Doctors, advocacy groups call on women to make regular breast cancer screenings a priority

SINGAPORE: Doctors and advocacy groups are calling for more women to go for regular breast cancer screenings and for men to be more aware about the breast health of their loved ones.

Only about 38 per cent of women in the 50 to 69 age group reported having gone for a mammogram screening in the last two years, according to the National Population Health Survey 2022.

While more than nine in 10 of those surveyed are aware of the need to go for mammograms, the top reasons cited for those who have never undergone the screening were: “Not necessary as I am healthy”, “It’s a painful test”, and “Never thought about it”.

With October marked as breast cancer awareness month, non-profit organisation Breast Cancer Foundation (BCF) and its partners have organised a calendar of activities and initiatives to create awareness on the disease and encourage more women to do regular check-ups.

Breast cancer is the most common cancer among women in Singapore – one in 13 women will be affected by the disease in their lifetime.

More than 2,000 women – an average of six per day – are diagnosed with breast cancer each year and over 400 die from the disease, making it the most common cause of cancer deaths in women here, according to a 2018 report by the Singapore Cancer Registry.

Early detection, however, significantly reduces mortality.

IMPORTANCE OF AWARENESS IN YOUNGER WOMEN

With increasing instances of younger women being diagnosed with breast cancer – one out of five patients is under 45 years old – doctors say there is urgency to instil the importance of self-examinations and screenings from early on.

Dr Choo Bok Ai, a senior consultant and clinical oncologist at Icon Cancer Centre, said: “In the past five years, I've seen breastfeeding women and pregnant women – one during her second trimester – who discovered that their breasts have cancerous lumps. Initially they thought they were just mastitis, a bit of engorgement of the breasts, but they turned out to be cancerous.

“It's devastating for them.”

He cited a BCF survey in 2017 that showed 60 per cent of female respondents under the age of 45 having limited to no knowledge of breast cancer.

“Many think this is a disease of the elderly and it will not affect them,” Dr Choo, who is also a member of the BCF medical panel at Breast Cancer Foundation, told CNA938’s Asia First on Monday (Oct 2).

“But once you have hit puberty, you really ought to be body aware. You need to be doing your monthly self-examination so that you can understand your body and the changes, and look out for signs and symptoms.”

He also stressed that early detection means a higher survival rate, adding that today’s medical advancement has led to improved chances of complete remission of the cancer.

“Back in the 1970s, the survival rate for breast cancer was only about 50 per cent. But now, the survival rate has gone up to 80 per cent. Overall, there's a huge difference in the availability of treatment and so the survival rate has gone up,” Dr Choo said.

“Sometimes, the cancer is diagnosed at stage zero, which means we can pick up cancer even before it becomes invasive. These patients need to just have lumpectomy or mastectomy, they don't have to go to chemotherapy at all.”

WHO SHOULD GO FOR MAMMOGRAMS, AND HOW OFTEN?

Women aged between 40 and 49 are typically encouraged to go for a mammogram screening to detect possible breast cancer once a year, with the recommended frequency decreasing to once in two years for women above the age of 50.

For those aged 50 and above, screening mammograms are Medisave-claimable.

Those below the age of 40 do not need to go for mammogram screenings, but women of all ages are urged to conduct a breast self-exam once a month and look out for abnormalities such as a new lump, sore spot, changes in the appearance of the skin, or nipple discharge, said the BCF.

Singaporeans who enrol under Healthy SG – the national healthcare strategy with a focus on preventive care – will benefit from free recommended health screenings, which includes breast cancer.

The Health Promotion Board’s (HPB) Screen for Life programme also offers screening subsidies for women 40 years old and above.

BRINGING MEN INTO THE PICTURE

This year, the BCF has also included an unlikely group to champion awareness on breast cancer – men.

The “Dear Men” initiative aims to encourage men to become more informed about breast health and look out for the women in their lives.

“Most people think of breast cancer as a women's disease, but really it is something that affects relationships, families, and our community,” said Ms Natalie Lau, the foundation’s head of advocacy and communications. 

“This (initiative) serves to encourage men to talk about breast health, in urging the women they hold dear – mothers, sisters, daughters and other loved ones – to prioritise breast cancer screening.”