October marks Breast Cancer Awareness Month, so let’s get the conversation going in Singapore.
One in 13 women will get breast cancer – it’s the most common type of cancer among women in Singapore. That’s a pretty terrifying statistic because it affects more people than you realise, especially women over the age of 40. But what got the alarm sounding for me was my friend, Cheryl de Mello, who’s been diagnosed with stage 4 breast cancer. She’s 33 and a mother of two young girls: Kiara, a tall, sensitive 10-year-old beauty, and Athena, a quiet observer with a feisty side, who’s turning five.
Day 1 was the discovery of a lump on her left breast while on a call with her mother. Day 7 saw her going for a regular visit to the polyclinic, where she found out it wasn’t just one but five lumps in her breast. Fast forward to day 30, when Cheryl was told her stage 4 breast cancer had spread to her liver and spine. All that in just 30 days.
Clearly, this is something that should be talked about. Because how much do you actually know about breast cancer? My guess is a reasonable amount, but the information you have may be outrageously outdated. That’s why I reached out to Dr Wong Chiung-Ing, an oncologist with Parkway Cancer Centre who sits on the board of Singapore’s Breast Cancer Foundation, to answer some of my questions – starting with setting the record straight on common myths.
The truth about breast cancer
Myth: If I don’t have a family history of breast cancer, I won’t develop it.
Truth: Only about 5% to 10% of breast cancers are inherited.
Myth: Breast cancer only occurs in older women.
Truth: Women of all ages are at risk. It’s important to perform breast self-examinations and mammogram screenings regularly.
Myth: Breast cancer is a death sentence.
Truth: The diagnosis of cancer is no longer a death sentence. The earlier it’s diagnosed, the higher your chance of recovery.
Even though there may not be obvious signs in the early stages of breast cancer, as it progresses, symptoms may appear. These include a lump in the breast or armpit area, a retracted nipple and unusual discharge from the nipple.
Cancer and its treatments have changed, so should our mindset
For Cheryl, stage 4 cancer meant losing her father. Fourteen years ago, her father battled it, refused treatment and succumbed to it quickly. She’s doing no such thing, as she has two young girls to live for.
How far have we progressed since then? Dr Wong says that compared to 10 years ago, the survival rate of breast cancer diagnosed across all stages has improved. According to a study from the American Cancer Society in 2017, the number of women who died from breast cancer dropped about 40% in the past 25 years. This is due to a combination of factors: improvement in screening and early detection, increased awareness of symptoms and more effective treatment options.
Here’s a simplified explanation of the stages of breast cancer:
Stage 1 – Cancer cells detected in the breast
Stage 2 – Number and size of lumps
Stage 3 – Cancer detected in the lymph nodes
Stage 4 – Cancer has spread outside of the breast
Yup, so far none of those stages say death.
Say it with me: Early detection
While it isn’t technically possible to be “cured” of breast cancer, here are some optimistic stats for you. The chance of a cure is related to the stage at diagnosis. When breast cancer is diagnosed at an early stage and localised, the five-year survival rate is more than 90%. When the tumour is larger and has spread to surrounding lymph nodes, the number is about 80%. If it has spread to other organs, the chances drop to 25%.
The real question is, can we actually prevent breast cancer? According to Dr Wong, we can lower our risk with healthy habits such as cutting down on alcohol, being physically active, and maintaining a healthy diet and weight. If possible, breastfeed your children and limit postmenopausal hormone therapy.
Cheryl, who’s too young for annual mammogram checkups, breastfed her two girls – as did I. Yet, I was diagnosed with potentially having breast cancer. As Dr Wong explains it, when breasts are exposed to lots of estrogen, the risk of developing breast cancer is slightly higher. That includes situations like early menstruation, late menopause, having your first child at an older age, and never having given birth or breastfed. So breastfeeding reduces the risk of breast cancer but doesn’t prevent it.
If you have a strong family history of cancer, talk to your doctor and see if genetic counselling is indicated. It’s crucial to do monthly breast self-examinations, starting from the age of 20, and screening mammograms annually from the age of 40 (and biannually after).
Touch yourself! Seriously, it can save your life
You should be doing this every month, nay, every day. In the shower or wherever’s convenient. The more you touch yourself, the more familiar you’ll be with any changes in your breasts. That means you’ll notice even the slightest difference and can get it checked.
When I breastfed, I constantly had engorgements. Breast cancer symptoms are almost identical to mastitis. That’s puckering skin, redness, lumps and discharge from the nipple. How can you tell what’s what? You can’t. A clogged milk duct feels very much like a lump. In my case, there was one lump that was moveable. Usually, clogged ducts are hard and can’t move around. The doctor suggested I stop breastfeeding to let the swelling go down and get a proper mammogram. Thankfully, it wasn’t breast cancer.
But if you need more information on how to do a breast self-examination or find support groups, hop on the Breast Cancer Foundation website. And if you want an inspiring reminder of how strong women are, follow Cheryl’s cancer journey on Instagram.
Repeat after me: breast cancer is not a death sentence. Early detection can save your life (and your breasts), so don’t forget your regular self-checks!
