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Breast cancer is the most common cancer among Singaporean women. KK Women’s and Children’s Hospital and National Cancer Centre Singapore experts explain the disease and provide the latest solutions.
 Breast cancer is definitely on the rise in Singapore and around the world. It has quickly become the new buzzword of the medical world.
Chances are, you know someone with breast cancer or maybe you have it yourself. In Singapore alone, almost 1,100 new cases are diagnosed each year, while about 250 women die from breast cancer every year. It is estimated that 1 out of 12 women will be affected by 2012. The bad news is no one is spared – the rising incidence of the disease is consistent across the 3 major ethnic groups.
The most common symptom of breast cancer is a lump in the breast. It is usually single, firm and most often painless. Other tell-tale symptoms include swelling on a portion of the skin on the breast or underarm; a previously protruding nipple that becomes inverted, a persistent rash at the nipple or areola, blood stained discharge from the nipple; and a change in the size or shape of the breast. The good news is that breast cancer is treatable and curable when detected at its earliest stage. Therefore, it is important that women aged 40 years and above do regular breast checks, which include once or twice yearly mammography, monthly breast self-examination and annual physical examination by a doctor.
Breast cancer treatments
w Lumpectomy
Lumpectomy is a popular type of breast cancer surgery that removes the cancerous cells, but leaves most of the breast intact. A course of radiotherapy to the preserved breast is required after surgery. The downside is that not all patients are suitable for lumpectomy. These include patients who have large or extensive cancers or patients who are not able to receive radiotherapy.
w Mastectomy
A mastectomy involves surgical removal of the entire breast. Sometimes, the surgeon will also remove the lymph nodes or lymph tissue in the armpit area, depending on the type of breast cancer.
A mastectomy is performed if the breast cancer is too extensive or present in different areas of the same breast, or if the patient cannot receive radiotherapy. In rare cases, a mastectomy is performed on patients with massive benign breast tumours that occupy the entire breast or are aggressive with multiple recurrences.
Unfortunately, it can alter the body profile of women and affect their self-image.
w Breast reconstruction
Breast reconstruction is usually performed immediately after a mastectomy. The breast is reconstructed by filling the breast skin with tissue from the lower abdomen or back, or with an implant. The first stage involves creating the breast form and the second, reconstructing the nipple and areola.
The most common method of reconstruction is the TRAM flap, which uses skin and fatty tissue from the lower abdomen. The flap is nourished by blood supply from one of the paired abdominal muscles. Since living tissue is used, the advantage is that it is warm and soft, and moves and feels like a normal breast. The other plus point is that the patient receives a tummy tuck at the same time.
Another reconstruction technique utilises skin and fatty tissue taken from the patient’s back. It is usually used for women with smaller breasts. A flap of skin and muscle from the back on the same side as the operated breast is used to create a new breast. Like the TRAM flap, living tissue taken from the back will feel and look natural.
Breast implants containing silicone or saline are also used for breast reconstruction. The surgery is fast and recovery time is short. Plus, there are no scars on other parts of the body. However, although they may look natural, they seldom feel as natural as those reconstructed with body tissue. Implants may also need maintenance surgery at a later date due to hardening and leakage.
The final part of breast reconstruction is constructing the new positions of the nipple and areola. Nipples are created with the existing tissue on the breast skin or a small graft from the opposite nipple. The dark colour of the nipple and areola is produced with a skin graft usually taken from the groin or labia region, or by tattooing.
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Tips For Lowering Your Risk of Breast Cancer
Maintain a healthy body weight (BMI less than 25) throughout your life. Weight gain after menopause has been shown to increase the risk of breast cancer.
Minimise or avoid alcohol. Alcohol is the most well established dietary risk factor for breast cancer.
Consume 7 or more servings of cruciferous vegetables (broccoli, cabbage, cauliflower), dark leafy greens, carrots, tomatoes, citrus fruits, berries and cherries.
Exercise regularly throughout your life. Aim for 30 minutes or more of moderate aerobic activity 5 or more days a week.
If possible, have your first child before 30 and breastfeed.
Limit the use of combined HRT. | |
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