Facts and Myths of Breast Cancer

Dr Radhika Lakshmanan is a general surgeon and breast specialist who has over 20 years of clinical experience in providing care and management for patients for a wide spectrum of breast conditions. In this article, we summarise the facts and myths of breast cancer shared by Dr Radhika in her webinar.

Myth 1 – Breast cancer occurs in older women
Fact 1 – We do not know the cause of breast cancer. In Asia, 19% of breast cancer cases occur in women between 20 and 44 years of age. The other peak occurs in women who are between their late 40s and 69 years of age. These two age ranges encompass a good proportion of women. Hence, breast cancer does not necessarily occur only in older women.

Myth 2 – My family has no history of breast cancer, hence I don’t have to worry
Fact 2 – Breastcancer.org shares that about 85% of breast cancer cases occur in women who have no family history of breast cancer. These occur due to genetic mutations that happen as a result of the aging process and life in general, rather than inherited mutations. Only 5–10% of breast cancers can be linked to known gene mutations inherited from one’s mother or father.

Myth 3 – Cancer usually presents itself with a lump
Fact 3 – Do you know that only 70% of cancer diagnoses present with a lump? Breast cancer can also show symptoms in other ways, such as nipple discharge, itches, breast deformity or pain. Other symptoms are ‘silent’. Since we are unable to diagnose and detect breast cancer on our own, screening is important.

Early and regular screening is important. It enables early breast cancers to be detected before symptoms appear. With early detection, the chances of survival can be greatly increased.

The Screen for Life Breast Cancer Screening programme has been screening Singaporean women since 2002. The best way to protect yourself from breast cancer is having regular routine breast examinations by an experienced primary healthcare professional. No screening test is perfect, including the mammogram. Some of the limitations of mammograms include their inability to obtain good imaging of women with small and dense breasts and younger women, because their breasts tend to be denser. Sometimes, the mammogram may pick up an abnormality that looks like cancer, but upon further investigation, the results turn out to be normal. Hence, where necessary, the healthcare professionals may also recommend other forms of breast imaging, such as breast ultrasounds, tomosynthesis (3-D mammograms) or magnetic resonance imaging (MRI).

Myth 4 – Mammograms increase the risk of cancer
Fact 4 – An article by SingHealth Duke-NUS Breast Centre addresses the concerns of radiation exposure from a mammogram:

“Radiation exposure from mammograms is low, equivalent to 6 months of background radiation exposure from daily living. The risk of harm is low, and the benefits outweigh the risk of having a cancer undetected and allowed to progress till symptoms appear when the cancer is more advanced.”

To summarise: Without screening, there is a risk of missing a diagnosis, especially for cancers with no symptoms.

The benefits of early detection far outweigh the risks of scans.
The survival rate for breast cancer has improved over the years. According to the Singapore Cancer Registry report released in 2017, Stage I breast cancer patients have a 5-year survival rate of 90% while Stage II patients have a 5-year survival rate of 80%. This is vastly different from the 1960s, when the overall survival rate was approximately 63%.

Breast cancer is not a death sentence. Despite an increasing number of diagnosed cases, advances in diagnostic techniques and an increase in effective treatment options have significantly improved breast cancer survival rates.

Conclusion
The best way to separate fact from myth is to talk to your doctor. It is important to see the right specialist.

If you spot a lump in your breast after a self-examination or find anomalies such as nipple discharge, itches, breast deformity or pain, it is recommended you see a breast surgeon for further evaluation.

“Cancer is indiscriminate, so do not be complacent even if you think you are not at risk. For example, if you got married early or had children at a young age and breastfed for 6 months … There are still risks due to a surge of hormones. This is why many women find it unbelievable when diagnosed (with breast cancer).”
- Dr Radhika Lakshmanan