Cancer occurs when cells start to multiply uncontrollably, often forming tumours. In breast cancer, uncontrolled cell growth begins in the breast and may eventually spread to the rest of the body if left untreated. Affecting 1 in 11 individuals, breast cancer is the leading form of cancer among Singaporean women. While more commonly found among women, males can get it too.
It is important to note that not all breast tumours are cancerous. In fact, more than 80 per cent of lumps found in the breast are non-cancerous. However, if you notice a lump, do see a healthcare professional as soon as possible to ensure it does not pose a health risk.
Breast Cancer Symptoms
Oftentimes, the discovery happens when someone notices a lump in their breast. While 8 out of 10 breast lumps are actually benign or non-cancerous, it is best to have them checked as soon as possible as a precaution. Here are some of the symptoms you should take note of:
- Lumps in the breast or underarm
- Unusual or bloody nipple discharge
- Irritation or dimpling of breast skin
- Breast or nipple pain
- Inversion of the nipple
- Redness or flaky skin in the nipple area or the breast
- Itchy rash around the nipple
- Changes in the size or shape of the breast
- Thickening or swelling of all or part of the breast
(See also: Breast Cancer Screening: What Really Happens during Your Mammogram?)
Breast Cancer Causes and Risk Factors
While the exact causes of may not be fully known, some risk factors have been observed to affect the development of breast cancer. They fall into two categories — non-modifiable and modifiable. Non-modifiable risk factors refer to conditions that are out of our control and are unalterable, while we can change modifiable risk factors through actions and decisions we make.
Non-modifiable Risk Factors: Things we cannot change
- Gender – The main risk factor is our gender. While males do get breast cancer, the condition is much more common in women than men. This also explains the misconception that it only happens to women.
- Age – Cancers may likely occur in the older age groups as they take many years to develop from initial stages until diagnosis. Hence, as our birthdays pass us by and we mature, our chance of developing breast cancer increases. In fact, more than half of Singaporean women diagnosed fall between 45 and 64 years old. However, it can occur regardless of age.
- Breast tissue density – Breast density, which can be measured through a mammogram, compares the amount of the tissue types in our breasts. A denser breast holds a higher risk of breast cancer. This means having more fibrous and glandular tissues than fatty tissues in a breast. The first two are responsible for holding the breast in place and milk production, respectively, while fatty tissue fills up space in between. It is best to undergo a mammogram to learn more about your breast density.
- Family history of breast cancer – The risk of breast cancer can be passed down the family line due to the inheritance of certain genes. Having an immediate family member with breast cancer thus doubles the risk. The risk is five times the average is you have two relatives with breast cancer. Having a male relative with the condition similarly increases one’s risk of getting the condition.
- Personal history of breast cancer – For breast cancer survivors, the chance of developing cancer in another part of or the other breast is three to four times higher than another who never had the condition previously.
(See also: Deliveroo Foodiepreneur Finalist Battles Cancer with Clean Eating)
Modifiable Risk Factors: Things we can change
- Alcohol consumption – Compared to non-drinkers, women who have one drink a day have a 7 to 10 per cent higher risk. Those who drink two to three drinks a day would have up to 20 per cent increase in risk. Similarly, men should also avoid heavy drinking as it could lead to liver disease and a higher risk of developing breast cancer.
- Obesity – Estrogen levels are linked to breast cancer — especially for post-menopausal women. Before menopause, estrogen is primarily produced by the ovaries. Upon menopause, fat tissues replace them as the source of production. Being overweight would raise estrogen levels, thereby increasing the chances of developing the disease. In men, fat cells convert the male hormone (androgen) into estrogen. Hence, obesity in men also translates to an increased risk.
- Exercise – Research also links physical inactivity to a higher risk of breast cancer in both men and women. Conversely, regular activity may reduce invasive breast cancer. Furthermore, studies also show that physical activity could lower estrogen levels in the blood, thus reducing your risk.
- Smoking – Smoking, including second-hand smoke exposure, can increase our risk of breast cancer, particularly in pre-menopausal women.
- Breastfeeding – New mums may want to consider breastfeeding if it is an option. Besides lowering breast cancer risk, breast milk has many health benefits for the child too. However, it is a personal choice and dependent on our individual situation and preferences.
- Hormone Replacement Therapy (HRT) – HRT is often used to ease menopausal symptoms in women undergoing menopausal transition. This involves a supplementation of lost hormones, including estrogen and progesterone. But HRT can increase our risk by about 75 per cent, even when used for only a short time.
(See also: Menstrual Disorders – Symptoms, Causes & Treatments in Singapore)
Breast Cancer Prevention
There are some lifestyle habits we can adopt to reduce our risk of developing breast cancer too. For instance:
- Limit your alcohol intake – Next time you are contemplating a drink, choose water or a non-alcoholic drink instead. Better yet, avoid consuming alcohol altogether. If you decide to drink, make sure to do so in moderation and limit yourself to no more than one drink a day.
