Breast cancer, an awareness to all

In Singapore, breast cancer is the most prevalent cancer with the highest mortality rate in females and sometimes occurs in males as well. Constant care and surveillance of the breast are vital for early detection and timely treatment.

By the team at Speedoc,

November 07, 2023

Learning about breast cancer

Breast cancer is characterized by the uncontrolled growth and spread of abnormal cells, leading to the formation of cancerous tumors. In most cases, it originates in the milk ducts (invasive ductal carcinoma, IDC) or lobules of the breast (invasive lobular carcinoma, ILC). Inflammatory breast cancer (IBC) is a rarer type that causes redness, inflammation, irritation, and changes in breast shape. IBC is challenging to diagnose as it may not produce a distinct lump that can be easily identified with a mammogram.

Treatment strategies of breast cancers are tailored according to hormone receptor types. The three main hormone receptor expressions in breast cancers are estrogen (ER), progesterone (PR) and human epidermal growth factor (HER2). Based on the positive and negative features of these receptors, subtypes of breast cancers can be identified according to the table below.

Receptors / Classification	ER+	PR+	HR+			HR-	HER2+	HER2-
Estrogen (ER)	✔︎	✗				✔︎	✗	✔︎	✗	✗	✗
Progesterone (PR)	✗	✔︎				✗	✔︎	✔︎	✗	✗	✗
Human epidermal growth factor (HER2)	✗	✗	✗	✗	✗	✗	✔︎	✗

HR+ HER2- breast cancer is the most common form of breast cancer that is typically treated with hormone therapy. HER2+ breast cancer accounts for 25% of breast cancer cases which respond positively with targeted therapy. Triple negative (HR-) breast cancer marked 15% of all breast cancers and is often associated with BRCA1 gene mutations.

Risk factors

Several risk factors are found to be associated with a higher chance of developing breast cancer.

Gender: Women have a greater chance of getting breast cancer than men.

Age: Occurance of breast cancer is more likely as age increases, especially after the age of 50, risk of breast cancer development is 10 times higher than when women are 30 years-old.
Family history and genetic inheritance: Individuals with first-degree family members of breast cancer or BRCA1 and BRCA2 genetic mutations have significantly higher chances of getting breast cancer under inheritance.
Pertaining factors of reproduction: Early menstruation, late menopause, and pregnancy at advanced maternal age could heighten the risks of breast cancer.
Obesity: People of obesity, postmenopausal women in particular, have high exposure to breast cancer.
Alcohol consumption: Albeit binge drinking or regular consumption, alcohol is associated with an elevated risk of breast cancer.

Prevention tips

1. Regular check-ups

Consistent attendance at clinical check-ups significantly enhances the potential for early detection, markedly improving the prospects for effective intervention. According to the Singapore Cancer Society, mammogram screening is suggested to perform annually between the age of 40-49 and twice a year after reaching 50 years old. Alternatively, cancer screening, clinical breast exams and self-breast examinations are recommended methods for monitoring breast health.

2. Breastfeeding

Breastfeeding practice would foster hormonal change and boost cell differentiation. These processes could lower estrogen levels and boost removal of carcinogens in breast tissues, reducing the chance of breast cancer development.

3. Genetic tests

Given that breast cancer can be triggered by specific genetic mutations, notably BRCA1 and BRCA2, undergoing genetic testing for oneself and close family members can assess the risk of breast cancer based on genetic characteristics and family history. With a clear understanding of the risk profile, prevention and intervention measures can be implemented earlier.