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Many Malaysians are dying from cancer because the cancer is found in late stages. This is especially true with breast and cervical cancer. With early detection, breast cancer can be found in Stage 1 (lump < 2cm) instead of the current scenario where the cancer is only detected in late Stage II and III when the lump is > 4cm! A simple breast examination can save lives.

Breast cancer is a cancer that starts in the breast, usually in the inner lining of the milk ducts or lobules. There are different types of breast cancer, with different stages (spread), aggressiveness, and genetic makeup. Treatment includes surgery, drugs (hormone therapy and chemotherapy) and radiation.

Worldwide, breast cancer is the second most common type of cancer after lung cancer and the fifth most common cause of cancer death. In 2004, breast cancer caused 519,000 deaths worldwide (7% of cancer deaths; almost 1% of all deaths).

Breast cancer is about 100 times as frequent among women as among men, but survival rates are equal in both sexes.  There are different types of breast cancer, including non-invasive, invasive, recurrent, and metastatic breast cancers. It can begin in different areas of the breast – the ducts, the lobules, or in some cases, the tissue in between.

Early Detection

Early detection is very important to save lives and reduce the suffering. It also can lower the cost of treatment. Early detection means finding the cancer in asymptomatic people when it is in the early stages of the disease. Research has proven that specific examinations and tests at regular intervals can detect cancer before a person displays the obvious symptoms of cancer.

The first symptom or subjective sign, of breast cancer is typically a lump that feels different from the rest of the breast tissue. According to the Merck Manual, more than 80% of breast cancer cases are discovered when the woman feels a lump. According to the American Cancer Society, the first medical, or objective indication of breast cancer as detected by a physician, is discovered by mammogram. Lumps found in lymph nodes located in the armpits can also indicate breast cancer.

Indications of breast cancer other than a lump may include changes in breast size or shape, skin dimpling, nipple inversion, or spontaneous single-nipple discharge. Pain (”mastodynia”) is an unreliable tool in determining the presence or absence of breast cancer, but may be indicative of other breast health issues.

To detect breast cancer in an early stage there are several ways:

1. breast self examinations
   
2. physical examinations by a health professional
3. mammography
4. laboratory tests

Screening Guidelines for the early detection of Breast cancer

Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips.

Here’s what you should look for:

• Breasts that are their usual size, shape, and color
• Breasts that are evenly shaped without visible distortion or swelling

If you see any of the following changes, bring them to your doctor’s attention:

• Dimpling, puckering, or bulging of the skin
• A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)
• Redness, soreness, rash, or swelling

Step 2: Now, raise your arms and look for the same changes.

Step 3: While you’re at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood).

Step 4: Next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a circular motion, about the size of a quarter.

Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage.

Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you’ve reached the deep tissue, you should be able to feel down to your ribcage.

Step 5: Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in Step 4.

If you have or suspect you may have a health problem, you should consult your health care provider.

Examination

Women age 18 – 39:  a monthly breast self examination, a clinical breast examination by a health care professional every 3 years

Women age 40 – 50: a  monthly breast self examination, an annual clinical breast examination, an annual mammogram

Women above 50: A monthly breast self examination, a mammogram every 1-2 yrs depending on the advice of  your health care professional

Women at increased risk (e.g. family history, genetic tendency, past breast cancer) should talk with their doctors about the benefits and limitations of starting mammography screening earlier, having additional tests (e.g. breast ultrasound or MRI) or having more frequent exams.

‘Be Aware. Get Educated. Early Detection Saves Lives’

For more information visit: National Cancer Society Malaysia or Breast cancer Organization

(NCSM and Breast Cancer Organization)