Surviving and thriving after breast cancer

How to do breast self-examination
Step 1
Stand in front of the mirror and look carefully for any changes to your breasts. Observe if there is any rash, wrinkles, swelling or skin colour changes.

Step 2
Use three of your middle fingers, but not the tips to examine your breasts. Put your fingers flat on the breast and move them in a circular motion, in a clockwise direction to feel any lump or thickening in the breast.

Step 3
Palpate the armpits and around the whole breast in smaller circles as well as below the collar bone.

Step 4
Look for any bleeding or discharge from the nipple by squeezing it gently. Keep your hands on the breast throughout the examination. If you feel anything unusual, or any of the above mentioned signs, visit a doctor as soon as possible. Do self-examination for breast cancer at least once a month, a week after the start of menstruation.

Rebecca Mayengo, 65
“I was diagnosed with breast cancer while living in the United States of America. I had never thought about doing breast cancer screening. But in 2004, the Centre for Treatment of Victims of Torture, an American organisation that I was working for at the time insured my health, so I decided to go and do breast cancer screening. To my surprise, the doctor asked me how long I had felt the lump on my left breast. After a mammogramme examination (an x-ray picture of the breast), it showed I had signs of breast cancer.

When I told the doctor I did not experience any pain, he informed me that cancers are usually painless in the early stages.
He insisted that I go for a biopsy, which confirmed I had breast cancer.

I was told to choose between mastectomy (surgical removal of the entire breast) and lumpectomy (removing a cancerous lump from the breast), with the aim of preventing the cancer cells from spreading to the rest of the body.

I opted for the lumpectomy and a month later, I started undergoing chemotherapy treatment. After chemotherapy, I started radiotherapy and hormonal therapy, which lasted five years. The doctor said hormonal therapy would help reduce the oestrogen levels, which are key risks for re-occurrence of cancer.

At the time of my diagnosis, I was married with two grown up children, who offered all the support I needed to cope with my condition. Also, having health insurance at the time helped me get the best care.

I am now cured even though I still go for breast examination once a year.

All women should go for breast cancer screening regularly, because the earlier the cancer is detected, the better a person’s chances of survival.

One lesson I take from my experience is that we should not go to the hospital only when we are sick. Regular check-ups will help a person identify many other conditions, and not just cancers.

In 2007, I returned to Uganda and joined hands with Gertrude Nakiggude, another breast cancer survivor to start the Uganda Women Cancer Support Organisation (UWOCASO).

With more than 50 members, the organisation offers support and counselling to women who have been diagnosed with breast cancer.

Leah Kasule, 54

“I was diagnosed with breast cancer at the age of 38. At the time, I was married with four children, and my youngest child was three.

I had heard about doing breast self-examination, and when I did it, I felt a lump on my right breast. The next day, I went for a breast x-ray examination at the former Case clinic, where the diagnosis showed I had breast cancer. Even though I was confident enough to walk into the clinic, I could not believe the news. I was helpless and thought God was being unfair to me.

Because I did not know of any family member with cancer, I did not tell anyone about my condition.

The doctor advised me to go to the Uganda Cancer Institute at Mulago National Referral Hospital for free treatment, but I did not have the courage to go there alone.

Overtime, as I came to terms with my condition, I opened up to my family members who offered support.

My sister escorted me to Mulago, where the doctor suggested that my breast be removed. I could not imagine myself with only one breast, so I gave up the idea. Instead, I went to a private facility where a doctor removed the lump without cutting off my breast. I only returned to Mulago for chemotherapy and radiotherapy treatment.

However, the doctor found two more lumps under my right armpit on re-examination.

At this point, I agreed to undergo mastectomy, even though I was still scared. I was counselled and after one week, I went into surgery, which was successful.

But the chemotherapy had a negative effect on me. I lost appetite for food, yet the therapy required me to have a lot of blood.
Sometimes, I could go for chemotherapy even when by blood levels were low, but the doctor would send me back home.

In some cases of cancer treatment, a person can lose hair and their nails turn black. However, I did not experience this.

I underwent treatment for five years, and this is testimony that a person can get cured, especially if they are diagnosed early enough. Now I spend my time doing outreach campaigns for breast cancer awareness so that women can identify the problem early and manage it.

Agnes Kasemira, 35

“When I was diagnosed with breast cancer, I had one child, and I was three months pregnant with the second one. That was in 2003.
I had read an article from an old newspaper that a food vendor used to wrap food, how to do self-examination for breast cancer.
When I went to practise what I had read in the newspaper, I was shocked to discover that there was a lump in my right breast.
I went to a nearby clinic in Nakulabye, a Kampala suburb, where the doctor referred me to Mulago National Referral Hospital. Although I did not experience any pain in my breasts, the doctor said the lump was a warning sign for breast cancer.

At Mulago hospital, a biopsy confirmed that it was indeed breast cancer. The good news though was when the doctor informed me that the cancer was still in the early stages, and that a simple surgery could be performed to remove the lump.

I underwent the surgery after giving birth. At first I was frightened, but when I was taken through counselling at the Uganda Cancer Institute, I became courageous enough to do the surgery.

At the cancer institute, I only paid for the tests, while the consultation, surgery and treatment were free. After surgery, I started treatment with chemotherapy and radiotherapy. The doctor closely monitored me and I went for re-examination twice a year until I completed the medication.

These days, I go for re-examination twice a year as the cancer can reoccur. I have three children now.