Cancer. The Big C. Many fear it, most don’t know how to deal with it. Despite the great advances in modern medicine in the last decade alone, majority of the populace still have a lot of trouble dealing with most diseases. Blame it on the healthcare system or the rampant spread of misleading information that is so readily available online.
Let us help by bridging that discrepancy and sharing with you information about cancer, specifically cancer of the breast, through this article which has been authored and verified by some of our very own Kindred doctors.
What is breast cancer?
First of all, what is cancer? To put it simply, cancer is the unbridled multiplication and growth of cells due to certain damages or mutations that they have sustained either from internal or external elements. Factors like toxic radiation, repeated trauma, chemicals, aging, or even genetics can trigger such an event and lead to this phenomenon. Any cell can be affected –– any one of the trillions that make up our bodies, inside and out.
So, you may ask yourself, if that’s true, why aren’t there more people who have cancer? It is actually very dependent on how healthy and tough your body and immune system is to prevent, detect, and eliminate or correct these “malfunctioning” cells before they can have any significant effects. Similarly, because breasts too are made up of cells, maintaining breast health can lower your chances of developing breast cancer.
Basically, breast tissue is made up of ducts, lobules, and fats. Ducts are the passageways for the secretions, such as milk, to pass through and out to be used. These ducts are made up cells that have been seen to be more susceptible to cancer development. The atypical growth of cells from within the duct can eventually grow uncontrollably and break out of containment and spread to other breast tissues. Slowly, and if left untreated, it can further spread into your lymph nodes, which are mostly in your armpits, and to other parts of your body like your bones, lungs, and liver.
Ideally, breast cancer must be treated as early as it has been detected. The percentages you see below these diagrams are actually survival rates if treatment starts at that stage, with noticeably very high rates if detected before it starts spreading heavily to the lymph nodes. This has been made possible because of the many advances in technology, studies, statistics, and more importantly awareness. Today, overall survival of breast cancer in general has reached up to 90%.
There are basically 3 types of breast cancer based on how it can start in any individual. The first two are more often interchangeable with each other. Hereditary breast cancer is related to genetic mutations. Familial breast cancer is passed through the lineages without any specific and identifiable genetic cause. Interestingly, these first two make up only 5-10% of all breast cancer cases. The last type is the most common one and has been seen in almost 95% of all breast cancer patients: The Sporadic type or having absolutely no definitive pattern. This means that absolutely anyone with a breast can develop breast cancer. And when I say anyone, I mean, anyone.
Did you know that men can develop breast cancer as well? 1 in every 1,000 Filipino men will be diagnosed with breast cancer. It is then very important for men to be checked as well.
Statistics
To put things into perspective, according to the latest census released in 2021 by the World Health Organization, breast cancer is now the number 1 cancer worldwide, overtaking lung and colon cancer just recently in 2020. Breast cancer affects as much as 2.3 million individuals annually and has become the second leading cause of cancer death, taking about 685,000 lives in 2020 alone. Similarly, the Filipino people hold this burden with 17.7% of cancers being related to the breast. That is about 27,000 people in 2020. According to the Philippines Statistics Authority and the DOH, 3 in every 100 Filipino women will be diagnosed with breast cancer.
Interestingly, out of the 197 countries globally, it was seen in 2017 that the Philippines had the highest prevalence rate for breast cancer. Meaning, as small as our country is, we had more cases per 100 individuals that year. But despite that number, our breast cancer mortality or death rate is only 10.7%, which may be related to individuals refusing medical care, deferring, or delaying treatment due to personal or financial reasons.
In another study done in 2022, released in 2023, it was seen that 1 in every 8 women will be diagnosed with breast cancer globally. That is roughly a 4% increase from the 1975 study, which can only mean that there is an increasing trend, may it be due to changing lifestyle choices, greater exposure to carcinogenic substances, or whatnot. But on a brighter note, it can also be because we are so much better now at detecting the disease that more people are seen and being treated. I can confidently say this because overall survival has also increased throughout the years, from 63% in the 1960s to almost 90% today.
Despite this significant improvement however, these same studies, published and verified by The National Breast Cancer Coalition or NBCC in 2022 before release, have concluded that every 13 minutes, breast cancer takes someone’s life, globally. Please take that value in and digest it for a while. It is scary. It is real. It can be right next door. But with today’s advances, there are many things we can do about it.
