When it comes to breast cancer detection, it’s best to take matters into your own hands.
When it comes to breast cancer detection, it’s best to take matters into your own hands.
Every October, the Breast Cancer Foundation (BCF) ramps up its efforts to rally about breast cancer awareness and you’ll see a pink ribbon perched on a lapel or three. Yet, breast cancer remains the number one killing cancer among women in Singapore—accounting for one in six cancer deaths among females (from 2013 to 2017)—and 30 percent of the cases are detected at Stage 3 or 4, which see poorer prognoses compared to the early stages.
THE FACTS AND FIGURES
The stats paint an optimistic outlook for those with Stage 0 and Stage 1 breast cancer (when atypical cells are contained to the milk ducts and the area where they first began to develop), with relative five-year survival rates of 99 and 90 percent. What that means is that the disease is a highly treatable one—if discovered and dealt with in its early stages.
The tune changes, though, when cancer is diagnosed and treated at later stages. The relative five-year survival rate drops to 80 percent for Stage 2 breast cancer (abnormal cells are growing and/or have spread to nearby tissue or lymph nodes); 72 percent for Stage 3 (cancer cells have spread beyond the breast, but not to distant organs); and 25 percent for Stage 4 (the cancer has spread to other parts of the body, such as the lungs, bones and brain).
Which underscores the importance of early detection and treatment—a key message the BCF has been promoting, through awareness talks, events and publications, since its founding more than two decades ago.
TAKE CHARGE
Resources to help you get your strategy on track
1. BCF.ORG.SG
Find everything you need here, from the hard facts of the disease to empowering testimonials from the women who’ve overcome it, support groups and ways to contribute to the fight.
2. HEALTHHUB.SG/PROGRAMMES/174/BREAST-CANCER-SCREENING
This gives an at-a-glance look at the risk factors for breast cancer and gets you up to speed on your breast cancer screening needs—the cost, the subsidies available, the screening centres and appointment hotlines.
3. CANCER HELPLINE
For times when you need emotional and psychological support, at any point in your cancer journey, simply call in (tel: 6225 5655) or write in (cancerhelpline@nccs.com.sg) for a chat or request for an in-person meetup. This service is free, confidential and manned by multilingual cancer-trained nurse counsellors.
DON’T LEAVE IT TO CHANCE
While mammography is the primary and currently most reliable screening tool for breast cancer, it is recommended only for those above 40, and typically done just once a year for normal-risk women aged between 40 and 49, and once every two years for normal-risk women aged 50 and above. Between regular screenings, make routine breast self-examinations (BSE)—at least once a month—part of your strategy for early breast cancer detection. Those below 40 should also get into the habit of performing BSEs to improve the odds of early detection.
The best time to perform a BSE is seven to 10 days after the start of your menstruation—when your breasts are the least tender. If you no longer menstruate, pick a fixed date every month. The exam itself is easy enough to execute: First, get in front of a mirror and observe your breasts. Stand with your shoulders straight, arms on hips, and note the shape, size and colour of your breasts and nipples; look out for changes in any of the three, such as bruise-like discolorations, swelling or distortion, and nipple inversion or discharge, along with abnormalities in skin texture such as dimpling. Then, raise your arms above your head and repeat the inspection, paying special attention to the underside of your breasts.
Next, use the pads of your three middle fingers—keep them flat and together—to palpate the breasts. Start from the perimeter, working in a circular motion and moving inwards towards the nipple, carefully feeling for lumps or thickened areas. Check for nipple discharge (that is not breast milk) by gently squeezing the nipple. Breast tissue extends to the underarm, so be sure to conduct the exam from armpit to cleavage. The goal here is to feel all of the breast tissue, so use different amounts of pressure—light pressure to examine the tissue closest to the skin, medium pressure to feel a little deeper, and firm pressure for the deeper tissue closer to the chest wall.
This tactile aspect of the BSE should be done in two positions: when you’re standing and when you’re lying down—the breast tissue spreads out evenly over the chest wall when we’re on our backs, making it thinner and easier to feel for abnormalities.
If you have detected a lump, there is no need to panic as nine out of 10 breast lumps are not cancerous. The first thing you should do is see a doctor, who will perform a clinical breast exam and, if needed, further diagnostics—a mammography, an ultrasound or a biopsy—to determine if the lump is benign or malignant.
