Breast Cancer occurs when there is an abnormal growth of harmful cells in breast tissue. These cells develop into a mass or a growth called a tumour.
Breast cancer is the most common cancer among women in Singapore. One in eight women will get breast cancer in their lifetime. The exact cause is not known but it may be due to genetic and environmental factors.
All women are at risk of breast cancer, and the risk increases with age. Early detection of breast cancer through screening will enable early treatment and longer term survival.
The most common presentation for patients with breast cancer is a breast lump. Doing a monthly breast self examination will keep you aware of any changes to your breasts and enable you to seek early treatment if you detects a breast lump.
Women over 40 years of age should go for regular mammograms to detect any abnormal lesions in the breast. Other presentations of breast cancer include bleeding or unusual nipple discharge, lumps in the axilla (armpit) or breast skin abnormalities.
Risk factors for breast cancer include a personal history of known BRCA1 or BRCA2 mutation, previous breast cancer, or other high risk breast lesions. A family history of breast cancer, ovarian cancer, BRCA1 or BRCA 2 mutation also increase the chances of having breast cancer.
Other known risk factors include early onset menstruation, late menopause, having your first child after the age of 30, not bearing any children, being on oral contraceptive pills, being on hormone replacement therapy and smoking.
Breast cancer is diagnosed from a biopsy, in which a small sample of tissue from a suspicious breast lesion is sent for testing. If breast cancer is confirmed, treatment options may include surgery. Techniques include breast conserving surgery, as well as mastectomy with or without breast reconstruction. Depending on the preoperative results, a sentinel lymph node biopsy or axillary clearance (removal of all the axillary lymph nodes) is performed for diagnostic and therapeutic purposes. Occasionally, preoperative chemotherapy and targeted therapy may be given prior to surgery.
All breast cancer cases will be discussed at the breast multidisciplinary tumour board. Recommendations for subsequent treatment, such as chemotherapy, targeted therapy, hormonal therapy and radiotherapy, will be given based on the type and stage of the breast cancer. The Enhanced Perioperative Care (EPOC) pathway, implemented for reconstruction patients, also provides a systematic guideline to enhance recovery from breast surgery.