Symptoms of breast cancer
“Interesting doc, now what? How can I know if I have it?”
There are symptoms you can watch out for to stay vigilant of your breast health. Many people may think that cancer is solely associated with a mass, a tumor, or a “bukol.” This is true, but you have to understand that even thousands of cells are too small to be felt. Acknowledging the statement “earlier detection equals better survival,” it is very important to know the early signs and symptoms that you may experience even before the “bukol” decides to rear its ugly face.
Symptoms can be simple breast pain, skin changes like rashes, glossiness, and itchiness, nipple discharge, nipple shape or contour changes, armpit lumps, breast dimpling, or even breast swelling which can also be common during routine breastfeeding.
Of course, having these symptoms does not mean you automatically have the Big C. Knowing this can guide you to be more aware and to seek professional help early. Do not be afraid to ask your doctor for affirmation. It is better to err on the side of caution rather than suffer the consequences years down the line.
Men, on the other hand, may have it worse when it comes to breast cancer, considering that it is more aggressive and when identified, due to less breast tissue mass, it can spread faster and easier to other non-breast tissues. So, it is very important to be educated about the possibility and know when to seek help.
https://www.againstbreastcancer.org.uk
Getting checked for breast cancer
To us doctors, there are two main reasons to get checked. It is either you want a problem addressed (aka diagnosis) or because you want to make sure everything is running okay (aka screening). The best example of the latter is through annual physical examinations your company or institution requires of you.
Let us say you have a symptom and you decided to seek professional advice. Your doctor will usually interview you and ask about your history with the symptom, when and how it started, and what activities or events may aggravate it. Your doctor may also ask about your medical, surgical, family, and social histories.
Some Filipinos, because of taboos, may be surprised if they also evaluate your obstetric, gynecologic, contraceptive, and sexual histories. All these may help guide us to determine your actual risk; which, in knowing, will gear our aggressiveness to diagnose and/or treat that which you are experiencing. Next would of course be a physical examination which will entail the palpation of your breasts, armpits, and neck area.
The other reason to see a doctor is through screening. Screening is the process of determining which certain factors expose you to increased risk of developing such a disease. When it comes to breast cancer, thousands of studies and decades of experience have helped us identify these risk factors.
Risk factors can be classified as either:
- a) Non-modifiable, factors that are predetermined and cannot be altered,
- b) Modifiable, factors which mostly involve lifestyle choices
Certain non-modifiable risk factors include age, sex, family history, genetics, breast tissue density, age when menses had begun, and age of menopause. Modifiable factors may include obesity, diet, hormone-replacement therapy, alcohol consumption, exposure to radiation, and late onset pregnancy. All these factors are somewhat related to hormonal balance and cycling which has been seen to be greatly related to the development of breast cancer.
What does this all mean? Through very advanced statistical analysis and correlational evidence-based investigations, it has been concluded that:
- Women are 100x more at risk than males
- Your risk increases with age with most breast cancer patients are diagnosed after 50
- Having identifiable genetic mutations (i.e. BRCA1 and BRCA 2) increases your risk significantly and have also been seen in younger age groups
- Early menarche (first menstrual cycle) and late menopause (after 55) exposes women to hormonal cycles longer which can increase risk for developing breast cancer
- Having more dense breasts have increased risk
- Personal history of breast or other cancers will increase risk
- Family history of having breast or ovarian cancers will increase risk
- Having undergone radiation therapy for other diseases will increase risk
Identifying these during a check-up will alert your physician to investigate further. Tools like a mammogram, ultrasound, MRI, biopsy studies, and blood work can help us check your breasts thoroughly. We therefore recommend that individuals who are 40 years and older and are asymptomatic should see their doctor at least once a year just to make sure everything is A-Okay.
But the moment you start feeling something or are unsure of anything, there is no harm in seeking a consult earlier. This also applies to those who are under the age of 40. But what can you do to lower your risk? That is where the modifiable risk factors come in. It has been seen that:
- Those who are not physically active have a higher chance of getting cancer in general
- Being overweight or obese after menopause has been seen to increase the risk of developing breast cancer
- Certain hormonal replacement therapies, prescribed or not, have been seen to increase your risk. Consult your physician and ask about the risk that may be involved with their prescriptions
- Having your first pregnancy after the age of 30, not breastfeeding, and never having a full-term birth may increase your risk
- Excessively drinking alcoholic beverages have been correlated with increased breast cancer risk
Of course, with identifying risk factors, times have come when misinformation is so easily spread and can be passed on from person to person and be taken as fact. It is very important to us to clarify and straighten out certain myths to allow you to make a more informed decision.