A UNIVERSAL DISEASE
While not all women have the same risk for developing breast cancer, “all women are at risk of the disease,” says Dr Shyamala Thilagaratnam, Group Director (Outreach) at the Health Promotion Board, with one in 14 women in Singapore diagnosed with it every year.
It doesn’t discriminate against age—while the risk increases with age, women as young as 20 have been diagnosed with it, and one in six women diagnosed here is under 45. Nor does it matter one’s race (the Chinese, Malays and Indians are all susceptible, though incidence rates differ), social status and sexuality. Breast cancer can touch anyone—even males (the National Cancer Centre Singapore saw 32 cases of male breast cancer between 2010 and 2017).
What’s more harrowing is that many breast cancers have no obvious symptoms—pain or visible lumps—in the early stages, which makes it all the more vital to commit to regular mammography capable of detecting lumps before they can be felt by hand. That, coupled with routine BSEs, is really your best defence against breast cancer.
Elizabeth Hurley
A PINK MISSION
Actress Elizabeth Hurley opens up on 25 years of breast cancer awareness campaigning and why she’s staying the course
An ardent advocate of breast cancer awareness, Elizabeth Hurley has been the Global Ambassador for The Estée Lauder Companies’ Breast Cancer Campaign (ELCompanies.com/breastcancercampaign) for over 20 years. Founded in 1992 by the late Evelyn H. Lauder, it aims to raise awareness of breast cancer as well as funds to support global research, education and medical services.
To date, it has raised more than US$89 million worldwide, funded more than 293 medical research grants, and supports over 60 breast cancer organisations globally. We talk to Hurley about the pink ribbon movement, being on the campaigning trail and just how far breast cancer awareness has come.
You’ve been advocating for breast cancer awareness for more than two decades. Tell us more about how your journey started: What was your first thought when Evelyn Lauder approached you to join the campaign and did it take much convincing for you to join the cause?
When Evelyn first asked me to join the Campaign, it was shortly after I had lost my grandmother to breast cancer. She passed away from breast cancer during a time when women did not speak openly about the disease. In fact, we didn’t even know she had it until she was very ill. I immediately said yes and wanted to do whatever I could, knowing that it was an opportunity to affect the lives of so many while honouring my own family’s history with the disease.
What’s your fondest memory of campaigning with Lauder?
There are so many—Evelyn was such a wonderful woman and we shared some very special moments together through our work. Seeing her passion as a champion for women’s health to truly make a difference through both the Breast Cancer Campaign and the Breast Cancer Research Foundation was remarkable. Whether it was something she did on a large scale or how she connected one-on-one with those personally touched by breast cancer, she was committed to saving lives and truly made a lasting, positive impact on people everywhere. She gifted me my first mammography on my 40th birthday and I’ve been getting one yearly ever since. She will always be an inspiration to me.
What’s the most common misconception about breast cancer you’ve come across?
That it only affects women. In fact, men can also be diagnosed with breast cancer and are more likely to have a fatal diagnosis. We must also not forget the important role that men play as supporters and caretakers to loved ones with the disease. Breast cancer truly touches us all and we must remain united around all of those affected.
What’s the biggest change you’ve seen over the years?
Breast cancer is no longer a disease only spoken about in whispers. We’ve come a long way and real positive impact has been made. I first started working with Evelyn on the Breast Cancer Campaign at a time when women around the world were dying from breast cancer and no one was talking about it. Today, we’re aware of the disease; it’s more openly discussed both by people and in the media, and early detection is saving lives—early-stage breast cancer has more than a 90 percent (relative five-year) survival rate when diagnosed and treated. The pink ribbon, which Evelyn co-created in 1992, the same year she started the Breast Cancer Campaign, inspired a movement and is now a globally recognised symbol for breast health.
Why do you feel it’s important to continue your work?
It remains that every 15 seconds, somewhere in the world, a woman is diagnosed with breast cancer. Our work must continue to inspire action, unite the global community and fund research to bring us closer to our mission of a breast cancer-free world. My grandmother’s story, along with those of so many others I know personally with breast cancer, has made my advocacy for awareness of the disease my most important life’s work.
PHOTOGRAPY: 123RF
