In Singapore, breast cancer is the leading cause of cancer death in women. The chances of a woman in Singapore being diagnosed with breast cancer is 1 in 16, with an increasing incidence of new cases reported every year. Women aged 40 – 69 are at the highest risk of breast cancer. However, breast cancer may be effectively detected early. Coupled with advancements in surgical and medical treatments, breast cancer can be treated with promising survival outcomes.
References:
Singapore Cancer Registry Interim Annual Report, Trends in Cancer Incidence in Singapore, 2010-2014, National Registry of Diseases Office (released 26 May 2015)
Risk Factors
Common risk factors for breast cancer include:
Non-modifiable risk factors
- Being a woman
- Increasing age
- Family history of cancer
- Early onset of menstruation (menarche) and/or late menopause
- Denser breast
- Proliferative breast conditions
Modifiable risk factors
- Having no children and lack of breastfeeding
- Being overweight
- Radiation exposure
- Alcohol or smoking
- Lack of physical therapy
- Long-term use of hormone replacement therapy or oral contraceptives
Regular screening such as annual mammograms is important to help detect breast cancer in its early stages. Early diagnosis improves survival outcomes and simplifies treatment plans. Talk to your doctor to find out more.
Signs & Symptoms
Common symptoms of breast cancer include:
- Painless lump in the breast
- Persistent itch or rash around the nipple
- Bleeding or unusual discharge from the nipple
- Skin over the breast is swollen or thickened
- Skin over the breast is dimpled or puckered
- Nipple becomes pulled in or retracted
It is recommended for women below age 40 to conduct a monthly breast self-examination to check for changes to the breast. For women aged 40 and above, it is recommended to go for a mammography at least once a year. Talk to your doctor to understand more.
Diagnosis
Your doctor will check your medical history and perform a clinical examination. The following diagnostic tests may be prescribed for a complete assessment:
- Mammogram
- Tomosynthesis (3D Mammography)
- Breast Ultrasound
- Magnetic resonance imaging (MRI)
If an abnormality is found during imaging, a biopsy may be required to confirm the diagnosis. This includes image-guided procedures such as:
- MRI-guided Core Needle / Vacuum-assisted Biopsy
- Stereotactic Core Needle / Vacuum-assisted Biopsy
- Ultrasound-guided Core Needle / Vacuum-assisted Biopsy
- Wire Localisation for Surgery (MRI, Stereotactic or Ultrasound-guided)
Treatment & Care
Treatment of breast cancer and chances of recovery depends on the subtype of the cancer as well as the stage and extent to which the cancer has spread. For most early breast cancers, surgical intervention is recommended to first remove the cancer from the body and to assess if the lymph nodes are involved.
In the past, traditional mastectomy (the removal of the whole breast) is performed. With advancements in surgical techniques, oncoplastic surgery or total reconstruction can now be safely performed to optimise the removal of cancer as well as restoration of the patient’s body image. Women no longer have to lose their breasts to breast cancer through mutilating surgeries.
For more advanced cases, chemotherapy with targeted treatments can now successfully downstage the cancers prior to surgery. Treatments like radiotherapy may also be required. Talk to your doctor to understand the treatment options available.
Emotional Support
Treatment of cancer may take a long time and the journey may be trying. It is important to obtain emotional support to help you through this difficult time.
CanHOPE is a non-profit cancer counselling and support service provider by Gleneagles Hospital. The CanHope team helps patients during their cancer treatment by providing counselling and education for them and their families. The team has dietitians who can recommend dietary plans for patients to stay healthy during treatment, and support group communities for patients to draw strength from each other. The staff at CanHOPE, experienced in working together with cancer patients and their families, aim to inspire hope and positivity to help patients cope with cancer. Find out more about CanHOPE support groups and programmes.