Your breasts change over your lifetime and breast health is every woman’s responsibility. Do you self-check your breasts for lumps each month? Have you noticed if they look or feel different lately? Why are regular breast screenings important? Getting to know how your breasts normally feel and look is the first step towards taking better care of them.

Dr Preetha Madhukumar​ and Dr ​​​Yong Wei Sean​, Senior Consultants from the Division of Surgical Oncology at National Cancer Centre Singapore, give details answers to your queries.​

Question by bibi_tay

At what age to start going for mammogram?

Answered by Dr Preetha Madhukumar, Senior Consultant, Singhealth Duke-NUS Breast Centre

If there are no risk factors, you should go for mammogram from 40 years of age.

Question by zuxxen

Recently my left breast has been quite itchy and I've googled and it may be a sympton of breast cancer. Everything is ok except for the itchiness.

In addition, normally there are small lumps in both breasts but recently, i noted that they have turned to one big lump each for each breast. My menses is delayed a bit also. For record sake, I'm currently 41 and my mother had her menapause at 45 (in case I may also inherit my mother to have early menopause... :() Please help to answer my queries above. Thanks.

Answered by Dr Preetha Madhukumar, Senior Consultant, Singhealth Duke-NUS Breast Centre

You need to see a specialist for further assessment. Apart from doing a proper physical examination of your breasts, they will arrange for mammogram and Us of your breasts. Itching and eczema of the nipples may be associated with breast cancer.

Question by rachel

I've just turned 50. Been going for mammograms the past few years. Approximately once in 18 months. No family history. I exercise on and off and I think my diet is now okay. I would really like to know - what else do I need to do to prevent breast cancer? Thanks.

Answered by Dr Preetha Madhukumar, Senior Consultant, Singhealth Duke-NUS Breast Centre

Being healthy, good exercise, less alcohol, low fat in the diet and avoiding hormone replacement therapy can reduce the risk of cancer. Obesity and stress also increases breast cancer incidence.

If you don't have high risk factors for breast cancer, you can go for mammograms once in 2 years, after 50 years of age.

Reposted by Administrator

Dear Dr Ong, I dread the pain of having mammograms – I am not that “busty”. Recently, I heard about thermography. However my doctor says thermography is not recommended as a form of breast screening? Why is that so? I was told it is a method that is more effective to detect early breast cancer. Is it? I would also like to know if mammograms can be made less painful. Thank you. ChngA

Answered by Dr Preetha Madhukumar, Senior Consultant, Singhealth Duke-NUS Breast Centre

Mammograms cause discomfort due to the pressure applied to get proper images. Thermography as such is not useful as a screening tool. If you do mammograms immediately after your menses, it may be less painful.

Reposted by Administrator

Dear doctor, I have a family history of breast cancer (my mother and two aunts). Angelina Jolie opted for a double mastectomy. Is it something to consider seriously? Are there unusual signs for breast cancer to take note of, e.g. not the usual lumps or bumps, changes in colour of nipple etc… Thanks! Concerned_82

Answered by Dr Preetha Madhukumar, Senior Consultant, Singhealth Duke-NUS Breast Centre

Your mum can go for genetic testing to look for abnormal breast cancer gene mutations. If she is positive, then we can screen the whole family and decide about the best option for screening and preventive therapy.

Reposted by Administrator

My daughter is 10 and she recently asked me to check her breast area as her left breast was feeling sore when she touches the area. I discovered a small bump, about the size of a flattened pea. I don’t want to scare her (or myself!) but should I bring her for a more thorough check up? Thank you for your advice. ScaredMom

Answered by Dr Preetha Madhukumar, Senior Consultant, Singhealth Duke-NUS Breast Centre

Yes. Definitely you need to see a doctor and get an opinion.

Reposted by Administrator

I am 42 years old and have 2 kids – 5 and 7 years old. How often should I go for breast screening? What can the screening tell me? Thank you! Sylvie73

Answered by Dr Preetha Madhukumar, Senior Consultant, Singhealth Duke-NUS Breast Centre

You can go for mammogram screening every year until the age of 50 years and once in 2 years after 50 years if your previous mammograms were normal. If there is any high risk lesions or any cancer in the breast then those patients will go for yearly mammograms.

Question by healthblur

I recently read that the US has just changed its recommendations re mammogram screening to start later (age 45, instead of age 40)Is that true? What about for Singapore? Should the guideline and considerations be the same for Asian and Caucasian women, or different?

Answered by A/Prof Yong Wei Sean, Senior Consultant, Singhealth Duke-NUS Breast Centre

In Singapore the HPB recommends regular 2 yearly mammo for women 50 yrs and above. For those 40 to 49 years, they should consult their doctor about the pros and cons of doing a mammo, and if mammo is done, it should be on a yearly basis.

Question by janey

I get confused between the need for mammogram versus ultrasound versus monthly self check. What's the purpose and difference for each? If I go for my two yearly mammogram post age 50, does this mean I don't need to go for any ultrasound check? Actually I have never been for an ultrasound test, but recently a friend of a friend told me her lump was detected by ultrasound which the mammogram missed. Please help!

Answered by A/Prof Yong Wei Sean, Senior Consultant, Singhealth Duke-NUS Breast Centre

HPB recommends doing a monthly breast self exam from the age of 30 yrs, so that a woman is aware of her breasts and if any abnormaility is detected, they should seek medical consult immediately.

HPB recommends a 2 yearly mammo for women above 50 years of age. Only if the mammo shows certain abnormalities, or if anything abnormal is felt in the breast, then an ultrasound would be done. It complements the mammogram and may give more information. Mammo uses xrays to look at the breast whereas u/s uses sound waves.

No breast imaging method is 100% foolproof, sometimes ultrasound may detect something not seen by mammo, and vice versa.

Question by john

1. I have heard that the earliest stage of breast cancer is 'carcinoma in situ'. Is that correct?
2. Does a mammogram detect breast cancer at this stage?
3. Does that mean it is fully curable at this stage?
4. My wife is quite scared of taking any scans or tests for fear of the results. Is there any other self check sign which can alert her to any problems?
5. And if these signs are there, does it mean it would be past the fully curable stage?

Thanks for your help in advance.

Answered by A/Prof Yong Wei Sean, Senior Consultant, Singhealth Duke-NUS Breast Centre

1. Yes, stage 0
2. It is able to
3. Yes, as dcis (stage 0) means that the cancerous cells are still within the basal membrane and is unlikely to have spread
4. For e.g. breast lumps, nipple discharge, skin changes on the breast etc
5. Not necessarily

However, would still advice regular mammograms, and clinical breast examination by a doctor on a regular basis.

Ref: Q15