Breast cancer is the most common type of cancer among women in Singapore today. 1 out of every 13 women in Singapore is likely to be afflicted by breast cancer.
Normal cells divide and reproduce in an orderly manner. Your body relies on this orderly activity to repair injuries and replace wornout tissue. Sometimes this orderly process is disrupted. Cells grow and divide out of control, producing extra tissue to form a mass or lump called a tumour. A tumour can be benign or malignant.
Benign tumours are not cancers. They may grow slowly but do not spread to other parts of the body.
Malignant tumours are cancerous growths and have the potential to spread to other parts of the body.
Breast cancer is a malignant tumour which occurs when breast cells become abnormal and divide without control or order.
The majority of breast cancers start in the milk ducts. A small number start in the milk sacs or lobules. Within these two groups, some grow very slowly while others develop more rapidly.
Breast cancer can spread to the lymph nodes and to other parts of the body such as the bones, liver, lung and sometimes to the brain.
Screening simply means performing a procedure or test to detect an abnormality before symptoms appear. This allows problems to be detected earlier, investigated and treated early.
Breast screening methods include:
A. Breast Self-Examination Breast Self-Examination (BSE) is recommended once a month about 1 week from the first day of menses. For women who no longer menstruate, choosing a date each month is an easy way to remember. Report to the doctor any breast changes such as redness, swelling, presence of a lump, skin changes or discharge from the nipple.
Self-awareness of breast changes through regular BSE and being familiar with what is normal and stable is useful to detect abnormalities.
B. Clinical Breast Examination
Have a doctor or breast specialist nurse examine your breasts once every year if you are 40 years and above. This includes a visual examination and a manual check of the entire breast and underarm area for changes. Changes in the breast may not be due to cancer and diagnostic tests may be performed to assess these changes.
C. Mammogram Screening
Mammography is a low-powered X-ray technique that gives an image of the internal structure of the breast. Usual screening mammograms involve taking X-ray images with the breast compressed between two plates with two views taken — cranial caudal or horizontal and mediolateral oblique or diagonal.
Mammograms take an image of the internal structure of the breast and can help detect abnormalities.
Additional angles and magnified views may be taken if there are areas of concern. It can detect the presence and position of abnormalities and help in the diagnosis of breast problems, including cancer.
The risk of developing breast cancer increases with age. Women with risk factors such as a family history of breast cancer should discuss with their doctors when to go for and the interval of regular screening.
There are other tests such as breast ultrasound, tomosynthesis and MRI, available for assessment of the breasts.
These are not used for regular screening in well women and are used for further evaluation after initial screening mammogram, but may be considered for women with high risk of breast cancer.
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