In the USA 1 in 8 women will get breast cancer. In Malaysia, the incidence has been discovered to be 1 in 19 women and accounts for around 30% of all new cancers.

Around 5,000 Malaysian women are diagnosed with breast cancer every year, most of them aged between 30 and 60 years, where nearly half of those affected are under 50-years of age.

Malaysian patients have poor survival rate due to lack of awareness of the signs and symptoms fear of screening and delay in medical treatment when traditional alternative is preferred.

High risk factors

• Family history of breast or ovarian cancers
• BRCA gene positive (more than 50% chance of getting breast cancer)

Lifestyle Risk Factors

• Smoking
• Alcohol consumption
• Overweight (BMI more than 25)
• Lack of exercise
• Early menarche or 1st pregnancy at a late age in life.

Breast cancer

Breast cancer either begins in the cells of the lobules (known as the milk-producing glands) or the ducts (known as milk passages) and rarely from fatty and fibrous tissue of the breast.  It can spread via the lymph nodes into other parts of the body. The breast cancer’s stage refers to how far the cancer has spread beyond the original tumour.

Symptoms or signs of breast cancer

There may be no symptoms at all.  Usually there is a breast lump, breast pain, skin dimpling, changes at the nipple such as in-turning, discharge, rash or redness.

Breast screening

• Mammogram is recommended every 2 years for women age 50 to 74 years
• Should not be denied in women between 40-49 even if they are low or intermediate risk,
  Malaysian Clinical Practice Guidelines (2010)

Treatment of breast cancer

Breast cancer is treated with a combination of surgery, chemotherapy or radiation and the choice depends on the cell type and stage of cancer.  Surgery aims to remove the entire cancer with a some surrounding normal tissue and lymph nodes where necessary.

What are the risks for recurrence?

• Stage of cancer at the time of diagnosis (more advanced stage has worse prognosis)
• Grade of cancer (higher grade with more undifferentiated cells have worse prognosis)
• Cancer cell type (invasive cells have worse prognosis)
• ER / PR hormone receptor positive (amenable to hormone therapy)
• HER2 gene positive (worse prognosis)

Follow up schedule after breast cancer treatment

• After initial surgery/chemotherapy/radiotherapy, you are recommended to see the doctor Every 3 months for the first 2 years
• After that, every 6 months for 3 years
• After that, every year for 5 years
• After that, as advised by the doctor

For more references:

• www.moh.gov.my | www.acadmed.org.my | www.cancer.org.my
• http://www.cancerresearch.my/research/breast-cancer/
• http://www.nationalbreastcancer.org/early-detection-of-breast-cancer

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