Be proactive about your breast health

[WORLD] Breast cancer continues to be a significant health concern for women worldwide, particularly in Malaysia. As we navigate the complexities of this disease, it's crucial to arm ourselves with knowledge about breast health, risk factors, and the importance of early detection. This comprehensive guide will explore the various aspects of breast awareness, helping you understand what to look for and when to seek medical attention.

The Importance of Breast Cancer Awareness

October has long been recognized as Breast Cancer Awareness Month, a global initiative that began in the 1980s. This annual campaign aims to educate the public about breast cancer prevention, early detection, and raise funds for ongoing research. In Malaysia, the significance of this awareness cannot be overstated.

According to the National Cancer Registry, "Breast cancer is the most common cancer in Malaysian women with a lifetime risk of one in 23 for all females, one in 26 for Malays, one in 19 for Chinese, and one in 17 for Indians". These statistics highlight the pressing need for increased awareness and proactive measures in breast health management.

Understanding Breast Cancer Risk Factors

Breast cancer risk is influenced by a combination of factors, some of which are beyond our control, while others can be modified through lifestyle choices. Let's explore these risk factors in detail:

Non-Modifiable Risk Factors

Age and Gender: Being female and increasing age are the main risk factors for breast cancer. The incidence rate rises significantly with age, as evidenced by Malaysian statistics: "The age-specific incidence rate increases from 62.9 at 40-44 years to 94.3 at 45-49 years, 114.6 at 50-54 years, 132.3 at 55-59 years, 145.8 at 60-64 years, and 149.9 at 65-69 years".

Genetic Predisposition: Mutations in genes such as BRCA1 and BRCA2 can significantly increase breast cancer risk.

Family History: A history of breast or ovarian cancer in close relatives, especially if diagnosed at a young age, can elevate risk.

Personal History: Women who have previously had breast cancer or certain benign breast conditions face an increased risk of developing the disease again.

Menstrual History: Early onset of menstruation (before age 12) or late menopause (after age 55) can increase risk due to prolonged hormone exposure.

Modifiable Risk Factors

Lifestyle Choices: Regular exercise, maintaining a healthy weight, and breastfeeding can help reduce breast cancer risk.

Alcohol Consumption: Limiting alcohol intake is advisable, as excessive consumption has been linked to increased breast cancer risk.

Hormone Therapy: Prolonged use of hormone replacement therapy, particularly combined estrogen-progestin therapy, may increase risk.

Radiation Exposure: Previous chest radiation therapy, especially before age 30, can elevate breast cancer risk later in life.

Recognizing Breast Changes and Symptoms

Being aware of changes in your breasts is crucial for early detection. Dr. Milton Lum, a past president of the Federation of Private Medical Practitioners Associations and the Malaysian Medical Association, emphasizes the importance of breast awareness: "Breast awareness refers to the regular look out for any breast changes. Some women prefer breast self-examinations, which can be helpful. However, the most important action is routine monitoring of the breast for any abnormality and seeking medical attention if there are any concerns".

Key symptoms to watch for include:

• Changes in nipple appearance or skin around the areola
• Abnormal or bloody nipple discharge
• A lump or thickening in the breast
• Change in breast color or skin texture
• Pitting of the breast skin
• Pain in the breast or nipple

It's important to note that these symptoms don't necessarily indicate cancer, but they warrant prompt medical attention for proper evaluation.

The Importance of Early Detection

Early diagnosis of breast cancer is crucial for improved treatment outcomes and survival rates. In Malaysia, there's a pressing need for earlier detection, as "Half (50.5%) of Malaysian women had advanced disease at diagnosis with 28.3% and 22.2% in stages 3 and 4 respectively, compared to 15.1% and 34.4% in stages 1 and 2 respectively".

Early detection offers several benefits:

• Less intensive treatment options
• Improved effectiveness of treatment
• Higher survival rates
• Better quality of life during and after treatment

Breast Cancer Screening Methods

Regular screening is essential for early detection. The most common screening methods include:

Mammography: A low-dose X-ray of the breast that can detect abnormalities before they become palpable.

Clinical Breast Examination: A physical examination performed by a healthcare professional.

Breast Self-Examination: While not a substitute for mammography or clinical exams, regular self-exams can help women become familiar with their breasts and more likely to notice changes.

Ultrasound: Often used in conjunction with mammography, especially for women with dense breast tissue.

MRI: Recommended for women at high risk due to genetic factors or family history.

Breast Cancer Treatment and Support

If diagnosed with breast cancer, it's crucial to understand that treatment options have significantly improved over the years. Treatment typically involves a multidisciplinary approach, which may include:

• Surgery
• Radiotherapy
• Chemotherapy
• Hormone therapy
• Targeted therapies

Dr. Lum emphasizes the importance of comprehensive care: "Measures that address issues like mental well-being, sex, nutrition, counselling, etc, facilitate treatment completion and improved outcomes. As such, it is important that care is provided by a multidisciplinary team of healthcare providers".

Support groups can play a vital role in the breast cancer journey. They provide emotional support, practical advice, and a sense of community. In Malaysia, organizations like the National Cancer Society Malaysia, Breast Cancer Welfare Association Malaysia, and Breast Cancer Foundation offer valuable resources and support networks.

Moving Forward: Improving Breast Cancer Outcomes in Malaysia

While Malaysia has made strides in breast cancer awareness and treatment, there's still room for improvement. The World Health Organization's Global Breast Cancer Initiative aims to have more than 60% of cases diagnosed at stages 1 or 2, with timely diagnostic evaluation and comprehensive treatment for over 80% of cases5.

To achieve these goals, concerted efforts are needed from healthcare providers, policymakers, and the public. This includes:

• Increasing public awareness about breast cancer prevention and early detection
• Improving access to screening and diagnostic services
• Enhancing the capacity of healthcare systems to provide timely and comprehensive breast cancer care
• Promoting research to improve breast cancer prevention, detection, and treatment

Breast awareness is a crucial component of women's health. By understanding the risk factors, recognizing potential symptoms, and participating in regular screening, we can significantly improve breast cancer outcomes. Remember, early detection saves lives.

As Dr. Lum aptly states, "Early care is better care". Take charge of your breast health today by staying informed, performing regular self-exams, and seeking prompt medical attention for any concerns. Together, we can work towards a future where breast cancer is detected early, treated effectively, and ultimately, prevented.