Breast cancer is the most common cancer and the number one cause of cancer deaths among
women in Malaysia. It is caused by an uncontrolled growth of cells within the breast tissue.
If not detected and treated promptly, breast cancer can metastasize, spreading to the lymph
glands and other parts of the body, including lungs, bones and liver. This leads to various organ
failures, subsequently death.
Prevalence of breast cancer in Malaysia
- A woman in Malaysia has a 1 in 20 chance of getting breast cancer in her lifetime.
- About 4,000 women are diagnosed each year, mostly between 35-60 years old.
- The cumulative life time risk of developing breast cancer:
1 in 16 for Chinese women, 1 in 17 for Indian women, 1 in 28 for Malay women
Treatment for breast cancer
As breast cancer can be easily detected, you can do your bit to ensure that if it develops, it is
detected and treated early. Most women with early breast cancer go on to live long, healthy and
normal lives. To achieve the best outcome, doctors sometimes recommend a combination of
This removes the cancer and some surrounding normal tissue to ensure a margin of safety.
There are two ways of doing this:
- Lumpectomy – only a small or affected section of the breast is removed.
- Mastectomy – all the breast tissue is removed. With this type of treatment, a woman can opt to have breast reconstruction to surgically rebuild the breast.
High-powered x-ray waves are directed at the cancer site and surrounding tissue to help destroy
any remaining cancer cells.
Drugs or hormonal therapy are used to help destroy any remaining cancer cells.
According to the World Health Organisation’s International Agency for Research on Cancer, regular mammogram screening could reduce deaths from beast cancer by 35%.
A mammogram…can be used to detect breast cancer in women who have no signs or symptoms…it is called a screening mammogram. When it is used for diagnosis in women who have signs and symptoms… it is called a diagnostic mammogram.
Who is to have a mammogram is determined by the factors that increase a woman’s risk of breast cancer. Age is the most significant risk factor. The older a woman is, the greater the risk. However, the risk is not the same for all women in a certain age group. Women with the following risk factors are at increased risk:
- Personal history – women who have had breast cancer are more likely to develop another breast cancer.
- Family history – whose mother, sister and/or daughter have breast cancer, particularly if it occurred before 50 years of age. It is also increased if a male relative has breast cancer.
- Genetic history – women who have the BRCA1 and BRCA2 genes. Those who have certain changes in these genes have more risk than those without the changes.
- Menstrual history –whose first menstrual period occurred before 12 years of age, or menopause occurred after 55 years of age.
- Reproductive history – women who delivered a baby after 30 years of age or never delivered a baby.
- Hormone therapy – women who use combined oestrogen and progestogen hormone therapy for more than five years. Women who took diethylstilbestrol (DES) to prevent miscarriage may have a slightly increased risk.
- Radiation therapy – women who had radiation therapy to the chest, including the breast before 30 years of age.
- Body weight – overweight or obese.
- Physical activity – physical inactivity throughout life.
- Alcohol consumption-the greater the consumption, the greater the risk.
- Breast density – women with dense breast tissue.
- Breast biopsy changes – women with increased abnormal but non-cancerous cells (atypical hyperplasia), abnormal but non-invasive cells in the lobules (lobular carcinoma in situ), and in the ducts (ductal carcinoma in situ).
Benefits and risks of mammograms
- Early detection and treatment outweigh the small risk of radiation from the procedure…. less than one in 25,000 chance of the radiation from a mammogram causing breast cancer. Breast screening programmes report between 5 and 10 breast cancers…for every 1,000 women screened, the majority of which are at an earlier, curable stage.
- Detection of cancer does not necessarily mean that lives are saved. A rapidly growing breast cancer may have spread by the time it is detected by mammography.
- May be false negative results, i.e. the mammogram appears normal, when in fact, there is a cancer present… the false negative rate for a screening mammogram can be as high as 20%. The major cause… is increased breast density.
- May be false positive results, i.e. the mammogram is diagnosed as abnormal, when….there is no cancer present… results in additional investigations, i.e. diagnostic mammograms, ultrasound and/or biopsy.
Breast ultrasound complements mammograms… It is a useful procedure if the breast is dense or if the doctor wants to know whether a lump is solid or contains fluid. It also facilitates needle aspiration or biopsy of a suspected abnormal area.