In honour of Breast Cancer Awareness Month, breast surgeon DR GEORGETTE CHAN shares three key things about breast cancer symptoms and breast screening – including 3D mammography – to help inspire awareness, empowerment and hope. Plus, what to do if you find a lump in your breast.
#1 Not all breast lumps are cancerous
“Symptoms of breast cancer are quite variable. The most common breast cancer symptom is a painless lump in the breast. But, breast cancer can also present itself as persistent breast swelling, continual skin thickening or breast dimpling, or new lumps in the armpit,” explains Dr Chan. “Patients should also pay attention to nipple changes such as a new onset of nipple retraction, persistent rash over the nipple or bloody discharge from the nipple.”
She recommends doing regular breast self exams so that you’re familiar with your own breasts and can recognise any changes or early warning signs of breast cancer.
“A monthly breast self exam allows us to detect even subtle changes – things like lumps, nipple retraction or skin dimpling. Young women should ideally start doing this in their twenties to become familiar with how their own breasts feel. Seven to ten days after the start of your menses is the best time, when the breasts are least sensitive.”
If you do find a lump in your breast, don’t panic! She says 90 percent of lumps detected in the breast are benign.
“If you find one while you’re close to your period, it could be due to temporary hormonal changes, as can breast pain. So, I suggest waiting to do the breast self exam until after your period to see if it’s still there. If it is, go to see your GP or a breast specialist.”
#2 Early detection with breast screening can save lives
Early detection means earlier treatment, which ultimately means a better chance of survival. In fact, early discovery is associated with a 20 percent drop in breast cancer mortality, explains Dr Chan. An early diagnosis can also reduce the need for major surgery, and hopefully avoid the need for chemotherapy – which is why she says that routine breast screening is so important for all women, whether they’ve got symptoms or not.
Dr Chan recommends yearly screenings from the age of 40 – or earlier if there’s a family history of breast cancer – and once every two years from the age of 50, as a screening mammogram can detect cancer in the breast even before the tumour can be felt or cause any symptoms. She typically uses methods like ultrasound and magnetic resonance imaging (MRI) for further evaluation, or in conjunction with mammography – particularly for those women at high risk.
“In my opinion, the most effective tool for detecting breast cancer is a mammogram – a special type of x-ray that reveals any changes and abnormalities in the breast tissue. It has an accuracy rate as high as 90 to 95 percent, and has proven effective in detecting cancers early, even before any symptoms present.”
#3 Advancements in breast screening have made detection more effective
Recent developments in mammography have made breast screening more effective than it’s ever been, says Dr Chan. One such advancement is 3D mammography, which is an extension of a digital mammogram. It involves compressing the breast like 2D mammography, then taking multiple low- dose x-ray images. These images are combined to give a three-dimensional picture of the breast, in addition to the standard 2D views.
While 3D mammography is not yet available at every clinic in Singapore, Dr Chan is among the doctors who are currently using it alongside 2D mammography, breast ultrasounds and MRI scans.
She says the advantages include better resolution, a higher accuracy of breast cancer detection and lower false positive rates. Plus, clearer views make it possible to evade unnecessary biopsies. “3D mammography is a particularly beneficial screening tool for patients who have a high risk of developing breast cancer. This includes those with a strong family history, known genetic mutation or previous breast biopsy with atypical findings.”
Dr Georgette Chan
#11-09 Mount Elizabeth Medical Centre, 3 Mount Elizabeth
6836 5167 | georgettechan.com.sg
This article first appeared in the October 2022 edition of Expat Living. You can purchase the latest issue or subscribe, so you never miss a copy!