Take your breasts seriously

If you think the title of this column is funny, think again. This year, more than 14,000 Filipino women are expected to develop breast cancer, almost half of whom will die.

The Philippines has the dubious distinction of having the highest number of breast cancer cases in Southeast Asia. For every 100,000 Filipinas, almost 48 will have breast cancer, an incidence rate that exceeds that of several Western countries. Breast cancer is the number one cancer among Filipina women. Its incidence starts rising steeply among Filipinas age 30 years and older.

Embarrassment, shyness, ignorance, lack of time, fear, and lack of money are the usual reasons many Filipino women give for not undergoing regular breast cancer screening. That’s too bad because screening can detect breast cancer at an early stage, before it is felt or causes symptoms and, hopefully, catch it at a time when it is still curable.

 There are three main methods of screening for breast cancer. Mammography or breast x-ray is the best screening test to reduce a woman’s risk of dying from breast cancer. Modern mammography equipment emits extremely low levels of radiation so you need not worry. Each breast is x-rayed individually. The breast is flattened between two panels to facilitate visualization of abnormalities. This can be uncomfortable, though the discomfort lasts for only a few seconds. Mammograms are most uncomfortable when done just before or at the beginning of the menstrual period, so avoid scheduling your mammogram at these times, if possible. Breast cancer cannot be diagnosed by mammography alone. Women usually require further testing (e.g., ultrasound or biopsy) if the mammogram shows a suspicious mass, new calcium deposits, or other abnormal findings. The presence of cancer is only confirmed once a biopsy has been performed.

Clinical breast examination (CBE) is the visual and manual examination of the breasts by a doctor. Both CBE and mammography appear to be important: studies show that 5 to 10 percent of breast cancers are detected by clinical breast examination and missed by mammography, while about 40 percent are detected by mammography and missed by examination. CBE is typically performed as part of a yearly physical examination. Doctors usually inspect the breasts for any changes in size, shape or presence of skin changes and then palpate (feel) all areas of the breasts to include the area under both arms (armpits) for any change in texture or the presence of lumps.

Breast self-examination (BSE) is a do-it-yourself way of detecting changes in your breasts. Ask your doctor to demonstrate how to do BSE and how to tell the difference between normal tissue and suspicious lumps. BSE is typically performed at the same time each month. Doing it regularly may improve your ability to detect subtle changes that you would otherwise not have appreciated. You might even detect a lump in the time interval between the yearly clinical, mammogram and / or ultrasound examinations. Remember: breast self-examination is not a substitute for mammography or clinical breast examination done by a doctor.

Most experts recommend routine screening with both mammography and clinical breast examination for women ages 50 years and older. However, an increasing number of experts recommend screening for women in their 40s as well. This may even start at a younger age in high-risk patients, those with a family history of breast cancer in a first-degree relative or several relatives.

The Breast Center of St. Luke’s Medical Center has state-of-the-art equipment for breast cancer screening and evaluation, such as the most up-to-date mammography and high-resolution breast ultrasound units. The Center also has cutting-edge facilities and equipment for breast biopsies, such as Fine-Needle Aspiration (FNA), Core Needle, Incision and Excision biopsies as well as a minimally invasive ( small incision) vacuum-assisted breast biopsy device (mammotome).

The Breast Center is the most comprehensive multidisciplinary breast care center in the country. In the event that a patient is diagnosed with breast cancer, the Center is ready to provide various specialists that will form part of a multidisciplinary team for initial consultation, evaluation and, if the patient wishes, co-management of the disease. This team is composed of surgeons, radiologists, medical oncologists, radiation oncologists, plastic surgeons, pathologists, psychiatrists, and other support staff.

Breast cancer is best managed through a multidisciplinary approach because the disease has far-reaching effects that go beyond its physical symptoms. Breast cancer management should also address the emotional, psychological and spiritual needs of the patient as well as provide after-care support.

Dr. Alejandro C. Dizon heads the Breast Center at the St. Luke’s Medical Center. For inquiries, please contact 723-0101 ext. 5206 or visit the Breast Center, 12th Floor, North Tower, Cathedral Heights Building Complex, St. Luke’s Medical Center.