Breast cancer remains the leading cause of cancer related death in women today. The aim of screening is to detect the disease at an early stage when the tumour is small and survival rate is high. Ninety percent of breast lumps are felt by the women themselves. Thus, it is important for women to understand and practise BSE (breast self-examination).
Incidence of Breast Cancer
The incidence of breast cancer in Singapore is rising and every year about 1,000 new cases are diagnosed.
What is Cancer?
Normal cells that make up various parts of the body reproduce themselves so that growth occurs, worn out tissues are replaced and injuries repaired. The characteristic of cancer is uncontrolled growth and the spread of abnormal cells.
Risk Factors
Research has shown that several factors together appear to increase the risk of breast cancer :
A family history of breast cancer
Age over 35 years
Early (under age 12) menarche ?start of periods
Late menopause (after age 50)
Childless or first child after 30 years of age
Benign breast disease
A diet high in animal fats
Symptoms of Breast Cancer
Changes in the breast are often the first indication that breast cancer may be present. These include :
A lump in your breast that persists
Bleeding or discharge from the nipple
A change in the shape of the breast
A puckering or dimpling of the skin of the breast
A new retraction (pulling in) of the nipple
When to do BSE?
If you are over 35 years old, examine your breast once a month about one week after your period ends. The breasts are softest after menstruation when hormone levels are low.
If you are menopausal, fix a day every month.
Investigations...
Mammography: This low-dose X-Ray of the breast is the most useful in the detection of early breast cancer, and is recommended for women above 45 years.
Ultrasound: This non-invasive test involves passing high-frequency and short wavelength sound waves through the breast tissue.
Treatment
Surgery :Major breast surgery is usually required for the treatment of breast cancer. It involves removal of the whole breast and is known as mastectomy. In most cases, the lymph nodes in the armpit or axilla on the same side are also removed.
The lymph nodes will be sent for microscopic examination to see whether they are affected by cancer. This is important in determining whether further treatment is needed after surgery.
In a few selected patients with small cancers, only part of the breast with the tumour needs to be removed, together with the lymph nodes in the axilla.
Radiotherapy :Surgery together with radiotherapy is usually the treatment for early breast 3 cancer. Radiotherapy destroys cancer cells by destroying their ability to mulitply. Patients on radiotherapy may experience nausea, vomitting or feel exhausted.
Chemotherapy :Sometimes anti-cancer drugs or hormones will be used by the specialist. Chemotherapy can be given as an out-patient or in-patient basis. Side effects include hair loss, skin rash, nausea and vomitting, loss of appetite and general tiredness. Blood tests may have to be done while the patient is on chemotherapy.
Post-Operation Recovery
In order to regain shoulder movements, arm exercises should be started as early as possible. There is no restriction on diet. Drains can be removed once the drainage is minimal. Water-tight dressings should be left on until stitches have been removed ?around the 10th day.
Rehabilitation
Most women after simple mastectomy, are discharged from the hospital within a week. It is common to have tenderness and a feeling of a pulling sensation at the mastectomy site for a few months after surgery. Normal productive lives can resume within a month or two.
The Reach-to-Recover programme offers psychological, physical, cosmetic and additional post-operative support. At the doctor’s request, the Singapore Cancer Society’s Reach-to-Recovery volunter will visit the patient after the operation.
The Reach-to-Recovery volunteer, who herself has had a mastectomy, is living proof of how attractive a person can look, and how good the quality of life can be after a mastectomy.
Breast prothesis
To regain body image, appearance, and self-confidence, an external breast prosthesis made up of silicon may be worn. It looks and feels like a breast. There are various models and sizes to choose from. If you decide to use one, the Breast Care Nurse will asist you during a personalised fitting session, usually six weeks after the operation.
Reconstruction surgery
Recent advances have made a breast reconstruction by plastic surgeons an alternative choice. Besides using silicon or saline for reconstruction, some surgeons are using the patient’s own fat from the abdomen, thus creating a breast while performing a tummy tuck at the same time.
