Despite the fact that women over the age of 40 are advised to get frequent breast tests, breast cancer can still be identified in younger people. In Singapore, women under the age of 45 account for 1 in 6 incidences of breast cancer.
To learn more about young women’s pregnancies and breast cancer, we speak with Dr Lee Wai Peng of the Solis Breast Care & Surgery Center.
Breast problems, both benign and malignant, are Dr Lee’s area of expertise. She worked at Changi General Hospital (CGH) as a Senior Consultant and Adjunct Assistant Professor before joining Solis. She progressed to this position after finishing her advanced speciality training in general surgery in 2014. She works hard to give women with breast issues individualized, comprehensive care with a personal touch. She also strongly supports combining surgical therapy and cosmetic procedures.
Q1: What are some symptoms that mothers may face during and after pregnancy that can be mistaken for breast cancer?
A: Our breasts undergo multiple changes during and after pregnancy. Lumpy breasts and even breast nodules/lumps are common symptoms that are encountered that may be mistaken to be breast cancer. Uneven breast tissue (lumpy breast) can be due to the hormonal change that is happening in the lady and breast nodules/lumps may be due to blocked ducts/milk cysts or even infections such as abscesses. Blood from the nipple may be due to excoriation or injury to the nipple as a result of poor latching technique. This may be mistaken to be breast cancer where patients may also present with bloody nipple discharge.
Q2. Once a woman contracts mastitis, will it become a reoccurring issue?
A: Mastitis can recur at any point in time, particularly so in lactating women. In such instances, it may be attributed to one or more of these factors: breasts not emptied, unable to fully empty their breasts during breastfeeding or an injury to the nipple resulting in bacteria entering the breast. Women who have diabetes or conditions that may suppress their immunity will have an increased risk of developing mastitis as well as recurrent episodes.
Q3: For women who were previously diagnosed with breast cancer but have completed their course of treatment/chemotherapy:
i) Is it advisable for them to try to conceive?
A: If the couple desires a child, they are strongly encouraged to discuss with their oncologist on the appropriate/suitable timing. Chemotherapy will affect the fertility of women hence if fertility is desired possibly after their treatment or when cancer is in remission, it is advisable to discuss it with their oncologist or breast specialist prior to the commencement of any treatment.
ii) How long would they have to “recuperate” their body before they would like to try to have a baby?
A: This would be largely dependent on the type of treatment that they have undergone and how mentally ready the couple is to move to another phase in their life. I would suggest a detailed discussion with your medical physicians to establish the best time interval for trying for a child.
Q4: Have you been seeing more younger women (e.g. age could range from 20 to 35 years old) diagnosed with breast cancer and/or other breast health issues in recent years? If so:
i) Are they usually in the early or later stage of cancer?
A: This often varies. This is because screening advice is often recommended for ladies above the age of 40. Hence, ladies below 40 most often present to a breast specialist when they feel a breast lump. If left ignored, should this lump be cancerous, the cancerous cells may progress further, resulting in ladies presenting at a later stage of cancer. However, we do see a fair number of younger ladies being diagnosed at an early stage and this finding is often incidental due to health screening.
ii) If detected early, will most patients usually get through the “cancer survival rate”?
A: As with any cancer, early detection saves lives. Similarly for breast cancers, the earlier we pick them up through screening (i.e. mammogram for those ladies above the age of 40 or breast self-examination), the better the chances for survival and the lower the risk for relapse. Breast cancer in a young lady (<40 years old) can potentially be associated with an underlying genetic mutation. Itmaybeadvisabletoseekyourdoctor’sadviceifgenetictestingisrequiredinsuch instances.
iii) Breast health issues – Are younger women getting more lumps and bumps (e.g. benign conditions)? What could it be possibly due to? When a biopsy is required, is there such a thing where there is a “best” or “less painful” type of biopsy?
A: Thankfully due to increased awareness of breast health, physicians may notice more ladies who discover lumps in their breasts during self-examination. At least 80% of breast lumps tend to be benign (non-cancerous). Such benign lumps are not genetically linked. Some of the common causes include fibroadenomas and breast cysts. Breast biopsies these days are done largely in an outpatient setting and local anaesthesia often suffices. The simplest technique is known as core (needle) biopsy where the different portions of the breast nodule are sampled. Vacuum-assisted biopsy is currently the more popular technique for breast biopsy where a breast lump, if small enough, can also be removed at the same setting (minimally invasive method). In a vacuum biopsy, the wound is extremely small unlike the conventional breast lump removal (excision). The above two biopsy methods can be done fairly quickly, and pain is manageable with very minimal analgesics.
Q5: Should a patient be diagnosed with breast cancer during her pregnancy, how are treatment plans best tailored for the patient?
A: In such instances, a multidisciplinary team approach will be extremely beneficial for the care of this patient. The team would include her gynaecologist, breast specialist, medical oncologist, and radiation oncologist. The priority of care and the well-being of her unborn foetus should be carefully discussed with the patient and her spouse.
All women are susceptible to being diagnosed with breast cancer, even though the risk does rise with age. Young women should perform routine self-checks and screenings to make sure that any breast health concerns are identified early because they are also prone to breast cancer and other breast-related conditions. Since early detection is always preferable, we wish to persuade women to seek out a breast health check for their own well-being without hesitation. You will receive the professional attention you require and deserve from Solis in the most frictionless manner possible. Consequently, there is nothing to worry about because you can trust Solis to take care of you at all times.
For more information on Solis Breast Care and Surgery Centre, please visit: Website: solis.sg
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