Breast cancer will affect one in 15 women over their lifetime. Here’s what you need to know about the disease, and the screening tool that can save your breasts – and your life
No one in your family has had breast cancer. You live a healthy lifestyle, eating well and exercising regularly. You think you’re safe – until one day, you discover a lump in your breast.
Breast cancer is the leading cancer amongst Singaporean women and the leading cause of death. Each week, 37 women are diagnosed with breast cancer, and a majority of those diagnosed are aged 45 to 64 years old.
While it’s true that genes play a significant role in determining whether you get breast cancer – women with hereditary genetic mutations, such as in their BRCA1 or BRCA2 genes, do carry a high lifetime risk of developing breast and ovarian cancer at a young age – the truth is that majority (90%!) of women carrying the disease do not actually have a family history of it.
So what other factors can put you at risk?
- Age – breast cancer risk increases as one gets older, especially after menopause;
- Being overweight after menopause;
- Being physically inactive;
- Drinking alcohol (including wine and beer) regularly; and
- Use of combined hormone replacement therapy (HRT), comprising oestrogen and progestin, for more than five years.
Early detection, new advances
Mammography is your best defence against breast cancer. Regular mammograms can detect breast cancer even before a lump is felt by the patient or the doctor, or appears on ultrasound.
Who needs to get screened? Women aged 40 to 49 should have screening mammograms annually, while women aged 50 and above should do it once every two years. Those with family members affected by breast cancer should consider starting earlier; specifically, five years earlier than the age at diagnosis of their youngest affected relative. Those with a genetic predisposition to the disease – such as BRCA mutations – should begin even earlier, in consultation with a breast specialist.
As technology improves, other options such as supplementary ultrasound and magnetic resonance scans (MRI) may be used as well. Genetics testing is also a developing field and may be beneficial for a select group of patients, who can get treatment to prevent breast cancer!
Demystifying the mammogram
A mammogram is essentially a low-energy x-ray of the breast, used to detect abnormalities in the breast tissue. It is considered a very safe screening tool for breast cancer, and its benefits actually outweigh the minute potential harm of radiation. The amount of radiation is estimated to be equal to normal environmental background radiation over 7 weeks. There are two kinds:
Screening mammogram detects breast changes in women who do not have any symptoms. Typically, two x-rays of each breast are taken.
Diagnostic mammogram examines a particular part of a woman’s breast under very specific circumstances. For example, if the patient has breast symptoms, an abnormal screening mammogram, or if the doctor has detected changes during a clinical examination. The doctor will assess, and recommend necessary imaging (MMG and US usually), followed by biopsies (needle tests).
Holistic approach
A diagnosis of breast cancer is the first step in getting treatment. At Thomson Medical, patients receive the highest standards of care from its dedicated team: breast surgeon, breast care nurses and other relevant specialists. After careful assessment, the most appropriate treatment plan is recommended based on the patient’s health status, tumour profile and lifestyle needs. Counselling and support are also available to help patients complete the treatment journey – ultimately, the aim is to ensure women with breast cancer enjoy a healthy life full of vitality.
WHAT TO EXPECT AT A MAMMOGRAM
- First, you will need to remove your top or blouse. You need to only undress from the waist up, so it is a good idea to wear a two-piece outfit rather than dresses or jumpsuits.
- Avoid applying any ointments or powders, as they may make the interpretation of the images more difficult
- Avoid wearing excessive jewellery, as you will need to remove them during the imaging (we don’t want you to lose important and expensive items!)
- During the actual procedure, the breast is compressed between two plates for a few seconds and an x-ray is taken: once with the plates in a vertical position and another with the plates in a horizontal position.
- The pressure caused by the plates can be uncomfortable. If it gets too uncomfortable or you feel pain, do alert the radiographer.
TAKE CHARGE OF YOUR HEALTH
Lower your risk of breast cancer through:
- Regular exercise – studies suggest that 150 minutes of physical activity a week reduces one’s breast cancer risk. This means just 30 minutes of walking, five times a week.
- Eating a balanced diet that includes more fruits and vegetables.
- Maintaining a healthy weight, especially after menopause.
- Avoiding or limiting the amount of alcohol consumed to two or fewer drinks a week. Women who drink more run a 15 percent higher risk of breast cancer.
- Limit the use of combination HRT. Consider a lower-dose formula, and take it for a short period.
This Article is authored by Dr Tan Yia Swam, Clinical Director of Thomson Breast Centre.