Medically Reviewed by Dr. Chua Zi Wei.
Affecting 1 in 19 individuals, breast cancer is the most common form of cancer among Malaysian women. While more commonly found among women, males can get breast cancer too. Older men are more inclined to get breast cancer, but this can occur in men of all ages.
Cancer occurs when cells start to multiply uncontrollably, often forming tumours. In breast cancer, uncontrolled cell growth begins in the breast and may eventually spread to the rest of the body if left untreated. It is important to note that not all breast tumours are cancerous.
Breast Cancer Symptoms
Oftentimes, breast cancer is discovered when someone notices a lump in their breast. While 8 out of 10 breast lumps are actually benign or non-cancerous, it is best to have them checked as soon as possible as a precaution. Here are some breast cancer symptoms that can occur in both men and women you should take note of:
- Unusual or bloody nipple discharge
- Irritation or dimpling of breast skin
- Breast or nipple pain
- Inversion of the nipple
- Redness or flaky skin in the nipple area or the breast
- Itchy rash around the nipple
- Changes in the size or shape of the breast
- Thickening or swelling of all or part of the breast
- Lumps in the breast or underarm
Breast Cancer Causes and Risk Factors
While the exact causes of breast cancer may not be fully known, some risk factors have been observed to affect the development of breast cancer. These risk factors fall into two categories — non-modifiable and modifiable. Non-modifiable risk factors refer to conditions that are out of our control and cannot be altered; while modifiable risk factors can be changed through actions and decisions we make.
Non-modifiable risk factors: factors we cannot change
The main risk factor for breast cancer is gender. While males do get breast cancer, the condition is much more common in women than in men. This also explains why there is often the misconception that breast cancer only happens to women.
As our birthdays pass by and we mature, our chance of developing breast cancer increases. In fact, 64% of Malaysian women diagnosed with breast cancer fall between 40 and 60 years old. However, we should not forget that breast cancer can occur regardless of age.
Breast tissue density
Having dense breast tissue translates to a higher risk of breast cancer too. Breast tissue density can be affected by other risk factors and life events such as age, use of certain drugs, and genetics. Through a mammogram, you would be able to learn more about your breast tissue density.
Family history of breast cancer
The risk of breast cancer can be passed down the family line due to the inheritance of certain genes. Having an immediate family member with breast cancer thus increases the risk for others within the family.
For those who have one female relative with breast cancer, the risk is doubled; and for those with two, the risk is five times higher than average. Having a male relative with breast cancer similarly increases one’s risk of getting the condition. About 10-20% out of every 100 diagnosed are due to genes that were passed down through the generations.
A gene called BRCA2, is a mutation that occurs in one of several genes. Detected BRCA2 mutation puts individuals at greater risk of various forms of cancer such as breast, prostate and ovarian cancer. Cancer Research Malaysia (CRM) research shows that 1 in 20 breast cancer patients inherited alterations in the BRCA1 or BRCA2 genes.
Personal history of breast cancer
For breast cancer survivors, the chance of developing cancer in another part of or the other breast is three to four times higher than for those who never had the condition previously.
Klinefelter’s syndrome is a rare genetic condition where a man is born with an extra X chromosome. The individual has an XXY characteristic instead of XY. Men with Klinefelter’s are about 20 times more likely to get breast cancer than the average man. This makes their breast cancer risk the same as for the average woman.
Modifiable risk factors: factors we can change
Compared to non-drinkers, women who have one drink a day have a 7-10% higher risk of being diagnosed with breast cancer; those who drink two to three drinks a day would have as high as a 20% increase in risk. Similarly, men should also avoid heavy drinking as it could lead to liver disease and a higher risk of developing breast cancer.
As mentioned above, eostrogen levels are linked to breast cancer. In women, eostrogen is primarily produced by the ovaries before menopause. Upon menopause, the source of production is replaced by fat tissues. Being overweight would naturally raise eostrogen levels, thereby increasing the chances of developing breast cancer. For men, fat cells convert the male hormones (androgen) into eostrogen. Hence, obesity in men also translates to an increased risk of breast cancer.
Research has linked physical inactivity to a higher risk of breast cancer in both men and women.
Smoking, including second-hand smoke exposure, can increase our risk of breast cancer, particularly in premenopausal women.
For new moms, you may want to consider breastfeeding if it is an option. Besides lowering breast cancer risk, breast milk has many health benefits for the child too. However, it is a personal choice and depends on our individual situations and preferences.
Hormone Replacement Therapy
Hormone replacement therapy (HRT), often used to ease menopausal symptoms, can increase our breast cancer risk by about 75%, even when used for only a short time.
Individuals who are constantly exposed to radiation over a prolonged time are more likely to develop breast cancer, male or female. This has a greater effect if they have been exposed to radiation from the time they were children.
Breast Cancer Prevention
Here are some lifestyle habits we can adopt to reduce our risk of developing breast cancer too.
Limit Your Alcohol Intake
Next time you are contemplating a drink, choose water or a non-alcoholic drink instead. Better yet, avoid consuming alcohol altogether. If you decide to drink, make sure to do so in moderation and limit yourself to no more than one drink a day.
If you have not been active, you do not have to jump to intense exercises and workouts right away. We can start by ditching the escalator or lift for stairs when commuting or jogging for 30 minutes each day in your neighbourhood park. Remember to exercise within your own limits to avoid injuring yourself.
