‘Breast Cancer’ The deadly disease that (women) can detect early… through screening tests

When mentioning “cancer,” it is currently considered one of the most serious diseases. Once diagnosed, the chance of complete cure may be possible or may not exist at all, depending on the severity and location of the cancer. The most common cancer found in Thai women is breast cancer. Although “breast cancer” is a serious disease that can cause death, every woman can be aware of this disease by regularly observing their own breasts initially to see if there is anything abnormal. If anything suspicious is found… do not ignore it. You should see a doctor as soon as possible.

Interesting Topics

• How Does Breast Cancer Occur?
• Warning Signs Indicating “Breast Cancer”
• Risk Factors for Developing Breast Cancer
• Methods for Diagnosing Breast Cancer
• Who Should Be Screened for Breast Cancer
• Regular Self-Check for Breast Cancer and Screening
• How Does Breast Cancer Screening Differ Between “Ultrasound” and “Mammogram”?
• Ways to Reduce the Risk of Breast Cancer

How Does Breast Cancer Occur?

Dr. Anirut Niranat, a surgical oncologist specializing in breast cancer at Phyathai 1 Hospital Breast Clinic, explains the cause of cancer in the human body as “a process caused by abnormal cell division, resulting in the body being unable to control it, and spreading along the lymphatic pathways in the body.” Although breast cancer can be found in both females and males, it is mostly found in females, especially women aged 40 and above.

Warning Signs and Symptoms Indicating “Breast Cancer”

1. Feeling a Lump in the Breast Area Most patients visit a doctor because they feel a lump in the breast or under the armpit. The lump may or may not be painful. Although it is true that you can observe breast abnormalities yourself, if the lump is small, it is not easy to detect by touch. Usually, a lump must be larger than 1 cm to be felt, and most lumps are detected when the cancer cells have grown to stage 2-3. Having a specialist doctor examine or using diagnostic tools will yield better results.
2. Changes in Breast Size or Shape Although normally both breasts may differ slightly in size and shape, a sign of breast cancer is an abnormal increase in breast size, changes in the breast such as one side becoming larger or smaller, or a distorted shape that is noticeably different from the other side. Regularly observing breast changes is beneficial because noticing unusual characteristics early helps patients be aware of the disease from the initial stage.
3. Skin Dimpling on the Breast If the skin on the breast is dimpled like a dimple or swollen and thickened like an orange peel, including changes in color or skin around the nipple, it may indicate that cancer cells have spread to the tissue beneath the skin. If these symptoms occur, you should see a doctor for a detailed diagnosis.
4. Discharge of Lymph or Fluid from the Nipple Especially if the discharge resembles blood, you should see a doctor immediately.
5. Abnormal Breast Pain Some patients feel a lump but no pain, some have pain but no lump, or both pain and a lump. Anyone experiencing these symptoms should not ignore them!!! Because these are signs indicating a risk of breast cancer.

Risk Factors for Developing Breast Cancer

1. Age: Cell division in the milk ducts of older people is more likely to be abnormal than in younger people, so the chance of developing breast cancer is higher.
2. Having or Not Having Children: Women who have given birth have breast cells that develop to their fullest, so the chance of abnormal cell division is lower. The risk of breast cancer is therefore lower than in women who have never had children.
3. Contraceptive Pills: Taking contraceptive pills continuously for more than 5 years increases the risk of breast cancer because the body has abnormal natural hormone levels and prolonged high levels of these hormones, which increases the risk of abnormal breast tissue.
   This is because breast cancer occurs when the body has abnormal natural hormone levels, with prolonged high levels of these hormones, increasing the risk of abnormal breast tissue. Women who use oral contraceptive pills have a higher risk of breast cancer than those who have never used them. It is also found that those who start using contraceptive pills during their teenage years have double the hormone-related risk. The younger the age at which they start using, the higher the risk compared to adults. Additionally, those who use contraceptive pills continuously for more than 5 years are often found to have the highest risk of breast cancer. Therefore, contraceptive pills are contraindicated for breast cancer patients as they may cause the disease to worsen.
4. Genetics: If direct family members have a history of cancer, it may increase the risk of breast cancer. According to the article “Cancer and Genetics” from Prince of Songkla University, breast cancer is one of the cancers most frequently inherited genetically. The main causative genes are Breast cancer susceptibility gene 1 (BRCA1), Breast cancer susceptibility gene 2 (BRCA2), and P53. For the first two genes, the frequency is 1 in 1,000 of the population, and for P53, it is 1 in 10,000. Normally, the chance of breast cancer in the general population is about 12% (or 120 out of 1,000 people), but for those with abnormalities in the BRCA1 or BRCA2 genes, the chance of breast cancer is as high as 60% (or 600 out of 1,000 people). This shows that people with genetic abnormalities have a higher risk of breast cancer than the general population.

