Understanding Breast Cancer: Types, Symptoms, Stages, Treatments, and the Path to Recovery

According to the Ministry of Health, breast cancer is the most common type of cancer among women in Malaysia. Globally, 2 million women were diagnosed with breast cancer in 2018. Hence, it's important that women understand this disease and know its symptoms, the treatments available and even ways to protect themselves financially from this illness.

What is breast cancer?

Breast cancer occurs when cells in one's breast start to grow abnormally. These abnormal cells divide faster than healthy cells, and in an uncontrollable manner. As a result, they accumulate, resulting in the development of a tumour or breast lump. If left untreated, the cancerous cells can spread to other body areas.

As such, doctors may have to remove the breast to ensure that all cancer cells are eliminated.

Types of breast cancer

Some types of breast cancer include:

• Lobular carcinoma in situ (LCIS) occurs when abnormal cells multiply in the milk glands. Although LCIS is not cancer, it does increase one's risk of developing breast cancer.

• Ductal carcinoma in situ (DCIS) occurs when abnormal cells are present in the breast's milk duct. Although DCIS is the earliest form of breast cancer and hasn't spread to the surrounding breast tissue, it still requires treatment. DCIS is often discovered during mammograms.

• Inflammatory breast cancer develops when the cancerous cells block the lymphatic vessels in the skin covering the breast. This results in swelling, tenderness and redness and is considered a form of locally advanced cancer.

• Invasive lobular carcinoma begins with cancer in the milk glands and spreads to surrounding lymph nodes and other parts of the body.

• Paget’s disease of the breast begins on one’s nipple and progresses to the areola (the dark circle of skin around the nipple). This condition is more common among older women who also have ductal breast cancer.

• Angiosarcoma affects the lymph vessels and blood vessel linings, although this form of breast cancer is quite rare.

• Recurrent breast cancer may occur when some cancer cells are not eliminated during treatment. These cells continue to grow and, thus, cause cancer to return.

• Breast cancer in men is also possible, although it is less common than in women.

 

 

Breast cancer symptoms

Signs of breast cancer include:

• The presence of a lump is usually the first noticeable symptom. The breast lump feels different from other breast tissue and sometimes can be found in the armpit area.

• Skin changes such as discolouration, redness, or dimpling of breast skin can be a sign of breast cancer. The skin may also appear pitted or have ridges, something like how an orange's skin looks.

• Nipple changes, including the nipple becoming retracted or inverted or if there is the presence of clear or bloody discharge.

 

 

Symptoms of advanced stages may include the following due to the spread of cancer:

• Bone pain

• Difficulty breathing or shortness of breath

• Involuntary weight loss

• Reduced appetite

• Headache

• Neurological pain

 

 

Causes of breast cancer

Some causes, such as genetic mutations are known causes for breast cancer, one’s genes, lifestyle and even their surrounding environment (exposure to carcinogens) can contribute to the development of this disease.

Breast cancer risk factors

While it’s difficult to determine the exact cause, some risk factors may increase the likelihood of breast cancer, such as:

• Increasing age

• A family history of breast cancer

• A personal history of breast cancer or other breast conditions

• Gene mutations (BRCA1 and BRCA2)

• Being at an unhealthy weight

• Having your first period before 12

• Starting menopause at an older age

• Having your first child at an older age

• Never conceiving before

• Being on postmenopausal hormone therapy

• Radiation exposure

• Consumption of alcohol

 

 

Breast cancer diagnosis

Doctors used several methods to diagnose breast cancer, such as:

• Breast ultrasound - Soundwaves are used to produce pictures (sonograms) of the insides of one’s breast.

• Diagnostic mammogram produces images that are even more detailed than a breast ultrasound.

• Breast magnetic resonance imaging (MRI) scans the body with a magnet linked to a computer to produce detailed pictures of the insides of the breast.

• Biopsy is performed to remove breast tissue for more testing.

 

 

Breast cancer staging

Stage 0 (non-invasive breast cancer) - Abnormal non-cancerous cells or cancer cells are still contained in breast ducts and lobules and have not spread to neighbouring tissue.