- Exercise regularly – If you have not been active, you do not have to jump to intense exercises and workouts right away. Start by ditching the escalator or elevator for stairs when commuting, or jog for 30 minutes each day in your neighbourhood park. Remember to exercise within your own limits to avoid injury.
- Avoid or quit smoking – If you are not a smoker, do not start. If you are a smoker, take steps to quit today. Quitting smoking is not an easy process, but support is available. Learn about the resources available.
- Maintain a healthy weight – As obesity is a risk factor for breast cancer, we can minimise our risk by maintaining a healthy weight range. Have a balanced food intake while keeping up with an active lifestyle.
- Adopt a healthy diet – No one food or diet can prevent breast cancer entirely. However, a healthy, well-balanced diet rich in fibre, vitamins, and antioxidants can reduce our risk of cancer and boost our overall wellbeing.
- Limit Hormone Replacement Therapy – If HRT is unavoidable, make sure to discuss with your doctor about all your options. Try to work out an effective way to limit the dose and duration, to possibly reduce your risk of breast cancer.
(See also: Top 12 Foods to Eat for the Best Nutrition during Pregnancy)
Breast Cancer Screening
The benefits of early detection and treatment cannot be understated. In fact, individuals diagnosed with breast cancer at Stage 1 can have a survival rate as high as 91 per cent. Here are the common screening methods that can help to detect breast cancer as early as possible:
- Self-examination – Women should perform a breast self-examination every month to detect any unusual changes and symptoms early. Learn how you can perform a simple breast self-examination in the comfort and privacy of your home.
- Mammogram – Mammography can detect small lumps in the breasts before we can feel it physically. The Singapore Health Promotion Board (HPB) recommends women above the age of 50 to go for mammogram screenings yearly even if they feel well.
(See also: Mammograms in Singapore – Subsidised Breast Cancer Screening Programmes & Costs)
Breast Cancer Treatment
Treatment types for breast cancer can be classified into two groups: local and systemic therapy.
Local therapy includes surgery and radiotherapy, and treats cancer at the site without affecting the rest of the body. Meanwhile, systemic therapy, which includes chemotherapy, hormone therapy, and targeted therapy, involves the administration of drugs into the bloodstream to kill cancer cells throughout the body.
- Surgery – There are two main types of surgery for breast cancer. In a lumpectomy, also known as Breast-Conserving Surgery (BCS), the tumour is removed while most of the breast remains. Whereas a mastectomy is the removal of the tumour along with the whole breast. The choice depends on a variety of factors, including the size and location of the tumour, breast size, and personal preference.
- Radiation therapy – Radiation therapy uses high-energy rays to kill or limit the growth of cancer cells, often before and/or after surgery, to reduce the size of the tumour and prevent recurrence respectively. Side effects may include redness and dryness of the skin, swelling, and an increase or decrease in sensitivity. However, these effects are generally manageable and temporary.
- Hormonal therapy – Hormonal therapy is a treatment method that alters or stops estrogen secretion, often in conjunction with other measures. It can also act as a preventive measure for women at high risk.
- Chemotherapy – By introducing drugs into the bloodstream, chemotherapy helps to eliminate cancer cells throughout the body. However, the disadvantage is that many healthy cells die alongside the cancer cells.
- Targeted therapy – Similar to chemotherapy, targeted therapy involves the use of drugs to kill cancer cells. However, these drugs target specific genes, proteins, or tissue environments that contribute to cancer growth and survival, leaving healthy cells largely unaffected.
(See also: Cryoablation: this new Breast Cancer treatment deep-freezes the tumour to its death — at -170°Celsius)
Breast Cancer Support Groups
A breast cancer diagnosis does not only affect us physically but can impact our mental wellbeing too. That’s why it’s important to have a strong support system in place. Besides family and friends, patients and survivors in Singapore can join support groups. Connecting with peers going through similar experiences as oneself can be cathartic.
Here are some of the breast cancer support groups in Singapore that you can join for free.
- Bishana Ladies Group – A support group for all-female cancer patients and survivors. Formed in May 2014, it acts as a platform for women to give and receive psychological and emotional support, and participate in education, social and recreational activities together.
- Reach to Recovery – This breast cancer support group meets on the fourth Saturday of every month at the Singapore Cancer Society Multi-Service Centre. Since 1973, it has helped women cope with everyday challenges after their diagnosis. Members participate in activities ranging from educational talks and workshops, social and recreational events, outings, and enrichment programmes.
- Look Good Feel Better – This programme was specially developed to help women build self-esteem and manage the appearance-related changes due to cancer treatments. They conduct hands-on workshops at hospitals islandwide to help women learn about cosmetic techniques and hair alternatives.
(See also: Telling my Children that I have Cancer)
Living with Breast Cancer
Navigating the breast cancer journey is not easy — from the initial diagnosis and treatment to learning to live with the changes the disease and its treatment have on our lives. No matter how hard the going gets, always remember that you are not alone. Have faith and do not hesitate to reach out for help if you need it.
This article first appeared on Homage, an award-winning personal care solution that provides on-demand holistic home and community-based caregiving and medical services to seniors and adults, allowing them to age and recover with grace, control, and dignity.