Breast cancer is one of the top cancers among women. Most of us would know someone who has, or has had breast cancer, and with the ongoing media coverage of the condition, women are becoming increasingly aware of the condition. National breast screening programmes, dedicated breast clinics, advances in modern treatment methods together with ongoing research, all play their part in the early detection and successful treatment of breast cancer.
Screening For Breast Cancer Would Include:
1. Breast Self-Examination: Large scale studies have found that breast self-examination (BSE), when used for screening, did not reduce mortality rates from breast cancer. However, it is felt that BSE does improve women's awareness of their own breasts, thus allowing any changes to picked up earlier. BSE also helps improve women's awareness of breast cancer.
There are 2 parts to Breast Self-Examination:
(i) LOOK: Look at your breasts in the mirror to check for any changes. This should be done in various positions, such as leaning forward, holding your arms up in the air and with your hands pushing in on the hips. Compare both breasts.
Look for changes on the skin of the breasts (colour, dimpling, a lump or pulling in). The nipples should also be inspected for retraction, inversion, dryness or ulceration.
(ii) FEEL: Many women find it easier to do this while having a bath, because water and soap make it easier and may enhance detection of lumps. Feel all parts of your breasts with the flat of the palm and fingers, for areas that may be different from the rest (such as a lump, a band of hard tissue or a tender area). Remember to also check under the nipples and up into the armpits.
2. Clinical Breast Examination: Women who have found any change in their breast/breasts should consult their doctors for a clinical breast examination.
3. Mammography: The basic idea behind breast cancer screening, or any other screening for that matter, is that it allows for detection of the breast cancers before they become large enough to be felt. Early detection and treatment generally results in better treatment outcomes.
Mammography screening is widely accepted as appropriate and beneficial for women above the age of 50. In Singapore, the recommendations by the Ministry of Health for Breast Cancer Screening are as follows:
Asymptomatic women 50 - 69 years
All normal risk, asymptomatic women 50 - 69 years should have screening mammograms only every 2 years.
Asymptomatic women 40 - 49 years
Women aged 40 - 49 years with no significantly increased risk, should discuss the benefits, limitations and potential harms associated with screening with their doctors before making a decision on whether or not to have screening.
Asymptomatic women < 40 years
Normal risk, asymptomatic women under 40 years of age do not require breast screening.
Asymptomatic women > 70 years
Unlike in Western nations, where evidence supports mammographic screening every 2 years in women 70 - 75 years of age, the incidence of breast cancer in this age group among Singaporean women is significantly lower. As such, screening mammography may be less beneficial. Asymptomatic women in this age group should discuss the potential benefits and risks of screening with their doctor.
The following groups of women should consult their doctor about screening for breast cancer:
• Women who have increased genetic risk for cancers
• Women on hormone replacement therapy
• Women with prior breast cancer
• Women with premalignant breast conditions
Dr Ang C.D. has been in medical practice for over 12 years. He graduated with an M.B.B.S. degree from the National University of Singapore in 1997 and subsequently completed his post-graduate diploma in Family Medicine.
He has had training in Emergency Medicine, Internal Medicine, Geriatric Medicine, Orthopaedic Surgery, Obstetrics & Gynaecology, Neurosurgery, General Surgery, Colorectal Surgery and Urology.
Dr Ang currently practices in a family clinic in Singapore, seeing a good mix of paediatric, adult and geriatric patients.
With the goal of providing local and international patients with a resource for specialist care in Singapore, Dr Ang has founded SingaporeDoc.com, a Web Directory of Specialists in Private Practice in Singapore. http://www.singaporedoc.com
By Dr Ang C. D.
Screening For Breast Cancer Would Include:
1. Breast Self-Examination: Large scale studies have found that breast self-examination (BSE), when used for screening, did not reduce mortality rates from breast cancer. However, it is felt that BSE does improve women's awareness of their own breasts, thus allowing any changes to picked up earlier. BSE also helps improve women's awareness of breast cancer.
There are 2 parts to Breast Self-Examination:
(i) LOOK: Look at your breasts in the mirror to check for any changes. This should be done in various positions, such as leaning forward, holding your arms up in the air and with your hands pushing in on the hips. Compare both breasts.
Look for changes on the skin of the breasts (colour, dimpling, a lump or pulling in). The nipples should also be inspected for retraction, inversion, dryness or ulceration.
(ii) FEEL: Many women find it easier to do this while having a bath, because water and soap make it easier and may enhance detection of lumps. Feel all parts of your breasts with the flat of the palm and fingers, for areas that may be different from the rest (such as a lump, a band of hard tissue or a tender area). Remember to also check under the nipples and up into the armpits.
2. Clinical Breast Examination: Women who have found any change in their breast/breasts should consult their doctors for a clinical breast examination.
3. Mammography: The basic idea behind breast cancer screening, or any other screening for that matter, is that it allows for detection of the breast cancers before they become large enough to be felt. Early detection and treatment generally results in better treatment outcomes.
Mammography screening is widely accepted as appropriate and beneficial for women above the age of 50. In Singapore, the recommendations by the Ministry of Health for Breast Cancer Screening are as follows:
Asymptomatic women 50 - 69 years
All normal risk, asymptomatic women 50 - 69 years should have screening mammograms only every 2 years.
Asymptomatic women 40 - 49 years
Women aged 40 - 49 years with no significantly increased risk, should discuss the benefits, limitations and potential harms associated with screening with their doctors before making a decision on whether or not to have screening.
Asymptomatic women < 40 years
Normal risk, asymptomatic women under 40 years of age do not require breast screening.
Asymptomatic women > 70 years
Unlike in Western nations, where evidence supports mammographic screening every 2 years in women 70 - 75 years of age, the incidence of breast cancer in this age group among Singaporean women is significantly lower. As such, screening mammography may be less beneficial. Asymptomatic women in this age group should discuss the potential benefits and risks of screening with their doctor.
The following groups of women should consult their doctor about screening for breast cancer:
• Women who have increased genetic risk for cancers
• Women on hormone replacement therapy
• Women with prior breast cancer
• Women with premalignant breast conditions
Dr Ang C.D. has been in medical practice for over 12 years. He graduated with an M.B.B.S. degree from the National University of Singapore in 1997 and subsequently completed his post-graduate diploma in Family Medicine.
He has had training in Emergency Medicine, Internal Medicine, Geriatric Medicine, Orthopaedic Surgery, Obstetrics & Gynaecology, Neurosurgery, General Surgery, Colorectal Surgery and Urology.
Dr Ang currently practices in a family clinic in Singapore, seeing a good mix of paediatric, adult and geriatric patients.
With the goal of providing local and international patients with a resource for specialist care in Singapore, Dr Ang has founded SingaporeDoc.com, a Web Directory of Specialists in Private Practice in Singapore. http://www.singaporedoc.com
By Dr Ang C. D.
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