Everything You Wanted To Know About Breast Cancer

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.

Watch a video on breast cancer

High Risk Factors for developing Breast Cancer

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

Lifestyle Risk Factors for developing Breast Cancer

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

How does Breast Cancer form in the body?

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.

Main types of Breast Cancer

These are the 2 common breast cancer types which are based on the cellular origin of the cancer cells;

Ductal carcinoma is when the breast cancer starts from the milk ducts cells. In the early stage, it may be confined to the milk ducts and is called Ductal Carcinoma-in-situ (also known as DCIS)
Lobular carcinoma is when the breast cancer starts from the milk producing glands called lobules. In the early stage, it may be confined to the lobules and is called Lobular Carcinoma-in-situ (also known as LCIS)

Less common types of breast cancer include Inflammatory Breast Cancer (also known as IBC) where there is a rash over the breast with redness and skin dimpling as well as Paget’s Disease which is breast cancer of the nipple.

What are the 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.

How often should women have breast assessment using mammogram or ultrasound?

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

What is the Treatment for 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 Cancer Recurrence after Treatment?

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)

Click to view Dr Tasha video on Breast Cancer Recurrence

What is the follow-up schedule after Breast Cancer Treatment?

After your initial surgery/chemotherapy/radiotherapy, you are recommended to see the doctor every 3 months for the first 2 years (although this may vary depending on your situation and your treating doctor(s) recommendations)
After that, every 6 months for 3 years
After that, every year for 5 years
After that, as advised by your treating doctor(s)

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If you think you may be suffering from any medical condition, you should seek immediate medical attention from your doctor or other professional healthcare providers. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.