by Dr Tan Ern Yu
October is designated as Breast Cancer Awareness Month, or BCAM, as it is more commonly known. BCAM first started in the United States in 1985 and is now an international campaign organised by major breast cancer charities around the world. BCAM aims to increase public awareness of breast cancer, and to draw attention to the research and efforts being made to improve breast cancer treatment and prevention. So what is there to know about breast cancer?
1. Every woman is at risk of having breast cancer
Breast cancer is the most common cancer among women in Singapore.
One in every 17 women in Singapore will develop breast cancer in her lifetime.
Perhaps the most common misconception is that breast cancer only affects certain women, like those with a family history of breast cancer, or those who take hormone pills, or those who did not breastfeed. The truth is that any woman is at risk of developing breast cancer.
In fact, most women who develop breast cancer do not fall into any high-risk groups.
2. Misconception: A lump in the breast that is not painful cannot be breast cancer
It is another common misconception that pain is a sign of cancer. But more than 85 per cent of women who are diagnosed with breast cancer first notice a lump in the breast that is painless.
On the contrary, breast pain (mastalgia) is often caused by the natural rhythm of hormonal changes occurring in the body. It is often felt prior to or during menstruation and is very rarely a sign of breast cancer.
Other signs that warrant medical attention include bloody nipple discharge, changes in the nipple position or shape and unusual changes of the skin over the breasts.
3. Misconception: Many women who go for mammogram screening end up being treated unnecessarily
There has been talk that mammogram screening over-diagnoses breast cancer, and that many women end up being treated for a cancer that will never threaten her life. It is true that mammogram screening detects many more cancers than would have been detected by doctors in the clinic — but this is the whole purpose of screening. Screening aims to pick up cancer when it is still too small or early to show signs. Hypothetically, some of these cancers may never progress to a life-threatening stage.
However, since we have no means of differentiating such cancers from the more aggressive ones at present, treatment is offered to all. While opponents of mammogram screening constantly highlight this potentially unnecessary over-treatment, it is important to remember that all the major trials showed that mammogram screening reduced breast cancer deaths by almost 25 per cent. Hence all women above 40 years of age are still encouraged to attend regular mammogram screening.
BreastScreen Singapore is the national breast cancer screening program. Women between the ages of 40 and 49 years are encouraged to go for mammogram screening once a year; those older than 50 years, once in every 2 years.