Breast Cancer

What Do I Need to Know?

Breast cancer occurs when the cells in the lobules or ducts become abnormal and divide uncontrollably; these cells then invade surrounding breast tissue and eventually spreads via blood vessels and lymphatic channels to the lymph nodes, lungs, bones, brain, and liver.

Breast cancer is the most common form of cancer to hit Malaysian women, with 1 in 27 are at risk of diagnosis. In 2003, of the new cases reported in Malaysia, 64% of these cases were women between the ages of 40 to 60-years-old. 40% of all new cases reported, however, were already at the advanced stages of the disease.

Many different types of breast cancers occur in two broad categories – invasive and non-invasive. The two most common types of breast cancer are:

• Invasive Ductal Carcinoma (IDC)
  Breast cancer where cells grow outside the ducts into other parts of the breast tissue. Invasive cancer cells can also spread, ormetastasise, to other parts of the body. Thistype of cancer accounts for about 80% of all breast cancers.
• Invasive Lobular Carcinoma (ILC)
  ILC is another most common breast cancer where cancer cells spread from the lobules of the breast tissue that are close-by. These invasive cancer cells can also apply to other parts of the body. This type of breast cancer makeup 10 – 15% of all breast cancers and is often found in multiple sites in the breast

What Are the Risk Factors?

There are risk factors that CAN be changed and those that CANNOT be changed.

Risk Factors that can be Changed

• Not Physically Active – Women who are not physically active have a higher risk of breast cancer.
• Overweight or Obese After Menopause – Older women who ar e overweight or obese have a higher risk compared to those at an average weight.
• Taking Hormones – Certain forms of hormone replacement therapy taken during menopause can raise the risk of breast cancer when taken more than five years.
• Reproductive History – Having the first pregnancy after 30, not breastfeeding, and never having a full-term pregnancy may result in increased breast cancer risk factors.
• Alcohol consumption – Women’s risk of breast cancer increases with alcohol consumption.

Risk Factors that cannot be Changed

• Getting Older – The risk o f breast cancer increases with age. Women aged 50-year-old and above are susceptible to breast cancer.
• Genetic Mutations – Women who have inherited changes to specific genes, such as BRCA1 and BRCA2, are at higher risks.
• Reproductive History – Early menstrual periods before the age of 12 and menopause after the age of 55 expose women to hormones longer, leading to a greater risk of breast cancer.
• Personal History of Breast Cancer or Certain Non-cancerous Breast Diseases – Women who have had breastcancer are likely to face a recurrence. Non-cancerous breast diseases such asatypical hyperplasiaorlobular carcinoma in situ, are also at higher risks.
• Family History of Breast Cancer – Women whose mother, sister, or daughter (first-degree relative) or multiple family members on either mother or father’s side of the family who has had breast cancer are at
  greater risk.
• Previous treatment using Radiation Therapy – Women who had radiation therapy to the chest or breasts before the

What Are the Symptoms?

Symptoms of breast cancer are never the same among women. Some may not show signs or symptoms at all. Common warning signs of breast cancer are:

• New lump in the breast or underarm
• Thickening or swelling
• Irritation or dimpling of breast skin
• Redness or flaky skin in the nipple or breast area
• Pulling in of the nipple or pain in the nipple area
• Nipple discharge other than breast milk, including blood
• Any change in the size or shape of the breast
• Pain in any area of the breast

How Do I Prevent Breast Cancer?

The goal of screening is for early breast cancer detection. Early detection means applying a strategy that results in the diagnosis and treatment of breast cancer. Breast cancers detected due to arising symptoms tend to be relatively more extensive and may have spread beyond the breast, while breast cancers found during screening exams are more likely to be small and confined to the breasts.

Becoming breast aware is key to beating breast cancer, and early detection of breast cancer includes breast self-examination and mammography screening.

How Are Mammographs Performed?

Previously, mammography uses analogue mammograms where images are on film. Digital mammography is the next step for the screening of early-stage breast cancer, allowing healthcare professionals to capture and manipulate images to get a clearer picture.

For mammograms, the breast is compressed between 2 plates to flatten and spread the tissue lasting a few seconds to produce a fair and readable mammogram. A radiologist will interpret the result on the lookout for:

• Macrocalcification – Coarse calcium deposits representing degenerative
  changes in the breasts
• Microcalcification – Specks of calcium in the breasts.
• Mass – That can be caused by benign breast conditions or by breast cancer
• Cyst – Confirmation of a mass that is a cyst through breast ultrasound or
  removal of fluid with a needle.

When do you go for Mammographs?

Women above the age of 40 should consult a doctor or a healthcare professional on when to start and how often they should get a mammogram.