Dr Teoh Mei Shi

Consultant Breast, Endocrine & General Surgeon
MBBS (India), MS (USM), Fellowship Breast Oncoplastic & Endocrine Surgery (M’sia & Germany)

Screening Recommendation for Breast Cancer
(According to MOH Guidelines, 2nd edition, 2010)

• Mammography may be performed biennially from 50-75 years of age
• Women aged 40 – 49 years old should not be denied mammography screening if they desire to do so.
• Screening for women at high risk for breast cancer should start from age 30 with both
  MRI and mammography
• Breast ultrasound can be used as an adjunct to mammogram for breast cancer detection in women of all ages but is not recommended asa stand-alone breast cancer screening modality.

Breast Cancer is the leading cause of cancer in women worldwide. It affects women mainly in the middle-aged group (age 50-60) but the disease is also seen on the rise amongst the younger generation (age 30-40). In Malaysia, one in 15 Malaysian women have a lifetime risk of developing breast cancer. Breast cancer has also been detected in a 6-year-old girl in Malaysia, possibly one of the youngest in the world.

No one can avoid breast cancer but having an understanding on breast health can significantly make a difference to early detection of cancer. Being breast aware is one of the important aspects of preventing breast cancer. It involves knowing your breast cancer risk factors, understanding the genetic risk for breast cancer, going for screening mammography and being proactive when new changes are detected. For women, performing monthly breast self-examination (BSE) encourages you to know your breasts and how they change during your menstrual cycle and throughout the different stages of your life. Being knowledgeable and going for screening mammogram as recommended can help prevent or result in early detection of cancer.

Breast Cancer Myths Debunked

Myth:  Wearing underwire bra increases the risk of breast cancer

Fact: Wearing underwire or tight bras does not impact the lymphatic system nor does it cause accumulation of toxins resulting in breast cancer. However, it’s best to wear a properly fitted bra to avoid discomfort.

Myth: Men cannot get breast cancer

Fact: Although women are at a much higher risk, men still do have a lower risk for breast cancer. Therefore they usually present in the later stage. As such, all chest wall lumps around the nipple should be investigated.

Myth: Breast cancer tumor markers are effective as a screening test to detect cancer activity

Fact: The breast cancer tumour markers are not sensitive enough to detect early stage breast cancer. The tumor markers are usually used by the doctors to monitor the progress of the disease during treatment.

Myth : Breast biopsy can cause the cancer cells to spread

Fact: Breast biopsies are important part of the triple assessment in breast lump investigation. They do not cause the cancer to spread.

Myth: Most breast lumps are cancerous.

Fact: Fear not, about 80% of breast lumps are NOT cancerous. The physiological development of breast changes over the course of a woman’s lifetime. Many of these breast changes are normal and are caused by hormones. Nevertheless, it is recommended that all lumps should be properly investigated by a health care professional.

Myth: Breast cancer is preventable.

Reality: Unfortunately, No. Although we can identify possible risk factors (family history or inherited gene mutations), a significant percentage of women diagnosed with breast cancer have no identifiable risk factors and the disease can occur unexpectedly. It is strongly advisable to make positive lifestyle changes to further lower your risk of getting breast cancer.

Risk Factors For Breast Cancer

• Female: being a woman is one of the strongest risk factors
• Age: risk of developing breast cancer significantly increases as women age but it also can happen at any age.
• Increase estrogen exposure: seen in early menache, late menopause, women on oral contraceptive pills and hormonal replacement therapy.
• Personal history: those with previous history of breast cancer requires surveillance follow up to detect recurrence.
• Genetic & Hereditary breast cancer: family members diagnosed with breast cancer, especially before age 35, family members diagnosed with ovarian cancer at any age, male breast cancer in the family, family members with bilateral breast and ovarian cancer and presence of BRCA1 & BRCA2 genes.
• Dense Breast: Having dense breast makes it more difficult to detect cancer by mammogram alone therefore it requires additional screening methods like ultrasound or MRI.
• Breastfeeding & Pregnancy: Being pregnant and breastfeeding long term reduces the estrogen exposure to the breast tissue therefore could lower the risk of breast cancer.
• Lifestyle: leading a positive and healthy lifestyle will benefit your breast health and improve your overall well-being.

Leading A Healthy Lifestyle

• Diet:  Good nutrition and healthy eating habits are important part of a healthy lifestyle. Eat more fruits and vegetables, reduce sugar intake, avoid processed and preserved food. Drink plenty of clean water (at least 2L/day), avoid caffeine and canned drinks.
• Sleep: Consistent sleep is critical for a healthy life. Have at least 6- 8 hours of restful sleep at night. Sleep early, as your body will start to detoxify and repair between 10pm and 2am.
• Eliminate stress: Stress has a significant negative impact on our body’s immune system, which lowers our resistance to getting sick. Learning how to manage stress by mind-body relaxation is an important component to a better living.
• Exercise: Physical activity provides immediate stress relief. Just a simple 10-20mins of brisk walking can help you break a sweat, improve your sleep and give you more energy. At least, try to exercise 3 times a week for 30 minutes.
• Spirituality: Change your mind-set and live your life with positive affirmations that will attract healing energy thus leading you to an overall happier and healthier lifestyle.