The International Day of the Fight against Breast Cancer, which is commemorated every October 19, is an opportunity to reinforce prevention against this disease

In Ecuador, 18,000 people die each year due to cancer: 12% of the total due to breast cancer, according to data from the Ecuadorian Society of Gynecology and Obstetrics of Pichincha. It is the number one cause for cancer deaths in the country.

Verónica Andino MD, a surgeon and member of the Ecuadorian Multidisciplinary Society of Mastology (SEMMA), says the International Day to Fight Breast Cancer, which is commemorated every October 19th, is always an opportunity to break down taboos, promote education and to increase prevention to combat this disease that is diagnosed in 8,000 women a year in the country.

The Ecuadorian situation aligns with the world reality: the Pan American Health Organization says that breast cancer is the most frequent type of cancer and the most common type of cancer death in women worldwide. On average, the disease affects mostly women under the age of seventy. Dr. Andino —who cares for patients suffering from breast cancer— says that in Ecuador, the age group most vulnerable to breast cancer are women between the ages of 40 and 50 years old.

Education, the first step

Dozens of campaigns have been replicated with a single message: “touch yourself,” which have promoted breast self-examination over the years. And while it is a tool for social learning, says the Dr. Andino, it has also created confusion.

“These campaigns are usually, above all, political. We have seen that what they have done is confuse patients, because we find that they say, “I touched myself and there is nothing.”

“So, they stop going to the doctor and do not get a mammogram, which is the best test to detect it,” says Andino. She says that knowing our body is the right thing to do, but “we must not stop going to the doctor. These types of campaigns are to raise awareness among the population, but not for timely detection of cancer,” she says. Andino ass that education is vital.

Although breast cancer is multifactorial and there are risk factors that must be understood, says the physician. Among them are:

• Genetic mutation: People who have inherited mutations in certain genes — such as BCRA1 and BRCA2 — have a higher risk of breast and ovarian cancer.
• Family history with the disease: It is also a higher risk for a person if their first-degree relatives —such as sisters, mothers or daughters— but also second-degree relatives —cousins, grandmothers— suffered from the disease.
• Not having breastfed. 
• Obesity. 
• Over the years, the risk of breast cancer increases. Therefore, it is mandatory for a person to have an annual mammogram from the age of forty. 

There are also signs in the body that trigger alerts, says the Andean doctor. If you notice any of these symptoms, go to your doctor:

• If you notice an irregular or new lump in one of your breasts or under the arm, in the armpit area.
• The presence of ‘orange skin’ —which is the formation of small dimples in the skin— on your breasts can also be a sign that should alert you to consult a professional.
• If you see that the thickness of your breast has increased or is swollen.
• If your breast presents irritations or sinking in the skin.
• If you notice that your nipple emits a secretion —other than milk.
• If you feel pain or see a noticeable change in one breast.

Demolish the myths and fight the risk

“Can mammography give me radiation? Can it cause thyroid problems?” are just some of the questions surrounding mammography, which, according to the World Health Organization, is the most effective screening tool for breast cancer detection.

However, there are several myths surrounding it.

Dr. Andino insists that mammography does not emit radiation into the body.

“They have established that, not only in their heads, but also on a social level. And it is extremely important that they perform the mammogram. They are not going to have radiation [in their body],” she says.

She also says that she has seen “some patients cover their necks because they are afraid of having thyroid problems. That is not so, we have to dismantle that myth,” she insists.

But, perhaps, one of the greatest myths that have not yet been demolished is that cancer is “synonymous with death.”

It is not true, says Andino.

“With early detection, you can have a healthy life. The important thing is that the exams are carried out, although there is a problem of access, especially in public institutions.”

Ecuador currently faces a crisis in health services and one of the most affected groups of patients are cancer patients.

“A public policy is needed that guarantees access to tests for the early detection of the disease, but also guarantees for patients facing cancer. Not everyone can afford a private service,” she says.

In the public health system, criticizes Andino, the demand for patients is usually so high that there are people who can only access an exam after six months of having requested it.

