Did you know that over 60 percent of breast cancer patients in Brunei Darussalam are diagnosed at the late stage when the cancer has already spread to the lymph nodes or other organs?
Sadly, breast cancer continues to be the most common type of cancer among women in the Sultanate, with more than 100 new cases recorded each year between 2009 and 2018, and that number is growing every year.
October is Breast Cancer Awareness Month, and in that spirit, we here at Neue challenge you to share this story with as many people as you can to help raise awareness.
Here are some things that EVERY young woman should know about breast cancer:
#1. What exactly is breast cancer?
Breast cancer is a disease in which cells in the breast grow out of control. There are different kinds of breast cancer. The kind of breast cancer depends on which cells in the breast turn into cancer.
Breast cancer can begin in different parts of the breast. A breast is made up of three main parts: lobes, ducts and connective tissue.
Inside these lobes are smaller sections, called lobules. At the end of each lobule are tiny “bulbs” that produce milk. These structures are linked together by small tubes called ducts, which carry milk to the nipples. Fat fills the spaces between the lobes and ducts.
The ducts are tubes that carry milk to the nipple. The connective tissue (which consists of fibrous and fatty tissue) surrounds and holds everything together. Most breast cancers begin in the ducts or lobules.
Breast cancer can spread outside the breast through blood vessels and lymph vessels. When breast cancer spreads to other parts of the body, it is said to have metastasized.
#2. Finding a lump in your breast means you have breast cancer?
Most breast lumps are caused by benign (noncancerous) changes, cysts, or other conditions.
Breast tissue is changing all the time because of fluctuating hormone levels, especially during times of menstruation and breastfeeding. It’s important to be aware of how your breasts normally look and feel, and know what changes to look for.
While most breast lumps will not turn out to be cancer, lumps that feel harder or different from the rest of the breast (or the other breast), or change over time, should always be checked by your doctor.
#3. Feeling pain in your breast is a symptom of breast cancer?
Most breast cancers do not cause pain in the breast (although some do).
Many women experience breast pain or discomfort in the week leading up to their period. The pain usually goes away after menstruation. Other breast conditions, such as mastitis (an infection of the tissue of the breast that occurs most frequently during breastfeeding), may cause more sudden pain.
If you have breast pain that persists and is not related to the menstrual cycle, you should be checked by your doctor.
#4. True or false? If I don’t have a family history, I won’t get it.
Many people think of breast cancer as an inherited disease. But only about 5 to 10% of breast cancers are believed to be hereditary, meaning they’re caused by abnormal changes (or mutations) in certain genes passed from parent to child. The vast majority of people who get breast cancer have no family history, suggesting that other factors must be at work, such as environment and lifestyle.
#5. How to do a breast self-examination?
Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and both of your arms on your hips.
Press firmly down on your hips to engage the chest muscles, which will help you notice changes.
Here’s what you should look for:
- Breasts that are their usual size, shape, and colour
- Breasts that are evenly shaped without visible distortion or swelling
If you see any of the following changes, bring them to your doctor’s attention:
- Dimpling, puckering, or bulging of the skin
- A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)
- Redness, soreness, rash, or swelling
Step 2: Now, raise your arms and look for the same changes.
Turn side to side, lifting your breasts up so you can see underneath and on the side of them.
Step 3: While you’re at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood).
Step 4: Next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. If you are checking the right breast, lift your right arm above your head (and vise versa)
Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a circular motion, about the size of a quarter.
Cover the entire breast from top to bottom, side to side – from your collarbone to the top of your abdomen, and from your armpit to your cleavage.
Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn.
This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you’ve reached the deep tissue, you should be able to feel down to your ribcage.
Check your nipples for any irregularities. Using light but firm pressure, squeeze your nipple between your thumb and forefinger. Note any lumps or if it expels any discharge (this could be a watery, milky, or yellow fluid or blood).
Step 5: Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in step 4.
Early detection is key
In a Neue article published in 2018, Dr Amalinda Suyoi, Associate Specialist in Breast Surgery at Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, noted that most women in Brunei who are diagnosed with breast cancer are often already at an advanced stage.
“It doesn’t have to be that way. Women need to be more vigilant about how their breasts feel; even though they may have just a small lump, they should seek attention at an early stage.
“The common misconception that women have is that if the lump is not painful, it’s okay and they don’t need to have it checked, because they think it’s probably benign,” she said.
Dr Amalinda also emphasised that any lump should be checked out, because you can’t know for sure if it’s benign until you can get a professional opinion.
Help is available
The Early Detection and Cancer Prevention Services (EDCPS) at Pantai Jerudong Specialist Centre launched last November was set up as a dedicated service for early detection and cancer prevention to the existing screening services that the Ministry of Health provides to the people of Brunei. It offers health education and facilitates cancer screening for individuals of target age groups who are interested to be screened for early detection of cancer.
Specifically for breast cancer screening, if you are between the ages of 40 to 69, you may be eligible to enrol in the National Breast Cancer Screening programme. However, if you are younger, the EDCPS also provides consultation for individuals with specific symptoms of breast lumps or nipple discharge, and for healthy individuals with a strong family history of cancer.
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In the spirit of Pink October, EDCPS have also arranged activities for cancer awareness and to support cancer patients and their families. These activities range from educational sessions to educate more on breast cancer, to fun make-up tutorial sessions to make patients feel good throughout treatment. If you are interested or you know someone who may be interested, check on their updates on @pjscbrunei Instagram page and share the information around.
The EDCPS is located at Level 2, PJSC opposite TBCC Outpatient Department. You may also contact them at 2613333 (extension 1515) to set up an appointment.