14/04/2016

Breast course for Nurses Module 3: Zimbabwe

Discussion - Module 3 course
For the first time, we have run a day for doctors and oncology sisters. By dividing the course up into 3 modules, we have been able to stratify the course content to suit different health professions. Nonetheless, we started the day with the normal breast and assessment of the breast.



When looking at the provision of health resources in developing countries, pathology has often been overlooked. Without a reliable diagnostic service, it is impossible to treat patients appropriately. It was really inspiring to hear Prof Rudo Mutasa speak about different types of breast cancer. She referred to the cancer registry of Zimbabwe and talked about the need to collect accurate data.

Prof Rudo Mutasa
After the tea break, Dr Linda Kumirayi, Dr Sandra Ndrukwa and I talked about the importance of neoadjuvant therapy in the management of locally advanced breast cancer. In Zimbabwe, as in many neighbouring countries, a lot of women have locally advanced breast cancer at the time of diagnosis. Instead of surgery always being the first intervention, it is preferable to use systemic therapy first whenever possible.

The diagnosis of breast cancer is often difficult so we had a session on breast biopsy. In most of the developed world, biopsies are done under image guidance. However, when the cancer is easily palpable, it is not always easier to use imaging: it may be accurate and more appropriate to biopsy without imaging. Dr Mvere and I ran the session and debated the pros and cons as we went.

In the afternoon, we had a discussion about appropriate breast screening in Zimbabwe. Cervical screening clinics are fairly readily accessible in most provinces. Should breast examination be offered at the same time? According to the cancer register, the incidence of cervical cancer is much higher than breast cancer. Is that a true reflection of the disease profiles or as a result of improved screening?


Doctors and oncology nurses attended the course

Many thanks to everyone involved and of course to our sponsors, to name a few: Lancet, High Tech Medical, Bettercare and all individuals that have supported the course through funding.

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