“When that happens, the tumor has already been growing. The important thing is to detect it before, even in first level centers. But the system is so saturated that there are referrals to second and third level hospitals and everything ends up collapsed,” she says.

Against this background, Dr. Andino reiterates that suffering from the disease is multifactorial, but there are also risk factors that can be reduced if patients:

• Have a good nutritional diet, with high consumption of nutrients and vegetables.
• Avoid having a sedentary life. Instead, physical activity is essential to avoid obesity.
• Avoid alcohol consumption.
• Avoid the use of tobacco.
• Face the fear: consult your trusted doctor about the risks and treatments to combat the disease.

Free mammograms in Ecuador

From the age of forty, doctors specialized in breast cancer recommend performing a mammography exam annually. According to the Pan American Health Organization (PAHO), it is the most effective diagnostic imaging test for cancer screening. Its importance lies in the fact that it offers early detection of breast cancer.

These are some places where you can take the exam for free in Ecuador:

• Poly Ugarte Ecuadorian Foundation against Breast Cancer: The non-profit entity offers exam services, such as mammograms and ultrasounds, for the prevention and detection of breast cancer.

The Foundation carries out campaigns to prevent breast, cervical and prostate cancer throughout the country.

Contact phone: (04) 603-8402 / 095 894 1010

Address: Garzota 1st stage Mz. 13 Villa 1, Guayaquil.

• Cepreme: It is the representative of Ecuador in the Latin American Union for the Fight Against Women’s Cancer. The Foundation works to prevent catastrophic diseases with the highest mortality rate in Ecuador: breast, cervical, skin, prostate, lung and ovarian cancer.

At Cepreme, for every 5 patients who pay for their service, one low-income person receives the service completely free.

Contact phone: 593 95 889 2903

Address: Av. Antonio Granda Centeno and Gregorio Bobadilla

• Aprofe: The Ecuadorian Family Welfare Association is a private non-profit institution that promotes family planning as an indispensable right. The Association has service centers in Guayaquil, Cuenca and Quito.

Contact phone: 0990897798 / (02) 245-2060

Address: Giacomo Roca 33-155 y, Quito

Public centers

The network of the Ministry of Public Health offers these exams as well. This is a list by district area:

Zone 1 (Carchi, Esmeraldas, Imbabura and Sucumbíos)

• Marco Vinicio Iza Hospital
• General Hospital Delfina Torres de Concha, Esmeraldas
• Hospital Luis Gabriel Davila

Zone 2 (Napo)

• Francisco de Orellana General Hospital

Zone 3 (Chimborazo, Cotopaxi, Pastaza and Tungurahua)

• Puyo General Hospital, in Puyo
• General Provincial Hospital of Latacunga
• Provincial General Teaching Hospital of Riobamba

Zone 4 (Manabi and Santo Domingo)

• General Hospital Verdi Cevallos Balda, in Portoviejo
• Hospital Doctor Gustavo Domínguez, in Santo Domingo

Zone 5 (Bolivar, Los Rios)

• Alfredo Noboa General Hospital, in Guaranda
• Martin Icaza General Hospital, in Babahoyo

Zone 6 (Azuay, Cañar and Morona Santiago)

• Hospital Homero Castanier Crespo, in Azogues
• Vicente Corral Moscoso Hospital, in Cuenca
• General Hospital of Macas, in Morona Santiago

Zone 7 (El Oro, Loja and Zamora Chinchipe)

• Obstetric Hospital Ángela Loayza de Ollague, in El Oro
• Yantzaza Basic Hospital, in Zamora Chinchipe
• Julius Doepfner General Hospital, in Zamora Chinchipe
• Isidro Ayora General Hospital, in Loja

Zone 8 (Guayas)

• Abel Gilbert Pontón Hospital, in Guayaquil
• Guasmo Sur General Hospital, in Guayaquil
• Hospital of the Mariana de Jesus Day, in Guayaquil
• Guayaquil University Hospital

Zone 9 (Pichincha)

• Hospital Enrique Garcés, in the south of Quito
• Nueva Aurora Obstetric Gynecology Hospital, in the south of Quito
• General Hospital Pablo Arturo Suárez, in the north of Quito