A mother is the heart of the household. So when breast cancer interrupts her life, it also upends the lives of those dearest to her. Her cancer journey is equally their milestone; her pain, their suffering.

The latest figures from the Singapore Cancer Registry’s 2000 annual report, released on Dec 23 last year, show that more women in Singapore are suffering from breast cancer.

There were 12,303 cases of breast cancer between 2016 and 2020, making up 29.7 per cent of all cancers affecting women. This is higher than the 11,805 cases (29.4 per cent) in the registry’s previous report covering 2015 to 2019.

While the 2020 report does not show how many are mothers, it does reveal that breast cancer makes up a third of cancers for women aged 30 to 39 (33.6 per cent) and almost half of cancers among women aged 40 to 49 (46.6 per cent). Those are the ages when women are typically raising children.

Three mothers who overcame cancer reveal the stories behind their diagnoses. Behind the hard medical facts, managing breast cancer when you are a mother often means surrendering to the process.

Instead of always caring for others, they say they had to allow themselves to be cared for. Instead of putting their families’ needs first, they had to put themselves as priority.

Still, in this topsy-turvy post-cancer world, they uncovered new insights about their children’s courage and new depths of unspoken love in their husbands, parents and siblings. Beyond their tears of loss lies the greater gift of life – reclaimed, renewed, reaffirmed.

She waited until after PSLE to tell her younger kids about her breast cancer

For almost 10 months in 2021, Ms Eryannie Mohamad kept her two daughters in the dark about her Stage 2 breast cancer diagnosis.

She had discovered a lump in her left breast in late December 2020, just weeks before she was due for her first mammogram at age 40. A biopsy in January 2021 confirmed her worst fear and her doctor told her the lump was about nine months old.

“I was speechless. The only thought I had at that time was that my second one had the PSLE (Primary School Leaving Examination) that year and the youngest one was only eight. I didn’t want to tell them,” says Ms Eryannie, 42, who was then a teacher’s aide at a special needs school.

Single mum with breast cancer: ‘My daughters are much stronger than I give them credit for’

Ms Karampreet Kaur was doing her N levels in December 2014 when her mother broke the news of her breast cancer diagnosis to her and her younger sister.

“She had tried to hide it earlier on and didn’t want to tell us much until I said: ‘The exam is there. It doesn’t matter. Now, tell me what’s going on.’”

Ms Karampreet and her sister Navjodh Kaur, then 13, knew that their mother, Ms Kiranjit Kaur, had been to the accident and emergency (A&E) department for a swollen left breast, only to be told to go home with painkillers.

After her fever shot up during the night, she marched back into the A&E the next day. “I said I wanted to see a breast doctor immediately,” says Ms Kiranjit, who was then 40.

A mammogram and biopsy revealed that it was Stage 0 breast cancer, but widespread.

She told herself to hang on until her toddler could say ‘I love you’

Seven-month-old Nathan Xu breaks into a grin for the camera. His eyes are bright and attentive as his sister Michelle, six, tickles him playfully. They are the picture of family bliss as they pose with their parents.

Born in June last year, Nathan is a miracle baby. His mother Dai Wei, 34, overcame breast cancer when she was just 29.

“I’m super lucky,” says Ms Dai, who was born in China and is now a Singaporean, like her kids.

The smart mum’s guide to breast cancer

I have a lump in my breast, but I’m scared and so busy as a mum. Can I wait to get it checked out?

Despite all the publicity on breast cancer, many women do not get diagnosed early enough, says Dr Lee Wai Peng, a senior consultant breast surgeon at Solis Breast Care & Surgery Centre.

She cites “disheartening” data from the Singapore Cancer Registry that shows about 22 per cent of patients here are diagnosed with advanced stage breast cancer (meaning stages 3 and 4). Ten per cent are diagnosed at a metastatic stage where it has spread from its point of origin.

Women who are otherwise healthy may be in denial about their diagnosis or fear the unknown. Others may decline treatment or seek alternative, non-medical solutions.

The earlier you see the doctor, the better the likely outcome. “For example, women diagnosed with Stage 0 breast cancer do not need further treatment such as chemotherapy after their surgery,” Dr Lee says.

How do I break the news to my children?

Some mums may want to keep their diagnosis from their kids, fearing that they are not old enough to understand or will react badly.

“However, primary-school-age children are often perceptive enough to sense that something has happened in the family, even if the news is not explicitly conveyed to them,” says Ms Ranitha Govindasamy, a senior medical social worker in the Department of Psychosocial Oncology at the National Cancer Centre Singapore.

“They may notice changes in routines, their mother’s physical appearance or the functioning of the family unit. Not being able to understand these changes in context could cause them to become worried or anxious.”

Tell your children in a place where they feel comfortable or together with family members your kids trust, she adds. Use words they can understand and give them a safe space to express their feelings and ask questions. “

Children may need support as they see their mother go through physical changes during treatment, and knowing that they can turn to their parents gives the young ones assurance. Parents can also enlist the support of other family members and support networks to help children cope throughout the process,” says Ms Ranitha.

What role can my husband play?

“The presence of a spouse is exceptionally important,” Dr Lee says. Fathers can take the lead and say, for example, “mummy is not well”.

“In the conversation, the spouse can consider using sentences like ‘let’s support mummy’ or ‘it’s our turn to take care of mummy’,” she suggests.

Dads should also step up their involvement in household activities as the treatment process can be long and side effects can affect mothers’ ability to perform even seemingly simple chores.

I feel like a lousy mum since my breast cancer diagnosis.

You are not alone.

“Emotions are a natural way of responding to the cancer diagnosis and adjusting to life with cancer such as new routines,” Ms Ranitha says.

“Acknowledge these emotions and find adaptive ways to cope, such as taking walks, engaging in activities you enjoy or seeking support from your family and friends.”

Seek professional help if you are overwhelmed and it affects your sleep, appetite or motivation. Ask your doctor or join a support group at the Breast Cancer Foundation (www.bcf.org.sg). NCCS also has patient support group programmes and support programmes for children.

“Nobody needs to go through a cancer journey on her own,” she adds.