2020, Health Info, October

Breast Cancer

What To Know About Breast Cancer

Breast cancer is the most common invasive cancer affecting women in Malaysia. Based on the Malaysia Cancer Registry Report (MNCRR) 2012-2016, Malaysia recorded an 11.3 per cent increase in new cancer cases from 103,507 in 2007-2011 to 115,238 in 2012-2016.

Despite the Health Ministry’s strategy of pushing for early screenings to prevent late detection, the percentage of cancer cases detected in Stages 3 and 4 increased from 58.7 per cent from 2007 to 2011 to 63.7 per cent in 2012 to 2016. Although new cervical cancer cases dropped in 2012-2016 from 2007-2011, Malaysia reported a “significant” increase in breast and colorectal cancer.

Breast cancer occurs when the cells in the lobules (milk-producing glands) or the ducts become abnormal and multiply uncontrollably. If it goes undetected and not treated promptly, these abnormal cells begin to invade the surrounding breast tissue and may eventually travel to the lymph nodes under the arms. The lymph nodes are a primary pathway that helps the cancer cells move to other parts of the body.

Breast Cancer Risk Factors

There are several risk factors that increase your chances of getting breast cancer. However, having any of these doesn’t mean you will definitely develop the disease. Some risk factors can’t be avoided, such as family history. You can, however, change other risk factors, such as smoking. A number of risk factors for breast cancer include:

  • Age: 70% of breast cancer occurs in women aged 40 and above
  • Inherited Risk: If a close female relative has had breast cancer, you have an increased risk for developing it. This includes your mother, grandmother, sister, or daughter. If you don’t have a family history of breast cancer, you can still develop breast cancer.
  • Early menstruation: If you had your first period before age 12, you have an increased risk for breast cancer.
  • Late menopause start: Women who do not start menopause until after age 55 are more likely to develop breast cancer.
  • Giving birth at an older age: Women who don’t have their first child until after age 35 have an increased risk of breast cancer.
  • Never being pregnant: Women who never became pregnant or never carried a pregnancy to full term are more likely to develop breast cancer.
  • Alcohol consumption: Drinking excessive amounts of alcohol raises your risk.
  • Lifestyle: Women who are obese have a higher risk of developing breast cancer. Maintaining a healthy diet and getting more exercise could help you lose weight and lower your risk.

Breast Cancer Symptoms

In its early stages, breast cancer may not cause any symptoms. In many cases, a tumour may be too small to be felt, but an abnormality can still be seen on a mammogram. If a tumour can be felt, the first sign is usually a new lump in the breast that was not there before. However, not all lumps are cancerous.

Each type of breast cancer can cause a variety of symptoms. Many of these symptoms are similar, but some can be different. Symptoms for the most common breast cancers include:

Breast Cancer Early Detection

While there are risk factors you cannot control, following a healthy lifestyle, getting regular screenings, and taking any preventive measures your doctor recommends can help reduce your risk of developing breast cancer. Having regular breast screenings may not prevent breast cancer, but it can help reduce the odds that it will go undetected.

  • Breast Self-Examination (BSE): Women should regularly check their breasts for any changes in the appearance of the skin or abnormal lumps. It is important to check under the armpits for any lumps as this may indicate the spread of cancer to the lymph nodes. BSE is ideally done once a month just after menstruation. The exam can help you become familiar with how your breasts normally look and feel so that you’re aware of any changes that occur. If any abnormal changes are detected, visit your doctor immediately for a thorough check-up.
  • Mammogram: A mammogram is an x-ray of the breast, usually performed on women above the age of 40 years old. It is one of the best methods to detect breast cancer early and recommended to be performed once every two (2) years.
  • Breast Ultrasound: A breast ultrasound uses sound waves to create a picture of the tissues deep in your breast. An ultrasound can help your doctor distinguish between a solid mass, such as a tumour, and a benign cyst.
  • Magnetic Resonance Imaging (MRI): This is the most sensitive investigation to detect the presence of cancer cells as it gives a good picture of the soft tissue. However, not all cases require an MRI be conducted unless recommended by the doctor.

How to Perform a Breast Self Examination

Look for changes while either standing or sitting in front of a mirror, with your clothes removed. Examine both breasts and look for:

  • Visible lumps
  • Any unusual differences between the two breasts
  • Dimpling or indentations in the breast tissue
  • Redness, scaliness, or other changes to the skin or nipples that appear abnormal
  • Changes to your nipples, for example, a nipple that is newly inverted or pulling in

Look for the same changes in the breasts from Step 1 — such as redness, lumps and indentations — this time with your hands resting on your hips while squeezing your elbows forward since this might bring out lumps that might not appear otherwise. Keep your hands on your hips and slowly swivel from side to side to catch possible abnormalities from more angles.

Next, lift your arms above your head to see if there’s any puckering or dimpling of the skin when you elevate them.

The feel part of the breast self-exam should be done while lying down, with a pillow propping up your head and your arm resting behind it. With the opposite hand, take the first three fingers — index, middle and ring fingers — and use them to press down around the breast and surrounding area using circular motions. Using three fingers, rather than just one, keeps you from mistaking normal breast tissue for lumps. Increase the pressure you use with each pass around the breasts to ensure you are not just feeling superficial tissue.

After examining your breasts, it is important to perform a check of the areas around them. Continue to use circular motions and increasing pressure as you move from the collarbone to the sternum and down below the breast. From the lower part of the breast, travel up to the area under your arm to look for any swelling in the lymph nodes.

The most important thing about a breast self-examination is to know your breasts. Many women detect breast cancers or breast lumps themselves and that can be the beginning of an important conversation with your doctor.

References:

  1. Centers for Disease Control and Prevention
  2. Medical News Today