Dental Care: Oral health in breast cancer patients   |29 October 2021

According to the World Health Organisation (WHO), there were 2.3 million women diagnosed with breast cancer in 2020 and 685,000 deaths globally.

As of the end of 2020, there were 7.8 million women alive who were diagnosed with breast cancer in the past 5 years, making it the world's most prevalent cancer. Most women diagnosed with breast cancer can expect an excellent outcome with a five-year survival rate greater than 80%.

In commemoration of Breast Cancer Awareness Month in October, Dr Bibhakar Ranjan spoke to Seychelles NATION about oral health in breast cancer patients.    

He explains that breast cancer treatment comprising radiation and hormonal therapy often affects oral cavity and therefore, dental care is one of the important aspects that patients and dental teams should not miss before or after breast cancer treatment.

Dr Ranjan has been working as the principal dentist at ‘Dr. Murthy’s Family Medical & Dental Klinik’ at Anse Aux Pins for more than two years. He has diverse experience in general dentistry for more than eight years.

Seychelles NATION: Which age group is the most susceptible for breast cancer?

Dr Ranjan: The risk of developing breast cancer increases with age and almost 2 out of 3 cases of invasive breast cancers are diagnosed in women who are 55 or older. The majority of the cases of breast cancer are often diagnosed in postmenopausal women. 

Seychelles NATION: Is breast cancer a more common type of cancer among Seychellois women?

Dr Ranjan: The Seychelles National Cancer Registry shared their data in the year 2011-12 that in women, breast cancer is the most common site, comprising 43% of new cases.

However, breast cancer incidence rates compared to other African countries are intermediate. The distribution by summary stage for the period 2011-2012 was: 15% stage I, 20% stage II, 25% stage III, 30% stage IV, and 10% unknown.

Between 2012-2016, the Seychelles National Cancer Registry recorded 155 cases of breast cancer. According to the WHO data published in 2018, breast cancer deaths in Seychelles reached 12 or 1.68% of total deaths.

Image source: Seychelles National Cancer Registry

Seychelles NATION: What are the oral complications which patients may have post breast cancer treatment therapies?

Dr Ranjan: Oral complications from breast cancer therapies may have acute and chronic effects on the oral cavity. These include neurosensory changes, salivary and functional changes. The patient can also develop focal bony necrosis of the jaw and dental caries.

Oral Mucositis is the inflammation of oral mucosa and this usually happens post-chemotherapy. The patient often complains of lots of ulcers in their mouth, loss of appetite and taste sensation.

Xerostomia is one of the very common oral complications post-chemotherapy in which the patient often complains of a lack of saliva in their mouth; this also leads to a different oral disease which a dental team should take care of post-chemotherapy sessions.

Seychelles NATION: What are the prophylactic dental treatments that professionals suggest to a breast cancer patient?

Dr Ranjan: The National Institute of Dental and Craniofacial Research has developed guidelines to provide oral care for cancer patients. Most importantly, a breast cancer patient should visit a dentist before they begin their breast cancer treatment.

The pre-treatment dental examination gives the clinician a chance to carefully assess the patient's oral health status, and to decide if the patient needs any emergency treatment before the breast cancer treatment is initiated.

Many a time, a patient needs extraction and the wound site should be allowed to heal at least two weeks before radiation therapy.

During the visit, the dentist should make a dental plan for the patient that should take care of all initial deep caries and remove plaque, to maintain good hygiene during chemotherapy.

Seychelles NATION: Why is oral care important for women battling breast cancer?

Dr Ranjan: Oral complications of breast cancer treatment often affect the quality of life of the patient, especially during the treatment and also post-treatment. The patient often lives in pain and avoids eating food which in turn affects their overall health.

A comprehensive dental care plan pre and post-breast cancer treatment can help in relieving pain and can help to ensure the best outcomes for patients fighting breast cancer.