Items such as breast implants, drinking excessive amounts of milk, application of hair dyes or nail polish, usage of bras, tucking cellphones close to your chest, administration of HPV vaccines, and even use of deodorants have been linked to increased risk of cancer development. To all of which, I say, “No. They do not.” No study has specifically stated or shown correlation between any of those claims and breast cancer. So no need to fear when you are using these things appropriately.
One very popular modality of risk prevention is through the preventive removal of your breasts to decrease your risk completely. This was advocated by none other than Ms. Angelina Jolie who, in 2015, was identified to have a certain mutation that predisposes her to developing breast cancer. She opted to undergo risk-reduction surgery and has since been able to say that her children no longer have to fear losing their mother to breast cancer. Yes, this is very true. But mind you, this can only be offered to a specific subset of individuals who have a relatively higher predisposition of developing the disease.
So, do your part in thwarting its growth even before it can become a problem! May it be through making certain lifestyle choices or identifying your individual risks. Amazingly, screening and early detection have increased survivability significantly today.
Breast familiarity
For years, physicians have been advocating breast awareness through self-breast examination which was initially recommended to be done at least once a month. Recently, experts have moved from this towards breast familiarity. Breast familiarity is as simple as knowing your own body and breast configuration and identifying unusual changes through regular examination and vigilance.
Breast examinations may be done properly through these simple steps illustrated below. Upon waking up, you may start by palpating your breasts individually with the arm raise to allow full access. You may do so in a circular, then radial, then linear motion. Checking for changes, lumps, bumps, or tenderness. When you get up from your bed, do a quick visual inspection first with your arms to your side, then with arms raised to the side, then with arms raised above your head. Take note of anything unusual like rashes, glistening, or dimpling. Lastly, repeat the palpation but this time standing up. You may do this in front of the mirror or even in the shower.
This practice enables you to identify unusual changes which you can bring up with your doctor during your next visit.
https://julidesagiroglumdfacs.com/en/early-diagnosis-in-breast-cancer
Breast cancer diagnosis and treatment
Let us say, you felt a lump or a bump and sought medical advice. Your doctor will assess whether or not it is necessary to remove the bump or take a sample and send for a biopsy. A biopsy is necessary to confirm the diagnosis of cancer, which only happens in 20% of identified breast lumps. 80% of the time, breast lumps turn out benign.
https://julidesagiroglumdfacs.com/en/early-diagnosis-in-breast-cancer
When breast cancer has been confirmed, your doctor will tailor-fit a personalized and direct plan of attack. Given the great advances in breast cancer treatment, effectiveness and overall efficiency have improved significantly. You may be offered surgery, chemotherapy, targeted therapy, radiation therapy, and/or hormonal therapy depending on the type of cancer that has been identified. Some of these modalities are geared more for prevention of recurrence because it does happen.
Around 7-11% breast cancer cases recur within the first 5 years. This can be prevented with proper diagnosis, appropriate treatment, good compliance, and regular check-ups. This means you must be willing to undergo treatment and see it through. Nothing half-baked. No half-measures. This will greatly increase chances of living disease-free for the next 5, 10, 15 years, and more. Because breast cancer is no longer considered a death sentence! We have the tools. We have the know-how. Let us help you through it.
What can Kindred do to help?
The Kindred Clinic has been very active when it comes to disseminating necessary medical information to our patients. Through lectures, seminars, on-site and online consultations, and a wide array of healthcare packages that can involve diagnostics and screening modalities, our affiliates have been working tirelessly to bring you not just the care you need, but the care that every Filipino deserves.
Specifically, for breast cancer, the new breast health package includes consultation, examination, diagnostics, and specific procedures that can be tailor-fit to your very own needs. Entrust your safety and health to our very competent experts and let us help you secure a healthy future.
To summarize
Despite the lengthy text, a few things I wish for you to take home. First is that breast cancer is very real and is very present. It can affect absolutely anyone, even men. But due to the many advances, it is no longer considered a death sentence. Early detection leads to early treatment and better overall survival. Knowing these is great, but awareness is nothing without action. Support those who may need the new information you’ve learned and you never know. You just might save a life.