Early Detection is Your Best Protection

Written by Maria Kaiserin J. Santos-Lipana, MD, FPCS, FPSGS, MASBS Breast and General Surgeon 

Breast cancer is a real and dangerous threat to health for both women and men.

According to the Philippine Breast Cancer Network, one in 13 women in the Philippines will have breast cancer. The Philippines has the highest incidence of breast cancer in Asia. Among the kinds of cancer detected in the country, breast cancer is the most prevalent or the most common as it accounts for 16% of the 50,000 diagnosed cases of cancer.

Knowing it exists is not enough. What is important is to do something about it. You can do this in three simple ways:

• Make yourself aware of the disease;
• Know your own breasts; and
• Go for screening

Awareness 

Breast cancer starts from the uncontrolled growth of cells in the breast. Early on, this growth may manifest as microcalcifications which may not have obvious physical changes that may alert you to see a Breast specialist. These microcalcifications can only be detected by mammogram.

Eventually, if left unchecked, breast cancer may manifest as obvious physical changes in the breast such as a lump that you can feel (mass), liquid that may come out from your nipples (nipple discharge) or pulled in nipple, skin changes such as redness or dimpling. Once these changes, like microcalcifications seen only on mammogram or the obvious physical changes, are noted by a breast specialist, a biopsy is recommended and done.

A biopsy can be a daunting term to most, but it only means that a sample of the noted changes is obtained and are submitted for examination by a pathologist. The results of the biopsy will give invaluable information and serve as a definitive diagnosis and guide for appropriate treatment for the patient.

Appropriate treatment is guided by the stage of the breast cancer, and ideally, by the unique characteristics of the patient.

At The Medical City, we offer the utmost professionalized and personalized patient care. As treatment of breast cancer requires the expertise of various specialists, we have our multi-disciplinary team composed of breast surgeon, breast radiologist, oncologist, radiation oncologist, plastic and reconstructive surgeon, and if necessary, physicians from the Institute of Personalized Molecular Medicine (IPMM) and psychiatrists. This pool of doctors shares the singular goal of synthesizing and providing the best treatment for every patient to achieve the best possible outcome.

Each stage of breast cancer takes into consideration three things: the size of the lesion in the breast, whether the cancer has spread to the lymph nodes of the axilla (ALN) and whether cancer has spread to other vital organs. • Stage 0:cancer is confined and contained to the breast and has no capability to spread to the ALN and other vital organs

• Stage I: cancer in the breast is very small, cancer already has the capability to spread but ALN and other vital organs are not involved
• Stage II:The cancer in the breast has reached the size between 2 cm to less than 5 cm and cancer has spread to 1-3 ALN but no involvement of other vital organs
• Stage III: The cancer in the breast is 5cm or bigger or of any size but this time it involves the skin making it red or with ulcer, has spread to four or more lymph nodes, with, however, no spread to other vital organs
• Stage IV: Metastatic breast cancer is any size of lesion in the breast, with or without ALN spread but has spread to vital organs such as the lung, liver or bone.

Know your Breast through SELF-BREAST EXAMINATION (SBE) 

Starting at the age of 25, make it a habit to self-examine your breasts. Do the self-breast exam once every month, 10-14 days after the first day of your monthly menstrual cycle. To help you remember, use the acronym TLC (Touch, Look and Check)

• TOUCH and feel your entire breast from the area near the nipple, in an outward direction towards the underarm (axilla) or vice versa.
• LOOK into the mirror to detect changes in the skin of your breast (such as thickening, dimpling, asymmetry) or any changes in your nipple (pulled-in appearance, presence of liquid discharge).
• CHECK once every month to be thoroughly familiar with what is usual and normal to you. It is important to know your normal breasts, such that you can easily detect any abnormalchanges needing urgent attention by a breast surgeon.

Go for SCREENING = MAMMOGRAM 

Starting at age 40, for average risk patient, without any symptoms or changes in the breast (no mass, skin or nipple changes), a mammogram is recommended and a yearly visit to a breast surgeon for clinical breast examination. This is what is known as SCREENING.

To detect early breast cancer, the screening tool is a breast X-ray known as the mammogram. It detects abnormal microcalcifications, which may be the earliest sign of breast cancer. Early detection of this will prompt a breast surgeon to perform biopsy for definitive diagnosis and start the corresponding treatment.

The key to a successful breast cancer treatment is early detection. Early detection translates to early stage of breast cancer. Early stage breast cancer has more treatment options and better treatment outcomes. Survival rate with appropriate treatment of very early detected breast cancer is close to 99%.

Early detection is the best protection we have against this real health threat. To achieve early detection, awareness of the disease, knowing your own breasts and going for screening areessential.

The Medical City Breast Center is located at the Women’s Health Floor, 6th Floor, Nursing Tower (The Medical City, Ortigas Avenue, Pasig City). For inquiries, please call 9881000 or 9887000 ext. 6527 or 6528 or visit http://www.themedicalcity.com/services/centers_of_excellence/cancer-center/breast-center/