BREAST CANCER AND THE MYTH SURROUNDING LESBIANS

By Ntlotleng Mabena (ARV Doctor –South Rand Hospital)

Are lesbian women more at risk of breast cancer than their heterosexual counterparts?
First, let me emphasise, research is clear on one thing and one thing only – breast cancer is an epidemic among all women and is most highly associated with being female and being over the age of 50, regardless of gender identity, race or sexual orientation.

Some scientists have looked at the risk factors for breast cancer in lesbian women. Results show that the risk for developing breast cancer maybe two to three times higher for lesbians than for heterosexual women.

What was clearly certain is that lesbians as a group, have a higher incidence of certain higher factors that are linked to breast cancer such as, never having given birth, obesity, smoking and alcohol abuse.

Medical studies show that the risk of breast cancer is reduced by as much as 50% for women who have had one child.

Literature suggests that lesbians do not necessarily drink more than the general population but have a greater history of problems with alcohol.

Lesbians are also more likely to use tobacco and are less likely to visit a doctor for fear of homophobia.

For heterosexual women primary contact with health care system is through reproductive health system.

Since most lesbians do not access reproductive health systems for family planning or child birth they are most likely to miss early detection of breast cancer and other reproductive health problems.

Although nothing is certain, it is suggested that some lifestyle changes help reduce breast cancer risk such as maintaining a healthy weight, drinking fewer than four units of alcohol, exercise more than four and a half hours a week.

It is also believed that the studies regarding lesbians and the link to breast cancer will probably encourage more lesbians to get to their friendly gynecologist for mammogram.
So what is breast cancer and when does it occur?

Cancer, in general occurs as result of mutations or abnormal changes in the genes responsible for regulating the growth of cells and keeping them healthy.

Normally, the cells in our bodies replace themselves through an orderly process of cell growth where healthy new cells take over as old ones die out.
 
However, over time mutation can change genes and this changes cells that gain their ability to keep dividing without control or order, producing more cells just like it and forming a tumour.

A tumor can benign (not harmful to health) or malignant (potential to be harmful or dangerous). Benign tumours are not considered cancerous; their cells are close to normal in appearance, do not invade nearby tissues or spread to other parts of the body. 

Malignant tumours on the other hand are cancerous, and if left unchecked malignant cells eventually can spread beyond the original tumour to other parts of the body.
 
Usually breast cancer begins in the milk producing glands or the ducts, the passages that drain milk to the nipples. Less commonly, breast cancer can begin in the stromal tissues which are tissues of the skin which includes the fatty connective tissues of the breast.
 
Over time, cancer cells can invade nearby healthy breast tissue and make their way to the underarm lymph nodes, small organs that filter out foreign substances in the body.

If cancer cells get into the lymph nodes they then have a pathway into other parts of the body. The breast cancer stage refers to how far the cancer cells have spread beyond the original tumour.

Breast cancer is always caused by a genetic abnormality however, only 5-10% of cancers are due to an abnormality inherited from your mother or father. About 90% of breast cancers are due to genetic abnormalities that happen as a result of the ageing process and ‘wear and tear’ of life in general.

There are many, many lesbians battling this awful disease. They need as much economic and emotional support, health care and activism as we have been able to generate for the fight against HIV. We don't need to inflate lesbian risk, or make it the only lesbian health issue in order to generate the right community response.