BY DATO DR. JASWANT SINGH
KPJ SABAH SPECIALIST HOSPITAL
WHAT IS CANCER?
“A large group of disease characterized by uncontrolled growth and spread of abnormal
cell which is not checked results in death.”
RISK FACTORS OF BREAST CANCER
1) Getting older
The older a woman gets, the higher is her risk of developing breast cancer; age is a risk factor. Over 80% of all female breast cancers occur among women aged 50+ years (after the menopause).
2) Genetics
Women who have a close relative who has/had breast or ovarian cancer are more likely to develop breast cancer. If two close family members develop the disease, it does not necessarily mean they shared the genes that make them more vulnerable, because breast cancer is a relatively common cancer. The majority of breast cancers are not hereditary.
Women who carry the BRCA1 and BRCA2 genes have a considerably higher risk of developing breast and/or ovarian cancer. These genes can be inherited. TP53, another gene, is also linked to greater breast cancer risk.
3) A history of breast cancer
Women who have had breast cancer, even non-invasive cancer, are more likely to develop the disease again, compared to women who have no history of the disease.
4) Having had certain types of breast lumps
Women who have had some types of benign (non-cancerous) breast lumps are more likely to develop cancer later on. Examples include a typical ductal hyperplasia or lobular carcinoma in situ.
5) Dense breast tissue
Women with denser breast tissue have a greater chance of developing breast cancer.
6) Estrogen exposure
Women who started having periods earlier or entered menopause later than usual have a higher risk of developing breast cancer. This is because their bodies have been exposed to estrogen for longer. Estrogen exposure begins when periods start, and drops dramatically during the menopause.
7) Obesity
Post-menopausal obese and overweight women may have a higher risk of developing breast cancer. Experts say that there are higher levels of estrogen in obese menopausal women, which may be the cause of the higher risk.
8) Height
Taller-than-average women have a slightly greater likelihood of developing breast cancer than shorter-than-average women. Experts are not sure why.
9) Alcohol consumption
The more alcohol a woman regularly drinks, the higher her risk of developing breast cancer is. The Mayo Clinic says that if a woman wants to drink, she should not exceed one alcoholic beverage per day.
10) Radiation exposure
Undergoing X-rays and CT scans may raise a woman’s risk of developing breast cancer slightly. Scientists at the Memorial Sloan-Kettering Cancer Center found that women who had been treated with radiation to the chest for a childhood cancer have a higher risk of developing breast cancer.
11) HRT (hormone replacement therapy)
Both forms, combined and estrogen-only HRT therapies may increase a woman’s risk of developing breast cancer slightly. Combined HRT causes a higher risk.
DIAGNOSIS
1) Breast examination
The physician will check both the patient’s breasts, looking out for lumps and other possible abnormalities, such as inverted nipples, nipple discharge, or change in breast shape. The patient will be asked to sit/stand with her arms in different positions, such as above her head and by her sides.
2) X-ray (mammogram)
Commonly used for breast cancer screening. If anything unusual is found, the doctor may order a mammogram. High risk ladies should have first mammogram at the age of 45 years old. For normal population, suggested after the age of 50 years old.
3) Breast ultrasound
This type of scan may help doctors decide whether a lump or abnormality is a solid mass or a fluid-filled cyst.
TREATMENT
1) Lumpectomy
Surgically removing the tumor and a small margin of healthy tissue around it. In breast cancer, this is often called breast-sparing surgery. This type of surgery may be recommended if the tumor is small and the surgeon believes it will be easy to separate from the tissue around it.
2) Mastectomy
Surgically removing the breast. Simple mastectomy involves removing the lobules, ducts, fatty
tissue, nipple, areola, and some skin. Radical mastectomy means also removing muscle of the chest wall and the lymph nodes in the armpit.
3) Breast reconstruction surgery
A series of surgical procedures aimed at recreating a breast so that it looks as much as possible like the other breast. This procedure may be carried out at the same time as a mastectomy. The surgeon may use a breast implant, or tissue from another part of the patient’s body.
4) Radiation therapy (radiotherapy)
Controlled doses of radiation are targeted at the tumor to destroy the cancer cells. Usually, radiotherapy is used after surgery, as well as chemotherapy to kill off any cancer cells that may still be around. Typically, radiation therapy occurs about one month after surgery or chemotherapy. Each session lasts a few minutes; the patient may require three to five sessions per week for three to six weeks.
The oncologist will decide the radiation treatment that she may have to undergo based of the stage of breast cancer the woman has. In some cases, radiotherapy is not needed
5) Chemotherapy
Medications are used to kill the cancer cells - these are called cytotoxic drugs. The oncologist may recommend chemotherapy depending on the stage of the cancer.
Neo adjuvant is chemotherapy given before surgery to downstage the tumor.
Adjuvant is chemotherapy given after surgery.
PREVENTION & REDUCING RISK
• Reducing risk is WITHIN OUR CONTROL
• Take initiative to control your life style with:
• Regular EXERCISE
• Avoiding excessive SUN exposure; Use sun barrier cream
• STOP smoking
• REDUCE food fat content
• REDUCE red meat
• Eat MORE vegetables & fruit
• REDUCE alcohol consumption
• Regular SCREENING for colorectal, breast, cervical & prostate cancer
For more information, please contact KPJ Sabah Specialist Hospital at 088-322 000. Find them at Lorong Bersatu, Off Jalan Damai, Luyang, Kota Kinabalu, Sabah. Website: www.kpjsabah.com
For the complete article about this subject can be read on this October to December 2016 issue of Parents Avenue Magazine.
*Disclaimer: All information is for your general reference only. We (Parents Avenue) do not accept any responsibility whatsoever in respect of such information.
