Borštnar et al., 2006; Kumar, 2001).
Self-examination is the only effective tool every woman has in her own hands. So what are the warning signs we need to watch for?
- bloody nipple discharge,
- a change in skin color on the breasts (orange peel, red),
- an inverted nipple or other dimpling of the breast,
- a painless lump in the breast.
- Lymph nodes under the armpit may also be enlarged.
For detecting some types of cancer, screening tests are available, which can determine whether people who have no symptoms yet have cancer or its precursors.
In Slovenia, we have organized screening for three cancer sites:
- the national program ZORA – for detecting precancerous changes of the cervix for women aged 20 to 64, every 3 years
- the national program DORA – mammography screening for women aged 50 to 69, every 2 years
- the national program SVIT – a fecal occult blood test for detecting colorectal cancer for men and women aged 50 to 69, every 2 years
3. Tertiary prevention
This includes high-quality treatment, which helps reduce cancer mortality. New treatment methods have significantly improved outcomes for some cancers, for example testicular cancer and childhood leukemia. Survival is improving for patients with breast, ovarian, and colon cancer. There is also increasing focus on patients’ quality of life.
National Cancer Control Program (DPOR)
At the end of December 2012, the website www.dpor.si went live, where you can find a lot of important information about cancer. Today, cancer is the leading cause of death in Slovenia and has overtaken cardiovascular disease. Cancer is becoming an increasingly curable chronic disease. 30% of all cancers could be prevented if we lived healthily and followed experts’ recommendations.
You can learn more on the website of the National Cancer Control Program. You will also find out which healthcare institutions in Slovenia treat specific types of cancer.
ZORA The National Program for Early Detection of Precancerous Changes of the Cervix is intended for women aged 20 to 64.
More information: zora.onko-i.si
SVIT The National Screening and Early Detection Program for Precancerous Changes and Cancer of the Colon and Rectum is intended for men and women aged 50 to 69.
More information: www.program-svit.si
At Palmers, they created TheCancerBra, the first bra with breast cancer, reminding women of the importance of regular self-exams. #TheCancerBra #SelfExamine #Palmers In the video, they remind us that we actually only pay attention to our breasts when we’re buying bras. If we self-examined our breasts every day, many women could save their lives.
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