Breast Cancer

Breast Cancer

Breast Cancer is the most common type of cancer affecting women in Singapore. There is an increasing trend of breast cancer incidence over the past 30 years. Statistics showed 1 in 20 women will develop breast cancer in her lifetime.

Breast Cancer occurs as a result of uncontrolled faulted growth of altered breast tissues and cells. As the unchecked cancer cells grow, the cells can spread outside the breast through blood vessels and lymph vessels, and invade other parts of the body. This is known as a cancer metastasis.

Early detection places you at a better chance of survival. Treatment for early stages of breast cancer gives a survival rate of more than 90%. For this reason, it is imperative for women to check their breasts regularly for any changes, and speak to your doctor if any concern.

What are the Types of Breast Cancer?

Breast Cancer can be simplified into 2 main types:

  • Pre-invasive Breast Cancer (Ductal Carcinoma In Situ/DCIS)
    The breast cancer cells are confined inside the breast ducts and have not developed the ability to spread outside the breast. This is Stage 0 of breast cancer.
  • Invasive Breast Cancer (Invasive Ductal Breast Cancer)
    The breast cancer cells have spread to the surrounding tissues and later to the nearby lymph nodes, commonly underneath the armpit. In later stages, the cancer cells can spread to other body areas such as the lungs, liver, or bones. Invasive Breast Cancer is further classified into different stages (Stage 1,2,3,4) of breast cancer, with worsening severity with greater stages.

Other types of breast cancer include

  • Invasive Lobular Breast Cancer
  • Inflammatory Breast Cancer
  • Paget’s Diseases of the Breast

What are the Signs and Symptoms of Breast Cancer?

In the early stages of Breast Cancer, there can be no symptoms.

As breast cancer progresses, one may experience breast changes such as:

  • A palpable painless lump
  • Persistent nipple rash
  • Unusual discharge or bleeding from the nipple
  • Surrounding breast skin changes such as hardening, swelling, puckering (dimpling) of the skin
  • Nipple retraction (nipple appears to sink into the breast)

What are the Risk Factors for Breast Cancer?

The actual cause of breast cancer remains uncertain, with a complexed combination of both genetic and environmental factors.

The risk of breast cancer increases with age in females.

Other risk factors include:

  • History of breast cancer or other breast diseases
  • History of ovarian cancer
  • Family history of breast cancer or ovarian cancer
  • Early-onset of menstruation
  • Late development of menopause
  • First Childbearing after the age of 30
  • Have fewer children or Never have any child
  • Took hormone replacement therapy
  • Obesity

High Risks Factors for Breast Cancer include female with history of:

  • Breast Cancers in a few close members of the same family (sisters, mother, aunts)
  • Other solid cancers, in particularly ovarian cancers and colon cancer in members of the same family
  • Breast Cancer in close family member under the age of 40

BRCA Gene Mutation

Most Breast Cancers do not run in families. However, carrying particular genes such as BRCA1 and BRCA2 can increase a person’s risk of developing both breasts and ovarian cancers. The gene is possible to be passed from a parent to their child. This is the genetic mutation that occurs in Angelina Jolie leading to her preventive breast cancer and ovarian cancer surgeries. If a man carries the faulty gene, he may risk having male breast cancer and prostate cancer.

BRCA genes are not the only cancer risk genes. There are over 100 new faulty genes that can be associated with breast, prostate, ovarian cancer risks.

If you have 2 or more close relatives from the same side of your family who have breast cancers below the age of 50, speak to your doctor. Your doctor may offer you earlier vigilant surveillance for breast cancer and genetic testing.

What do I expect when I consult my doctor for Breast Cancer?

Your doctor will speak to you regarding your medical histories, family histories, and understanding of your lifestyle. A physical breast examination will be performed. Depending on individual case and risk factors, your doctor may offer you investigations such as ultrasound breasts or mammograms. If further concerns are arising, you may be referred to the Breast Specialist for further review and consideration of a breast tissue biopsy.

What are the Treatment Options for Breast Cancer?

Treatment options for breast cancer depends on

  1. The types of cancer cells
  2. Stage and extent of the cancer
  3. Individual age and other concurrent medical conditions

Breast cancer is usually treated with a combination of

  • Surgery
  • Radiotherapy
  • Chemotherapy
  • Hormonal therapy
  • Biologics therapy

Your doctor will discuss with you the best treatment plan for you.

Surgery

Radiotherapy
Radiotherapy uses high energy rays to kill the cancer cells and stopping them from growing further.

Chemotherapy
Chemotherapy can be used before surgery to reduce cancer recurrence and increase the chance of preserving the remaining breast tissue.

Hormonal Therapy
Hormonal therapy is used for Breast Cancers that are responsive to hormones such as estrogen or progesterone. These hormones may stimulate cancer cells to grow in some breast cancers, known as hormone receptor-positive cancers.

Biologics Therapy
This is a targeted therapy based on the fact that some breast cancer cells are stimulated for growth by a protein known as Human Epidermal Growth Factor Receptor-2 (HER2).

After Breast Cancer treatment, your doctor will schedule you for more frequent follow-ups to screen for recurrence in the first 5 years. You will be offered regular physical examination, blood tests, regular mammograms, X-rays, and bone scans.

Living with Breast Cancer

Dealing with cancer is a significant turning point in life for both patient and family. Additionally, affected women have to cope with the psychological and physical consequences of removal of part or all of a breast.

Speak to your family member, your doctor who you are comfortable with. Don’t suffer alone; you can always reach out for further support.

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