Breast cancer is considered the number one risk among all cancers in women and the number of cases is on the rise every year. Even though the information is frightening, and you may be starting to worry, the good news is that if detected and treated early, the chances of a good outcome are higher.

Let’s start by looking at three simple ways to check for breast cancer that you can do by yourself as well as warning signs which indicate that you are at risk of developing it.

Getting to know breast cancer

Breast cancer is caused by abnormal cells in the ducts or lobules. These cells divide abnormally and out of control, causing enlargement until they become malignant lumps and spread to nearby organs along the lymphatic pathways such as armpit lymph nodes and distant organs such as bones, lungs, liver, and brain. Like other cancers, as cancer cells grow, they steal nutrients and release certain substances that are harmful and damage organs causing patients to eventually die.

Causes of breast cancer

At present, medical science is unable to determine the exact cause of breast cancer and there is no vaccine that prevents the disease. However, studies have found that risks of causing the disease can be divided into two groups:

·       Controllable risks

o   Certain lifestyle behaviours such as regular consumption of alcoholic beverages

o   Obesity

o   Regular consumption of high-fat foods

o   Lack of exercise

o   Working or living in a high radiation area

o   Taking birth control pills or hormonal pills for a long time

o   Childlessness or having a child at the age of over 30 years old

·       Uncontrollable risks

o   Age (women aged 50 years old and over are at increased risk)

o   Having a history of breast cancer or having someone in your family with a history of breast cancer

o   Having a history of ovarian cancer

o   Mutations in the BRCA1 or BRCA2 gene (BRCA stands for BReast CAncer gene).

o   Menstruation at an early age or late menopause

o   Immunodeficiency

Four stages of breast cancer

In the early stages, breast cancer patients don’t feel any abnormal symptoms, which leaves them unaware that they are dealing with a serious medical issue. The symptoms of breast cancer can be broken down into four stages:

·       Stage 1: Breast cancer lumps are no larger than 2 cm and have not spread to axillary lymph nodes.

·       Stage 2: Breast cancer lumps are 2-5 cm and may have spread to the same axillary lymph nodes.

·       Stage 3: Breast cancer lumps are larger than 5 cm and have spread to the same axillary lymph nodes to the point that the lymph nodes fuse together to form a large mass or become firmly attached to nearby organs.

·       Stage 4: Breast cancer lumps can be any size. The cancer has spread outside the breast and nearby lymph nodes, such as the lungs, liver, brain, bones and elsewhere.

Patients diagnosed with breast cancer early at stage 1 or 2 or even stage 3 have a 70-90% chance of survival for five years or more. Only stage 4 detection can no longer be cured, with a survival rate of five years or more at 22%.

Breast cancer warning signs

When you feel or suspect that you have these symptoms, it should be assumed that they may signal the onset of breast cancer symptoms.

·       Feeling a thick lump in the breast area or under the armpit.

·       Breast cancer lumps are mostly hard and rough, but they can be smooth.

·       Nipples are abnormal such as being pulled back until they turn down and dimple. There is lymph or bleeding from the nipple or an ulcer.

·       The shape of the breast has changed.

·       Feeling pain in the breast, swelling, redness and hotness that can’t be cured.

·       When not menstruating, there is pain in the breast area.

Three simple methods to check for breast cancer yourself

1.        Check your breasts by standing in front of a mirror

·       Leave your arms at your sides comfortably. Observe the size of the breasts on both sides to see if the nipples are distorted or if there is anything wrong.  

·       Examine for abnormalities in overhead hand coordination or foot-waist posture.

·       Lean forward with both hands on your knees or a chair and look for abnormalities.

2.        Check your breasts lying down

·       Lie down in a comfortable position.

·       Raise your arms so you can see them above your head thereby flattening your breasts, especially around the upper outer area which has the thickest texture.

·       Use the index finger, middle finger, and ring finger of the other hand. Check all over the breast and armpit without squeezing the breast as it will make you feel like you've found a lump even though it isn't actually a lump.

·       When you’ve finished on one side, move to the other side, and do the same procedure.

3.        Check your breasts while taking a shower

·       Women with small breasts, raise the arm of the side to be examined above the head. Then, use the other hand to check the same way as checking while lying down.

·       Women with large breasts, use the hand to support and examine the breast from below. Then use the other hand to check from above.  

Examination by a doctor and modern technology

In addition to checking your breasts by yourself, anyone who is still unsure can come in for a medical examination at a hospital using various methods.

·       Mammogram

Mammograms are a special type of radiation test similar to X-rays. They are highly effective tests that can detect breast cancer at early stages. This gives patients the opportunity to receive treatment in a timely and efficient manner. This method is currently the best as it can detect abnormal calculus in the breast or small lesions. It only takes 30 minutes and doesn’t require you to refrain from drinking or eating before the examination.

·       Ultrasound

The breast tissue is examined by ultrasound. As the sound waves hit different tissues, they are reflected back to the probe. The technology makes it possible to detect the difference between normal tissue and lump tissue. It can also check if a lump is watery or sinewy. Ultrasound can help tell if the lump has smooth edges or if it is more or less malignant. This type of examination is also suitable for Thai and other Asian people as they have denser breasts than Western people. If there is a lump or any abnormality, it is likely to be obscured when using a mammogram whereas ultrasound detects small lesions of 2-3 millimetres, so abnormalities have nowhere to hide.

·       BRCA

BRCA tests detect abnormalities in the genetic code of the BRCA gene which can be passed on to offspring either from the father or the mother. Those who inherit the abnormal gene have a nearly 90% risk of developing breast cancer and 50% risk of developing ovarian cancer.

Who should be screened for breast cancer?

·       Women aged 40 years old and over should begin to have annual examinations.

·       Those with direct family history of breast cancer before menopause should start testing from the age of 30 years old.

·       Those with a history of abnormal genetic code test results or who have a direct relative who has ever detected an abnormality should have annual examinations from the age of 25 years old.

·       Those who find a lump or other abnormality in their breasts and nipples should consult a doctor.

Breast cancer is a deadly disease that kills many women. Even though it is dangerous, if you check regularly and take care of your health, should you get it you can get treatment in a timely and effective manner which will save your life.

Krungthai-AXA Life Insurance customers who want to have breast cancer treatment can obtain additional advice through Krungthai-AXA. For more information about treatment, please visit https://www.krungthai-axa.co.th/th/health-services/care-coordination.

References

·       Faculty of Medicine, Siriraj Hospital
https://www.si.mahidol.ac.th/sidoctor/e-pl/articledetail.asp?id=771
https://www.gj.mahidol.ac.th/main/knowledge-2/breast-cancer/

·       Bumrungrad Hospital
https://www.bumrungrad.com/th/conditions/breast-cancer

·       Samitivej Hospital
https://www.samitivejchinatown.com/th/health-article/detail/40

·       Siriraj Piyamaharajkarun Hospital
https://www.siphhospital.com/th/news/article/share/823

·       Paolo Hospital
https://bit.ly/3OJYbUx

·       MedPark Hospital
https://www.medparkhospital.com/content/stage-of-breast-cancer

·       Petcharavej Hospital
https://bit.ly/3AbrN9s

·       Pobpad website
https://bit.ly/3nk6oTR