Friday, October 23, 2009

Breast Cancer

What is breast cancer?

Our breasts are made up of fat and gland tissue. All glandular tissue in the breast is made up of individual cells that reproduce under the control of hormones. When the process goes out of control and an abnormal cell develops, this is the start of cancer. Breast cancer is the most common cancer among Singaporean women, with 1 out of 20 women contracting breast cancer in her lifetime.
  • There are two broad types of breast cancer - pre-invasive and invasive breast cancer.
Pre-invasive Breast Cancer
  • Cancer cells are confined to the breast's ducts or lobules and unable to spread.
  • Classified as stage 0 breast cancer.
  • If diagnosed at this stage, treatment is usually effective and chemotherapy or other adjuvant therapy are not required.
Invasive Breast Cancer
  • Cancer cells spread outside the milk ducts or the lobules, to the surrounding breast tissues.
  • Breast cancer cells then move into the lymph nodes or blood stream, travellng to other parts of the body usually bones, liver and lungs.
  • Classified into 4 stages (stage 1 to 4 according to severity).
  • The smaller the size of the cancer at diagnosis, the better the chances of survival for the patient upon treatment.
*It is important to diagnose a cancer early, especially when in its pre-invasive form, as a cure is possible with treatment at this early stage.

Who is at risk?

Women aged 40 and above are more prone to breast cancer.
  • Age - risk of developing breast cancer increases with age.
  • Personal history of breast cancer.
  • Family history of breast cancer in first degree relatives such as mother, sister or daughter.
  • Genetic predisposition - about 5-10% of breast cancers are inherited.
  • Radiation exposure to chest in childhood or adolescence.
  • Early onset of menses and late menopause.
  • Hormone replacement therapy with a combination of estrogen and progesterone for four or more years.
  • Birth control pills - use of pills for four years or more is associated with an increased risk of breast cancer.
  • Excessive alcohol intake.
  • Women who have never been pregnant also have a high risk of breast cancer. Getting pregnant for the first time after the age of 30 also increases the risk.
How can you prevent it?
  • Know the symptoms of breast cancer and conduct self-check regularly.
  • Lead a healthy lifestyle.
  • Limit alcohol intake.
  • Maintain a healthy weight -> clear link between obesity and breast cancer.
  • Avoid long-term hormone therapy.
  • Be physically active.
  • Eat foods high in fibre such as fresh fruits, vegetables and whole grains.
  • Consume more olive oil as oleic acid, the main component of olive oil, appears to suppress the action of some cancer related genes in breast cancer.
  • See a doctor immediately when you notice changes in your breasts.
How can you detect changes in your breasts?

Breast changes can be detected via:
• mammography (breast X-ray)
• clinical breast examination
• breast self-examination (do BSE one week after your period, when the breasts are less tender and lumpy. If you
no longer have your period, choose a day that you will remember each month.)

Age 20-39
Age 40-49
Age 50 and above

(once a year)

(once every 2 years)
Clinical breast examination
Self-check once a month

Do you have it?

According to the American Cancer Society, any of the following unusual changes in the breast can be a symptom of breast cancer:
  • swelling of all or part of the breast
  • skin irritation or dimpling
  • breast pain
  • nipple pain or nipple turning inward
  • redness, scaliness, or thickening of the nipple or breast skin
  • a nipple discharge other than breast milk
  • a lump in the underarm area
*You may not feel any pain for any of these changes. Most lumps and changes are not cancerous. However, you should still see a doctor immediately if you experience any of these symptoms.



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