Considered to be the Number One cancer among Singaporean women today, breast cancer should be the concern of every woman in the country. In fact, the Singapore Cancer Society has stated that 1 in 11 women will develop breast cancer during their lifetime, a sobering statistic which requires immediate action.
Let us go through the important things you need to know about breast cancer.
1) You Are at Risk
All women, including you, are at risk of developing cancer especially as you grow older. You have a higher risk if you are 50 years old and above and/or have a mother, sister or daughter with breast cancer.
Other risk factors that will increase your likelihood of developing breast cancer are the following:
- A family history of breast cancer
- History of benign or malignant breast disease
- History of ovarian cancer
- Menstruation began before the age of 11
- Menopause occurs after age 55
- Having no or few children or having a first child after age 35
- History of undergoing hormone replacement therapy
- Weight gain after menopause
There are also some risk factors which you can eliminate or modify to reduce your risk of breast cancer. These include overweightedness and obesity, smoking, and alcohol intake.
2) Early Detection Through Regular Screening is the Key to Early Breast Cancer Treatment
All women should make it a point to include in her health regimen regular screening of her breasts. The first and most important screening method is breast self examination.
Starting at age 29, a woman should already familiarise herself with the look and feel of her normal breasts so that it will be easy for her to detect any abnormalities.
Among the signs and symptoms of breast cancer are:
- Painless lump in the breast
- Redness, rash, or irritation around the nipple
- Swelling or thickening of the skin
- Dimpling or puckering of the skin
- Retraction of the nipple
- Bleeding or other unusual discharges from the nipple
Breast self examination is done in women starting age 30 and is performed once a month, one week after your period. Facing the mirror, you should check for any abnormalities in your breasts’ appearance. You will then feel/palpate each breast by quadrant or from the outer edge going to the centre for any lumps or areas of pain, soreness or tenderness. The nipples are also gently squeezed to detect blood or other discharges.
By age 40 to 49, it is important for a woman to go for a yearly mammogram. A mammogram is capable of detecting very early breast cancer that does not present with any signs or symptoms. By age 50, a doctor will advise mammogram once every two years. If there are any abnormal findings on the mammogram, your physician may perform breast ultrasound as well.
3) Diagnosis and Treatment
If a lump is detected, the doctor will order a biopsy to be done on the patient. The four types of biopsies that are performed are fine needle aspiration (FNA), core needle biopsy, excision biopsy, and sentinel lymph node biopsy (SLNB). Fine needle and core needle biopsy are done in the outpatient department while excision and sentinel lymph node biopsies are performed in the operating room. Once a sample is obtained, it is brought to a pathologist for analysis.
If the sample is found to contain cancer tissues, the doctor will proceed to remove the lump (lumpectomy) or the entire breast (mastectomy). Cancers that have been found to have spread to the armpit lymph nodes (based on findings in the sentinel lymph node biopsy) will require a lumpectomy or mastectomy plus the removal of the nodes.
Depending upon the stage of the cancer, the doctor may require the patient to undergo radiation therapy for over 6 weeks. For more advanced cases including metastatic breast cancer, chemotherapy is administered at intervals of 3 weeks over a period of 4 to 6 months. For women who are hormone-receptor positive, Tamoxifen is given to destroy cancers that have spread throughout the body.
Last but not least, you have targeted therapies, such as Trastuzumab (Herceptin), Pertuzumab (Perjeta), Ado-trastuzumab emtansine (Kadcyla or TDM-1) or Lapatinib (Tykerb). Although targeted therapies are more expensive, they are more effective in stopping the growth and spread of breast cancer cells and produce less severe side effects compared to chemotherapy.
4) You Need Not Suffer Alone
Being diagnosed with breast cancer can be devastating to many women. Because of the psychological burdens imposed by the disease, which can also affect a woman’s health and treatment, doctors advise these women to join a support group.
In Singapore, support groups like Bishana, Reach to Recovery, and the Look Good Feel Better Programme provide various educational, social and counselling activities for breast cancer patients and survivors.