Stage I - There is a small tumour, but cancer hasn't spread to lymph nodes in the area.

Stage II - Cancerous cells are found in the breast and surrounding lymph nodes. Patients may also have a tumour. Nonetheless, this is still early-stage breast cancer.

Stage III (invasive cancer) - Cancer has spread beyond the surrounding tissues, for instance, to the skin of the breast or the chest wall.

Stage IV (metastatic breast cancer) - Cancer has spread to other lymph nodes and organs, for example, the lungs, liver or bones.

Breast cancer treatment

Treatment for breast cancer varies depending on the type and stage of cancer, tumour-to-breast ratio and the patient’s health. Some available treatments include:

• Chemotherapy uses drugs to keep cancer cells from growing and dividing to stop the spread of the disease. Chemotherapy drugs travel through the patient’s bloodstream to reach every part of the body. As such, chemotherapy also damages healthy cells, resulting in side effects such as nausea and hair loss.

• Breast conservation surgery (BCS) is often recommended for women with stage I or II cancer. BCS enables only the tumour and a small margin of normal tissue surrounding it to be removed. This means the breast is preserved while giving patients the same survival rates as a total mastectomy.

• Mastectomy (complete removal of the breast) may be recommended it if tumours are 4cm or larger, radiotherapy is not an option, or if the patient is at risk of local cancer recurrence.

• Radiotherapy uses high-energy radiation to destroy cancerous cells. This treatment effectively reduces the risk of local or regional breast cancer recurrence. Thus, it's often recommended after the patient has BCS or a mastectomy.

• Endocrine therapy is an option for patients who have hormone receptor-positive diseases.

• Precision medicine considers the individual patient’s genetic makeup and the makeup of the cancer cells. For instance, the patient’s blood or tumour is tested and analysed. It also considers individual variability in lifestyle and environment. Doctors can then prescribe targeted treatment to enhance survival rates.

 

 

Breast cancer treatment cost

The cost of cancer treatment varies depending on the type of cancer, its stage, the treatment you're receiving, and how your body responds to the treatment. As such, cancer treatment costs can reach as high as RM400,000.

In addition Malaysia’s medical inflation rate is about 10% annually. This means medical costs will continue to rise, increasing the financial burden for those seeking treatment.

One way to ensure financial security in the event of a breast cancer diagnosis is via insurance.

For example, Prudential’s PRULady is a personalised insurance plan for women that covers a wide range of female-related illnesses, including breast cancer, osteoporotic fracture and rheumatoid arthritis. It also covers pregnancy complications and congenital illnesses in children.

Moreover, insurance plans such as PRUMy Medical Plus cover the cost of hospital treatments and medical bills so that you can concentrate on getting well.

Another insurance option to consider is Prudential’s Precision Medicine coverage. With advancements in genomic testing and targeted therapies, precision medicine is indeed a promising cancer treatment. Thus, our Precision Medicine coverage ensures you receive the best treatment if you’re diagnosed with cancer.

For more on insurance for cancer, read ‘Cancer Insurance: Protect Yourself from the Most Common Cancers in Malaysia’. 

Breast cancer prevention

While it may not be totally possible to prevent breast cancer, the following steps can help reduce its risk or help you detect the disease early:

• Breast cancer screening - Ask your doctor about clinical breast exams and mammograms and their benefits.

• Conduct breast self-examinations so that you’re familiar with them. Speak to your doctor if you notice any changes, lumps or signs of breast cancer.

• Limit alcohol consumption.

• Aim to exercise for 30 minutes daily and maintain a healthy weight.

• Discuss the risks of postmenopausal hormone therapy with your doctor.

 

 

For women with a high risk of breast cancer, preventive surgery can reduce your risk. However, you should discuss your situation and options with your doctor before deciding.

Conclusion

A breast cancer diagnosis is unfortunate. However, you can take steps to reduce the risk of this disease and protect yourself. Additionally, with continuous medical advancements, it is possible to beat cancer and live a long, healthy life.