Methods for Diagnosing Breast Cancer

We often hear recommendations for women to regularly check their bodies for abnormalities or to consult a doctor if suspicious symptoms are found. But what are the diagnostic methods? Let’s take a look.

• Taking a history of symptoms and family history to find abnormalities in the breasts and other organ systems, and to check if any direct relatives have had cancer to assess combined risk.
• Physical breast examination starting from the area under the collarbone, then the inner part of the sternum, next the side near the mid-armpit line, and below the 6th rib.
• Digital mammogram examination, which is an X-ray imaging of the breast using low radiation.
• Ultrasound should be done alongside digital mammogram to better detect the size of abnormalities such as tumors, cysts, or lymph nodes in the armpit.
• Magnetic Resonance Imaging (MRI) for high-risk individuals, such as those with a family history of cancer, or when mammogram and ultrasound show abnormalities but are not clear and require further detailed examination.
• Biopsy for laboratory examination when a suspicious breast lump is found that may be cancerous.

Who Should Be Screened for Breast Cancer

It seems that all women are at risk of “breast cancer,” and the risk increases after age 35, so breast screening is recommended. There are also several other risk factors that warrant screening…

1. No children or first child born after age 35
2. Family history of breast and ovarian cancer
3. Obesity, especially in women during menopause
4. Habitual alcohol consumption, high-fat diet, and lack of exercise
5. History of long-term contraceptive pill use

Regular Self-Check for Breast Cancer and Screening

Almost all diseases have symptoms or warning signs, but early-stage breast cancer does not have warning signs! Therefore, all women should regularly check their breasts to detect lesions as early as possible.

1. Women aged 20 and above should perform breast self-exams once a month, preferably 7 days after menstruation ends, to check for lumps, and should have a medical examination every 3 years.
2. Women under 35 years old should have an ultrasound examination once a year.
3. Women aged 35 and above should have a digital mammogram and ultrasound once a year or every other year.
4. Women over 40 years old should have a digital mammogram and ultrasound once a year.

How Does Breast Cancer Screening Differ Between “Ultrasound” and “Mammogram”?

Ultrasound is suitable for women under 40 years old. It can diagnose whether a breast lump is a cyst or a tumor because this age group has a higher risk of breast cysts than breast cancer. However, this does not mean there is no chance of breast cancer.

Mammogram is suitable for women aged 35-40 and above. It is a diagnostic method that provides accurate results with high-resolution images. It can detect calcifications in the breast, some of which are found in early-stage breast cancer, and can detect breast cancer even before a lump can be felt.

Ways to Reduce the Risk of Breast Cancer

1. Exercise at least 3-4 days a week, such as brisk walking, yoga, or aerobic dancing for 30 minutes each time, which can reduce the risk of breast cancer by 10-50%.
2. Reduce High-Fat Foods “Women with high body fat” have a higher risk of breast cancer because obesity increases estrogen levels in the body. Reducing calorie intake from fat to less than 20-30% per day may help protect women from breast cancer.
3. Avoid Smoking or exposure to secondhand smoke, as it increases the risk of breast cancer by 20%. Research shows that secondhand smoke contains more than 20 chemicals that increase the future risk of breast cancer.
4. Limit Alcohol Consumption Women who drink about 3 drinks per week (1 drink equals 12 oz beer, 5 oz wine, or 1.5 oz spirits) have a 15% higher risk of breast cancer compared to non-drinkers. For every additional 10 grams of alcohol consumed, the risk of breast cancer increases by 7%.

Besides regularly observing and self-examining breasts for abnormalities, women aged 35 and above should have a mammogram every year or every other year. Women over 40 should have a mammogram annually because it is a “test… to stay ahead of the disease.” Early detection increases the chance of complete cure. Mammogram is an accurate and highly effective method for detecting “breast cancer.” Every woman should choose the best for herself.