Breast cancer is the most common cancer and one of the leading causes of death among Thai women. Currently, the incidence of breast cancer is increasing, with about 1 in 10 women having a chance of developing breast cancer. Therefore, there is increased awareness for screening and treating breast lumps to diagnose breast cancer at an early stage and to promptly treat it before the disease spreads.
Who is at risk of breast cancer?
- Women aged 35 years and older (can occur at any age but the risk increases with age)
- Family members with a history of breast cancer or ovarian cancer
- Patients who have previously been treated for breast cancer or certain types of breast tumors
- Women who have no children or had children after the age of 30
- Presence of inherited gene mutations
- Women with denser than normal breast tissue
- Those who started menstruating before age 12 or experienced menopause after age 55
- Those who have taken female hormones or contraceptive pills for a long time
Warning signs that require immediate medical consultation
- Feeling a lump in the breast or armpit
- Changes in breast shape, dimpling, or wounds
- Abnormal thinning or thickening of the breast skin
- Redness of the nipple, discharge of blood or pus
- Pain in the breast area
Breast cancer is divided into 4 stages:
- Stage 1: The tumor is smaller than 2 cm and has not spread to the lymph nodes in the armpit
- Stage 2: The tumor size is between 2 – 5 cm and cancer cells have spread to the lymph nodes in the same armpit
- Stage 3: The tumor is larger than 5 cm and has extensively spread to the lymph nodes in the same armpit, causing the lymph nodes to cluster into a large mass or adhere firmly to adjacent organs
- Stage 4: The tumor can be any size but has spread to distant parts of the body such as bones, lungs, liver, or brain
*Early-stage breast cancer refers to stages 1 and 2, or some cases of stage 3, which have a good prognosis with a 5-year survival rate of approximately 80-90% after diagnosis.
What are the methods for early breast cancer screening?
- Breast self-examination should be done monthly to become familiar with the normal condition of the breasts, making it easier to notice changes each month. The best time to perform self-examination is 7 days after the start of menstruation because the breasts are least tense or swollen. For postmenopausal women, choose a specific day, such as the first day of the month, for convenience and to remind themselves to check regularly.
- Examination by a specialist doctor involves palpating the breast and underarm areas to check for abnormal lumps. The doctor also examines other features such as dimpling, lumps, abnormal hard masses, abnormal nipple retraction, or discharge such as lymph or blood from the nipple.
- Mammogram is a breast X-ray method that helps doctors visualize details of abnormalities, including very small tumors that cannot be detected by palpation, especially in older women.
There are 5 effective and widely accepted breast cancer treatment methods today:
- Surgical treatment of breast cancer includes 2 methods
- Complete mastectomy: removal of the entire breast with the tumor along with the lymph nodes under the armpit at the same time. If there is no spread, only the breast tissue is removed.
- Breast-conserving surgery: removal of only the cancerous lump while preserving the remaining healthy breast tissue.
- Radiation therapy
- Hormonal therapy
- Chemotherapy
- Targeted therapy
Early-stage breast cancer is primarily treated with surgery, and most cases require additional treatments to improve outcomes, such as chemotherapy after the surgical wound has healed, followed by radiation therapy combined with hormonal therapy. The treatment depends on the stage of the disease, cancer characteristics, and surgical methods, as each patient’s details differ, resulting in varied treatment approaches.
Dr. Supachart Chompoonuch
Chemotherapy Specialist
Cancer Center, Phyathai Nawamin Hospital