Avoid or Quit Smoking
If you are not a smoker, do not start. If you are a smoker, take steps to quit today. Quitting smoking is not an easy process, but support is available. Learn more about the resources available here.
Maintain a Healthy Weight
As obesity is a risk factor for breast cancer, we should have a balanced food intake while keeping up with an active lifestyle to maintain a healthy weight range and minimise our breast cancer risk.
Adopt a Healthy Diet
No one food or diet can prevent breast cancer entirely, but a healthy, well-balanced diet rich in fibre, vitamins and antioxidants can reduce our risk of breast cancer and boost our overall well-being.
Limit Hormone Replacement Therapy
If HRT cannot be avoided, make sure to discuss with your doctor all your options and try to work out an effective way to limit the dose and duration of hormone therapy, to possibly reduce your risk of breast cancer.
Breast Cancer Screening
The benefits of early detection and treatment should not be undermined. In fact, individuals diagnosed with breast cancer at stage 1 can have a survival rate as high as 90%. Here are the common screening methods that can help to detect breast cancer as early as possible.
Individuals are strongly encouraged to perform a breast self-examination every month to detect any unusual changes and symptoms early. Learn more about how you can perform a simple breast self-examination in the comfort and privacy of your home here.
Mammography can detect small lumps in the breasts before we can feel them physically. The Malaysian Clinical Practice Guideline (CPG) on the Management of Breast Cancer recommends the following: mammography screening may be performed annually or biennially for both males and females from 50-74 years of age. Get more information on both male and female mammograms here and the relevant subsidies available here.
BRCA Genetic Test
By taking a BRCA genetic test, individuals can better manage cancer risks. Find out more about taking a BRCA genetic test in Malaysia here.
In the past, celebrities like Angelina Jolie opted for a preventive double mastectomy and the removal of her ovaries a year later. She detected an inherited faulty BRA1 gene where doctors estimated an 87 per cent chance of getting breast cancer and a 50 per cent chance of getting ovarian cancer in her lifetime.
Her story led to a spike in requests for the BRCA genetic test throughout the world to better manage the risk of cancer.
Breast Cancer Treatment
Treatment types for breast cancer can be classified into two groups: local and systemic therapy.
Local therapy includes surgery and radiotherapy and treats cancer at the site without affecting the rest of the body. Meanwhile, systemic therapy, which includes chemotherapy, hormone therapy, and targeted therapy, involves the administration of drugs into the bloodstream to kill cancer cells throughout the body.
There are two main types of surgery for breast cancer. In a lumpectomy, (also known as Breast-Conserving Surgery (BCS)), the tumour is removed while most of the breast remains. However, in a mastectomy, the whole breast is removed along with the tumour.
Depending on a variety of factors including the size and location of the tumour, breast size, and personal preference, a lumpectomy or a mastectomy may be performed.
Radiation therapy uses high-energy rays to kill or limit the growth of cancer cells and is often performed before and/or after surgery, to reduce the size of the tumour and to prevent recurrence respectively.
Side effects may include redness and dryness of the skin, swelling, and increased or decreased sensitivity. However, these effects tend to be manageable and are temporary.
Hormonal therapy is a treatment method that slows or stops the growth of hormone-sensitive breast cancer by blocking the body’s ability to produce the hormone or interfering with the hormonal effect on breast cancer cells. It is usually used as an adjuvant measure to reduce the risk of recurrence in patients with hormone-sensitive breast cancer.
By introducing drugs into the bloodstream, chemotherapy helps to eliminate cancer cells throughout the body.
Similar to chemotherapy, targeted therapy involves the use of drugs to kill cancer cells. However, these drugs target specific genes, proteins, or tissue environments that contribute to cancer growth and survival, leaving healthy cells largely unaffected.
Breast Cancer Support Groups in Malaysia
Being diagnosed with breast cancer does not only affect us physically but can have an impact on our mental wellbeing too. That’s why it’s important to have a strong support system in place. Besides family and friends, breast cancer patients and survivors in Malaysia can join support groups and connect with peers going through similar experiences as themselves.
With a support group, you can give and receive psychological and emotional support, and take part in educational, social, and recreational activities together. Here are some of the breast cancer support groups in Malaysia that you can join for free.
Breast Cancer Welfare Association Malaysia (BCWA)
The BCWA is a self–help support group. Its members are breast cancer survivors, family members, and friends of breast cancer patients, related professionals, and volunteers who help provide psychological and emotional support, information, and education. Pink Inspirer is a metastatic breast cancer support group under BCWA.
MAKNA (Majlis Kanser Nasional) or National Cancer Council
Wira Kanser was celebrated by MAKNA for the first time in 2011. MAKNA has since then, decided to hold the event once every two years seeing how the programme had left such an indelible experience and impact on the cancer survivors who attended the inaugural event.
Women Cancer Support Group (Pink Unity)
Formed in 2010, Pink Unity is a support group for all female cancer patients and survivors as a platform for women to give and receive psychological and emotional support, and participate in education, social and recreational activities together. Membership is free.
Living with Breast Cancer
Navigating the breast cancer journey is not easy – from the initial diagnosis and treatment to learning to live with the changes and its treatment have on our lives. No matter how hard the going gets, always remember that you are not alone. Have faith and do not hesitate to reach out for help if you need it.
Homage provides caregiving services for your loved ones at every stage. Our trained care professionals are able to provide companionship, nursing care, night caregiving, home therapy and more, to keep your loved ones active and engaged.
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