Breast Cancer

Breast cancer is one of the most common cancers in women in Singapore. The disease causes the cells in the breast to grow at an abnormal rate and although there are different kinds of breast cancer, most of these begin in the ducts or lobules. In progressive stages, cancer cells can spread outside the breast through lymph and blood vessels.

Risk Factors of Breast Cancer

There are various risk factors that can lead to breast cancer such as genetics and age. Women who are 50 and above are at higher risks of breast cancer. Other risks include:

  • Genetic Mutations: Abnormal genes can be passed on from parents to children and throughout generations. 10% of breast cancer cases are said to be hereditary. Most cases of inherited breast cancers are caused by mutations of the BRCA1 (BReast CAncer gene one) and BRCA2 (BReast CAncer gene two) genes.
  • Reproductive System: Girls who have their first menstruation at age 12 or below, have a higher risk of breast cancer later on. The earlier the breast development occurs, the earlier the breasts become sensitive to the hormonal changes in and around the body as well as to the hormone-disrupting chemicals in modern-day products.
  • Physically Dense Breast: Women with dense breasts are more prone to breast cancer because they have greater amount of fat tissue which hides the tumors at the initial stages.
  • Family History: Genetics play a significant role in the development of breast cancer. A person’s risk is doubled when she has a daughter, mother or sibling who is diagnosed with breast cancer. When two first-degree blood relatives are diagnosed, the person’s risk is increased 5 times.
  • Personal History: Those who are previously diagnosed with breast cancer have a higher chance of getting cancer in the other breast or another part of the same breast.

Signs and Symptoms of Breast Cancer

The primary symptom of breast cancer is a lump or hard mass in the breast tissue. However, different breast cancers have distinctive symptoms and signs, which include Invasive lobular carcinoma (ILC), abnormal thickening of breast and other physical signs.

  • Physical changes in the infected breast such as soreness and swelling
  • Rashes, itching, redness, or other prominent changes
  • An increase in size or change in the shape of the breast(s)
  • Deformation of nipples
  • Abnormal nipple discharge other than breast milk
  • Constant pain in both or one of the breasts
  • Upon pressing, a lump or node can be felt

Breast Cancer Treatment Options

There are various forms of treatments based on the type of cancer and patient’s conditions. Breast cancer patients often go for multiple treatments instead of relying on one or two methods to deal with the complexity of the cancer cells.

  • Surgery: The surgical treatment is recommended in severe cases.
  • Chemotherapy: Chemotherapy involves prescribing the patients cancer medicines or injection to kill cancer cells.
  • Hormonal Therapy: Hormonal therapy medicines address the hormone-receptor-positive breast cancers but are ineffective against the hormone-receptor-negative ones. In essence, the therapy aims to reduce or block hormone estrogen, which the hormone-receptor-positive breast cancers need in order to grow.
  • Radiation Therapy: Breast cancer patients are also given radiation therapy in which cancer cells are killed using high-energy rays.

Surgical Treatments for Cancer:

There are two kinds of surgeries that can be done to cure breast cancer.

Lumpectomy

This procedure is a form of “breast preservation” or “breast-conserving” surgery, and is technically a partial mastectomy. In this surgery, only the tumor and a small portion of healthy tissues surrounding the tumor are removed. This surgery is recommended for patients with cysts that are not mature yet.

To further eliminate cancer cells that may remain after lumpectomy, most patients go through radiation therapy for around 2 months after the surgery. If chemotherapy is also required, patients are usually advised to undergo chemotherapy before radiation therapy.

Some Risks of Lumpectomy

  • There is a higher chance of cancer recurrence
  • The breast may become much smaller or deformed after surgery
  • Most of the Lumpectomy patients have to go through 4-5 weeks of radiation after surgery to make sure that the cancer cells are completely killed.

Mastectomy

Mastectomy is the surgical removal of the whole breast to completely take out the breast tissues. In a total mastectomy, no muscle under the breast is removed. The lymph nodes in the armpits are also retained unless they are within the breast tissue. On the other hand, a radical mastectomy includes the removal of underarm lymph nodes and the chest wall muscles.

Nowadays, modern mastectomy provides patients with the option to retain the nipple or preserve the skin in the breast region when removing the breast tissues. These mastectomy options allow for the reconstruction of the breast with a tissue taken from another part of the body or with an implant. Skin-saving and nipple-sparing mastectomy can only be performed when the tissues under the skin or nipple are free from tumor cells.

Risks of Mastectomy

  • Longer recovery process
  • Risk of infection
  • Scar tissue formation and build-up can occur and are sometimes painful

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