Breast Cancer

Breast cancer is the uncontrolled growth of abnormal cells in the breast. It originates from the cells lining the milk ducts and glands of the breast.

It is the most common cancer in females. It can invade the surrounding tissue and then gain entry to the lymph nodes or the bloodstream. This will allow it to spread to other organs, forming new tumours there known as metastases.

Breast cancer can generally be classified as:

• Non-invasive breast cancer (Carcinoma-in-situ)
• Invasive breast cancer

Non-invasive breast cancer is confined to the ducts or lobules that it originates from. On the other hand, invasive cancer spreads beyond the ducts or lobules into the surrounding breast tissue.

Symptoms of breast cancer include:

• A painless, immobile lump in the breast,
• Persistent rash around the nipple
• Bleeding or unusual discharge from the nipple
• Swollen or thickened skin of the breast
• A small dent or a wrinkled and folded area of skin on the breast
• A nipple that is drawn inwards

It is important for women to recognise and treat breast cancers early. If anyone discovers such symptoms, it is advised that they seek medical advice as soon as possible.

Women over the age of 40 are recommended to go for regular breast screenings, which includes a regular mammogram. It is also encouraged that they also conduct regular breast self-examinations once a month. Early detection is important as more treatment options will be available, and chances of recovery are increased.

A mammogram is a low-dose X-ray examination of the breast. It is the most reliable way to detect a tumour in the breast, allowing for lumps to be detected before they are felt by hand. This allows the doctor to pick up very small breast cancers. In this screening, the breast is gently flattened between two plates of the X-ray machine. This allows for a good X-ray image to be taken as the breast tissue will be spread apart. The doctor check the X-ray images for any abnormalities. A sample of tissue from these abnormalities, known as a biopsy, may need to be taken to check if there is any cancer there.

Women aged 50 and above should have a mammogram done once every two years, while women from the age of 40 to 49 can go for a mammogram once a year after discussing the benefits and limitations with their doctor.

The risk of developing breast cancer increases with age, especially after age 50. The other risk factors would include:

• Having a mother, sister or daughter who have had that has breast cancer
• Having a history of a previous malignant or non-cancerous breast disease
• Having a history of ovarian cancer
• Menstruation at a young age
• Late menopause
• Having few or no children
• The use of hormone replacement therapy
• Obesity, or weight gain especially after menopause

Treatment options for breast cancer depends on what type of cancer cells are involved, whether the stage of breast cancer is early or late, and also the age and general health of the individual. In the early stages, only surgery may be required. In the later stages, a few treatment options may need to be used in combination. Treatment is multidisciplinary, personalised and precise and there are a variety of treatment options available. These may include the following, and possibly in combination:

• Surgery
• Radiation therapy including:
  • 3D-conformal radiotherapy
  • Intensity Modulated Radiotherapy
  • Stereotactic Radiosurgery
• Targeted Therapy
• Chemotherapy
• Hormone Therapy
• Immunotherapy

Once the diagnosis is made, a consultation with an oncologist is essential in order to understand which treatment options are the most suitable. AARO oncologists are trained in both cancer drug and radiation treatment to provide a holistic assessment.