Breast cancer, the number 1 deadly cancer in women

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Breast Cancer… The No.1 Deadliest Cancer in Women

When mentioning the word “cancer”, it is believed that no one is not afraid because nowadays it is considered one of the most serious diseases. Once diagnosed, the chance of complete cure is low or may be none, depending on the severity and location of the cancer. The most common cancer in men is liver cancer, but for women, the number one cancer that takes the lives of Thai women is breast cancer.

How Does Breast Cancer Occur?

Dr. Anirut Niranat, a surgical oncologist at the Breast Clinic, Phyathai 1 Hospital, explains the cause of cancer in the human body as follows…
“It is 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 50 and above, who have the highest mortality rate from cancer among women. In males, the incidence is very low.

Risk Factors for Breast Cancer

Currently, the medical field does not know the exact cause of cancer, but the following risk factors have been identified:

  1. Increasing age
  2. Family history of ovarian or breast cancer increases risk compared to the general population
  3. Hormonal factors such as taking female hormone pills or continuous contraceptive pills
  4. Long-term use of contraceptive pills
  5. Early menstruation before age 12 and late menopause after age 55
  6. Having the first child after age 30 or never having children
  7. Previous history of ovarian or breast cancer
  8. Smoking, lack of exercise, being overweight, and alcohol consumption

What Are the Symptoms of Breast Cancer?

Dr. Anirut Niranat, a surgical oncologist at the Breast Clinic, Phyathai 1 Hospital recommends observing the following abnormal symptoms that may indicate breast cancer:

  • Usually painless in the early stages
  • Palpable lump in the breast or armpit
  • Skin of the breast has wrinkles or dimples resembling orange peel
  • Inverted nipple or nipple retraction
  • Discharge of lymph or blood from the nipple

Which Stage of Breast Cancer Can Be Cured?

It is well known that when cancer is diagnosed, doctors will inform the patient of the “stage”. The cancer stage is important for determining severity and the chance of cure as follows:

  1. Stage 0: Cancer is small and has not spread to tissues. Survival rate is 95-100%
  2. Stage 1: Cancer grows and spreads to lymph nodes in the same armpit. Survival rate is 90-100%
  3. Stage 2: Cancer grows larger than stage 1 and spreads to a few lymph nodes. Survival rate is 85-90%
  4. Stage 3: Cancer is large, may ulcerate or adhere to chest muscles, and spreads to many lymph nodes. Survival rate is 65-70%
  5. Stage 4: Final stage where cancer spreads through the bloodstream to other organs. Generally, survival is less than 3 years with a survival rate of 0-20%

Breast Cancer Diagnosis

Dr. Anirut Niranat, a surgical oncologist at the Breast Clinic, Phyathai 1 Hospital recommends that all women regularly check for abnormalities or consult a doctor if suspicious symptoms appear. The diagnostic methods include:

  • Medical history and family history review
  • Physical examination by palpation for lumps
  • Mammogram, which is a low-dose X-ray imaging of the breast
  • Ultrasound examination
  • Magnetic Resonance Imaging (MRI)
  • Biopsy for laboratory examination

How to Treat Breast Cancer for a Cure?

The best approach for treating breast cancer, as well as other types of cancer, involves a collaborative plan between the medical team (multidisciplinary) and the patient and family. Treatment methods include:

1. Surgery: Two types

  • Partial Mastectomy where the surgeon removes only the cancerous lump as much as possible. The criteria for this surgery include:
    • The lump should be small
    • The breast should be of sufficient size
This method is not suitable for breasts with multiple lumps, large cancerous lumps, or small breasts. Lymph nodes may also be removed if cancer has spread.
  • Total Mastectomy where the surgeon removes the entire breast including the nipple. If cancer has spread to lymph nodes, the lymph nodes in the armpit are also removed. In some cases, both breasts may be removed if the patient is at high risk of cancer spreading to the remaining breast.

Complications After Breast Cancer Surgery

  • Change in breast shape, which can be corrected with breast prosthesis or reconstructive surgery. Consultation with a doctor is recommended before initial surgery.
  • Infection or bleeding at the wound site; watch for swelling or redness
  • After complete removal of lymph nodes in the armpit, the arm on that side may swell and feel tight, with numbness on the inner upper arm. Physical therapy or arm and shoulder exercises are recommended
  • After complete removal of lymph nodes in the armpit, the arm on that side may swell and feel tight, with numbness on the inner upper arm. Physical therapy or arm and shoulder exercises are recommended

2. Radiotherapy or Radiation Treatment uses high-energy radiation to destroy cancer cells

  • Patients who undergo partial mastectomy should receive radiation therapy as well
  • Radiation is given to patients who have had total mastectomy with large tumors or spread to lymph nodes in the armpit
Side Effects of Radiation and Care
  • Fatigue during radiation; rest well and eat nutritious food
  • Skin in the radiation area may darken, become irritated, sometimes painful. Care includes avoiding water on the skin, not applying creams or soaps, avoiding sun exposure, and not scratching
  • Swelling and stiffness of the arm and shoulder; perform arm and shoulder exercises and use pillows to elevate the arm to reduce swelling

3. Chemotherapy uses drugs to destroy or inhibit cancer cell growth, administered by injection or orally

Goals of Chemotherapy
  • To facilitate surgery: some patients receive chemotherapy before surgery to shrink the tumor
  • To cure cancer: chemotherapy is given as adjuvant treatment after surgery to prevent recurrence
  • To prolong life and provide palliative care in cases where cancer has spread to other organs or has recurred

Side Effects After Chemotherapy and Care

Some patients may have no side effects, but others may experience severe symptoms because chemotherapy not only destroys cancer cells but also affects normal cells such as bone marrow, which produces white blood cells. Common side effects include:
  • Nausea, vomiting, mouth sores, dry throat; care includes eating soft foods like porridge or ice cream, eating small frequent meals, rinsing mouth often to prevent infection, and drinking 8–10 glasses of water daily
  • Increased risk of infection due to low immunity; avoid crowded places and pollution
  • Hair loss, which is temporary and hair will regrow later

4. Hormone Therapy: Some breast cancers grow faster when exposed to estrogen, so doctors use anti-hormone drugs to reduce estrogen levels

Caring for Breast Cancer Patients

In fact, whether a patient has breast cancer or other types of cancer, basic care is not very different. The guidelines are as follows:
  1. Maintain strict hygiene as infections can easily occur
  2. Do not take any medications other than those prescribed by the doctor, or if needed, always consult the doctor
  3. Get enough rest and avoid overworking
  4. Quit alcohol, smoking, drugs, and avoid caffeinated beverages
  5. Maintain strong mental health and avoid stress and depression
  6. Engage in activities with family to build morale for fighting the disease
  7. Know how to care for yourself during low white blood cell counts
  8. Follow doctors’ and nurses’ instructions strictly
  9. Attend all medical appointments
  10. Limit intake of very sweet and salty foods as they affect blood sugar and kidney function
  11. Try to eat regularly even if appetite is low
  12. Eat nutritious food covering all five food groups

Breast Cancer Screening

  • Self-breast examination by palpating for lumps about one week after menstruation; can be done monthly
  • Mammogram, especially for women over 40 years old, recommended annually
  • Breast examination by doctors and nurses
Although breast cancer is a frightening threat and one of the cancers in women, it can be prevented by maintaining good health, avoiding risk factors, and importantly, having regular annual health check-ups, especially “breast cancer screening”, which helps detect the disease early before symptoms appear, thereby reducing mortality from breast cancer.
Dr. Anirut Niranat
Specialist in Surgical Oncology
Breast Care Center, Phyathai 1 Hospital

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