A STUDY on Malaysian women revealed that seven out of 10 believe breast cancer screening should only be pursued when they experience symptoms .

However , early detection is a vital shield against the threat of breast cancer . Regular screenings and vigilant self-examinations allow us to catch any abnormalities before they escalate , providing a critical advantage in the fight against breast cancer .

By identifying the disease at its earliest stages , medical interventions can be more effective and less invasive , leading to higher survival rates and a better quality of life .

It is crucial for women to maintain vigilance regarding their overall breast health and to be self-aware , promptly noticing any abnormalities in their breasts and performing regular breast self-examinations . If any abnormality is detected , seeking immediate medical attention is essential .

Look out for key signs and symptoms a . Painful or painless lumps in the breast or axilla b . Redness , dimpling or thickening of the skin c . Nipple retraction or discharge d . Changes in the shape of the breast

UNRAVELLING THE RISKS : NAVIGATING MODIFIABLE AND NON-MODIFIABLE FACTORS

Breast cancer risk factors are categorised into modifiable and nonmodifiable factors : a . Non-modifiable factors : Increasing age , female gender , family history of breast cancer , early menarche , late menopause , dense breasts , history of neoplastic breast disease , i . e ., previous history of carcinoma in situ or atypical hyperplasia of the breast . Other factors , such as exposure to therapeutic radiation to the chest at an early age , usually for the treatment of Hodgkin ’ s lymphoma , can also increase the risk of developing breast cancer . b . Modifiable factors : Nulliparity , lack of breastfeeding , late first childbirth ( 35 years and above ), oral contraceptives , hormone replacement therapy in postmenopausal women , obesity , sedentary lifestyle , smoking , and alcohol consumption . By being aware of the modifiable risk factors , women can make conscious decisions and alter their lifestyles to avoid these risk factors . Breast cancer screening is done on

people without any symptoms . The age to start screening depends on the risk of developing breast cancer , and this can be categorised into average risk , moderate risk and high risk , where the lifetime risks of developing breast cancer are 12.4 per cent , 15-20 per cent and more than 20 per cent , respectively .

The lack of awareness regarding screening guidelines and the true purpose of screening represents a significant barrier that hinders women from getting screened .

GUIDELINES FOR EARLY DETECTION : TAILORED APPROACHES FOR DIFFERENT RISK CATEGORIES

Major risk factors that are used to determine a woman ’ s risk category include a personal or family history of breast , ovarian , or peritoneal cancer , associated BRCA1 / BRCA2 mutations , a known carrier of a mutated gene for hereditary breast or ovarian cancer syndrome in self or relative ; previous breast biopsy showing a high-risk lesion e . g ., atypical hyperplasia , reproductive factors ; and radiation therapy to the chest . Without any of these factors , a woman falls under the average risk category , and screening mammography is recommended every two years for women aged 50-74 .

For women with moderate risk ( those with a family history of breast cancer on a first-degree relative but do not have a genetic syndrome ), screening mammography should be performed annually from age 40-49 and annually or biennially from age 50-59 and every three years from 60 onwards .

As for women with high risk ( those with a known personal or family history of BRCA gene mutation or inherited cancer syndromes , strong family history of breast or ovarian cancer , and a history of chest radiation at a young age ), an annual MRI of the breast is recommended at the age of 30-49 , annual mammography from age 40-69 and a mammogram every three

years from age 70 onwards .

BEYOND MAMMOGRAPHY : REVOLUTIONARY TECHNOLOGIES IN BREAST CANCER DETECTION

Advancements in breast cancer detection have gone beyond traditional mammography , offering revolutionary technologies that hold promise in improving early diagnosis and saving lives . While mammography remains the gold standard and has proven effective in reducing breast cancer mortality , new cutting-edge tools like Digital Breast Tomosynthesis ( DBT ) are taking early detection to the next level : a . Mammography : The beststudied and the only imaging modality shown to reduce breast cancer mortality . Mammography is available as screen-film mammography , digital mammography and digital breast tomosynthesis ( 3D mammography ). b . Digital Breast Tomosynthesis ( DBT ): A new screening and diagnostic breast imaging tool to improve breast cancer detection early . Several meta-analyses have shown that DBT plus Full-Field Digital Mammography ( FFDM ) yielded higher detection rates for breast cancer in asymptomatic women compared to FFDM alone . Therefore , DBT is recommended in the screening and diagnosing breast cancer , but its usage is limited by its availability .

GENETIC TESTING FOR EMPOWERMENT : ASSESSING BREAST CANCER RISK THROUGH ADVANCED SCREENING

Genetic testing identifies genes linked to cancer risk , including BRCA1 and BRCA2 variants associated with higher risks of breast , ovarian , and related cancers . Mutated BRCA genes can elevate breast cancer risk to 45-85 per cent and ovarian cancer to 10-45 per cent .

Women with strong family histories can choose genetic testing , determined

Fig 2 : Digital Breast Tomosynthesis tool

by criteria like early diagnoses , family history , and specific cancers . Those meeting criteria should consider testing with pre-test counseling , followed by post-test counseling for those with pathogenic / likely pathogenic BRCA1 and BRCA2 genes . This includes screenings , risk-reducing surgeries and chemoprevention .

LIFESTYLE CHOICES : REDUCING BREAST CANCER RISK THROUGH POSITIVE CHANGES

Research has brought to light a remarkable finding : Lifestyle modifications can potentially reduce or even prevent a significant 25-30 per cent of breast cancer cases . Making thoughtful adjustments to daily routines can profoundly impact breast health and overall well-being .

Among these changes , key factors include making wise dietary choices , ending smoking habits , abstaining from alcohol consumption , maintaining a healthy weight and embracing an active lifestyle with regular physical exercise . Notably , regular exercise is pivotal in lowering breast cancer risk by influencing hormones such as oestrogen , insulin , and insulin-like growth factor 1 ( IGF-1 ), positively impacting other risk factors like obesity and insulin resistance .

Empowering yourself with this knowledge , you can proactively safeguard your breast health and significantly reduce the risk of breast cancer . By embracing these lifestyle adjustments , you enhance your overall well-being and build a formidable defence against breast cancer .

Your choices today can make a lasting difference in your health and future . Taking control of your well-being is paramount , and together , we can pave the way for a healthier and happier life .

Awareness of key signs and symptoms , along with understanding risk factors , empowers women to make informed decisions about their breast health . Encouraging advancements like digital breast tomosynthesis offer promising avenues for improved detection , while genetic testing provides valuable insights for high-risk individuals to take necessary precautions .

As healthcare professionals and communities , let us unite to promote breast health and early detection , saving lives and improving outcomes for breast cancer patients in Malaysia and worldwide . – The Health

Dr Ina Shaliny Duraisamy is a Consultant Clinical Oncologist at Sri Kota Specialist Medical Centre . You can visit their website at : https :// www . srikotamedical . com