Breast Cancer Treatment

What is breast cancer?

Breast cancer is a disease characterized by abnormal growth and multiplication of cells in the breast. When cells grow uncontrollably, a tumour forms. While most breast lumps are not cancerous, those that are malignant and cancerous can be life-threatening. Visiting a specialist called a medical oncologist as soon as a lump is noticed can help you screen for breast cancer.

What are the symptoms of breast cancer?

The most telling symptom of breast cancer is a lump or thickness either in or near the breast. Unexplained swelling or shrinkage of one of both of the breasts, dimples on the breast, non-milk discharge from the nipple or skin changes on the breast such as flaking or thickening are also symptoms of breast cancer.

Even when you are not experiencing symptoms, it’s important to keep up on your routine mammograms if you are above 40 years old. It is recommended that ladies above 40 should get regular mammograms once every year. A routine mammogram is the most common way breast cancer is discovered early. However, mammograms may be combined with ultrasounds as some cancers may not be picked up by mammograms alone.

What are the causes of and risk factors for breast cancer?

Although family history is the largest indicator for a woman’s likelihood of developing breast cancer throughout their lives, most ladies with breast cancer do not have a family history of it. A tiny number (2% to 5%) of breast cancers are actually inherited through known gene mutations – such as the BRCA1 and BRCA2 gene mutations. The majority of breast cancer cases (80%) occur in women over the age of 50. However, more medical data is emerging that perhaps breast cancer is related to many other genetic mutations but these are yet to be discovered. This is a rapidly changing field.

Did you know?

Breast cancer tumors are potentially harder to detect in obese women, so tumors in these women tend to be larger upon discovery. Some studies suggest that obese or overweight women should consider more frequent visits and be more vigilant about their health.¹

What are the possible complications of breast cancer?

The possible complications of breast cancer can range from mild to severe. These complications can include tenderness and temporary swelling of the breast, hardness from scar tissue that may form at the incision site, infection, bleeding, or arm swelling if you have had your lymph node removed.

When should I see a specialist for breast cancer?

You may wish to see a specialist for consultation as soon as you notice any symptoms or otherwise that you suspect may be related to breast cancer – especially if you detect any lumps. The earlier the detection, the better the survival odds.

How should I prepare for my appointment?

Before going to see the specialist, you should list out your questions beforehand to make sure you get all the information you are looking for. You should also be prepared to discuss every aspect of your symptoms in as much detail as possible so the specialist can establish a timeline, which may influence treatment decisions. Choosing a radiology centre that does accurate mammograms with up-to-date machines and having a experienced radiologist team can also benefit a patient’s treatment process.

Do not wear deodorant on the day of your appointment, as the chemicals in this product may show up on the scan and complicate the image.

How do specialists screen for and diagnose breast cancer?

To diagnose breast cancer, specialists typically screen using mammography and ultrasound. If the results of a mammogram come back abnormal, the specialist may then perform diagnostic tests such as a breast biopsy. If the mammogram or ultrasounds are suspicious but not clear, an MRI scan may be recommended.

What treatments are available for breast cancer?

Once the diagnosis is confirmed, your specialist will go over the treatments available for breast cancer. Generally, these options include:

● Surgery. Surgery can come in the form of a lumpectomy or a mastectomy. In a lumpectomy, just the tumor is removed, while a mastectomy involves removing the entire breast.
● Lymph node sampling and removal. Lymph node sampling is always performed during the surgery. If the tumor is small, then only a few lymph nodes (mapped the sentinel lymph nodes) would be removed. If these sentinel lymph nodes are affected by cancer, then more lymph nodes may be removed to complete the procedure.
● Radiation therapy. Radiation therapy may be required to reduce the risk of cancer returning if the lymph nodes are involved or if breast conservation surgery is performed.
● Chemotherapy. Chemotherapy is the use of drugs to destroy cancer cells, but in most cases, chemotherapy is used as a preventative measure to reduce the risk of cancer recurrence.

The specialist will choose the most appropriate treatment for your cancer. This will depend on a few factors, including the tumor’s subtype, the stage of the tumor, your age, and your general health.

Reviewed by: Dr See Hui Ti
Medical Oncologist
Parkway Cancer Centre
Mount Elizabeth Medical Centre

[1] Strand F, et al. BR252-SD-WEB1. Presented at: Radiological Society of North America Annual Meeting. Nov. 26–Dec. 1, 2017; Chicago.