Breast cancer can affect women with no risk factors. Specialists from the National Cancer Singapore (NCCS) and KK Women's and Children's Hospital (KKH) share prevention tips and what to look out for.
Breast cancer is the most common cancer among women in Singapore today, with one out of 13 women likely to be afflicted by it. The incidence is growing with modern fast paced lifestyles including rich food, unhealthy diets, and increasing alcohol consumption by women.
Breast cancer often happens in women with no risk factors, but you can help yourself by adopting the following habits all year long for optimum breast health: observe, self-examine, screen.
Although most lifestyle factors influence risk of breast cancer only to a minor extent, here are some tips offered by the Division of Medical Oncology from National Cancer Centre Singapore (NCCS), to help keep your breasts and body healthy. NCCS is a member of the SingHealth group.
7 Tips to lower breast cancer risk
Maintain a healthy body weight
Maintain a BMI less than 23 throughout your life. Weight gain and obesity may increase your risk of breast cancer. Be aware: Fat is not inert. Fat deposited in the organs produce substances that cause inflammation and damage to multiple organs.
Make time for regular exercise. Break it up to make it up
Adopt an active lifestyle. Aim for 30 minutes or more of moderate aerobic activity at least five days per week. Here’s a tip from our doctors: If you cannot devote the time for a full workout, keeping active by walking and stretching for 10 minutes before each meal each day also helps! Remember - every bit counts towards a healthier you.
Minimise or avoid alcohol
Alcohol is one of the most well-established dietary risk factor for breast cancer. Women
who consume more than two glasses of alcohol a day are at higher risk.
Eat more veggies to boost your immune system
Consume more cruciferous vegetables (broccoli, cabbage, cauliflower), dark leafy greens, carrots, tomatoes, citrus fruits, berries and cherries. Cruciferous vegetables are a rich source of glycosylates, which may help fight cancer. Local leafy greens such as
Kai Lan and
Spinach are high in healthy fibre, contain healthy nutrients like Vitamins A and C, which act as antioxidants that can protect your body, may help boost the immune system and reduce risk of cancer.
Target to have your first child before 30. Mothers who breastfeed their babies for six months or longer may have a slightly lower risk of developing breast cancer.
Early detection is your best protection
Breast self-examination is recommended once a month about 1 week from the first day of menses. For women who no longer menstruate, choosing a date each month is an easy way to remember. Be sure to notify your doctor any breast changes such as redness, swelling, presence of a lump, skin changes or discharge from the nipple. For how to perform breast self-examination, see below.
between the ages of 40 to 50: a mammogram every year after consultation with their doctor
above the age of 50: a mammogram once every two years
Quit smoking (if you haven't)
The risk of many cancers, including breast cancer, and other health problems increases if you smoke.
When it comes to breast cancer, apart from lowering your risk, early detection is your best protection!
How to perform breast self-examination
(To perform once a month, 7 to 10 days after the start of your period)
1. Look for changes in front of a mirror. First, with arms at your sides. Next, with arms raised above your head. Finally, with hands pressed firmly on hips and chest muscles contracted
In each position, turn slowly from side to side and look for:
2. Feel for the changes lying down. Put a small pillow under your right shoulder. Place your right hand under your head
Use the pulp of your left fingers to feel for any lumps or thickening in your right breast. Feel for the changes lying down. First, feel the armpit. Then start on the outside edge of your breast and feel round the whole breast in smaller and smaller circles. Finally, feel behind the nipples itself.
3. Look for bleeding or discharge from the nipple. Squeeze the nipple gently to see if there is bleeding or any discharge.
Repeat step 2 and step 3 for the left breast.
Breast cancer screenings for Singapore Citizens and PRs
Here is a step-by-step on how to book for a mammogram screening through the national Screen for Life (SFL) programme.
1. Find out your screening eligibility
Subsidies for breast cancer screening are only available for women above the age of fifty, once every two years.
|||Pioneer Generation: The screening mammogram will be $25.|
Merdeka Generation (with effect from 1 Nov 2019): The screening mammogram will be $37.50.|
Community Health Assist Scheme (CHAS) Cardholders - Blue or Orange: You will be able to enjoy further subsidies on your screening mammogram. Visit chas.sg for more information.|
Community Health Assist Scheme (CHAS) Cardholders - Green / Singapore Citizens (with effect from 1 Nov 2019) / Singapore Citizens: The screening mammogram will be $50.|
Permanent Residents: The screening mammogram will be $75.|
The screening can be paid using MediSave at approved centres. Click here to find out more about MediSave and the list of approved centres.
2. Book a screening
An appointment is required for a mammogram.
Make an appointment at your nearest polyclinics and public/private healthcare institutions.
Schedule your appointment one week after the first day of your menstrual period.
Bring your NRIC, CHAS/MG/PG card and relevant document(s) to the clinic for the screening appointment.
*Please call ahead to check before your appointment.
3. Prepare for screening
On the day of screening:
Wear a two-piece outfit as you will need to undress from the waist up.
Do not use any perfume, deodorant, powder or ointment on your underarms or breasts as this may affect image clarity.
4. After the screening
If your results are normal (do not need to follow up at the hospital), continue to go for regular screening at the recommended frequency.
If your results are abnormal, you will be referred to a hospital to have further investigations done. It is important for you to attend this follow up at the hospital.
What puts you at risk of breast cancer?
Dr Lim Geok Hoon, Senior Consultant for
KK Breast Centre at
KK Women's and Children's Hospital (KKH), a member of the
SingHealth group, shares the risk factors for breast cancer.
As a woman, your risk of developing breast cancer is
higher if you:
Are > 50 years old
Have a close relative (mother, sister or daughter) who has breast cancer or if you have a genetic mutation
Have taken hormone replacement therapy for more than 5 years after menopause
Have previous breast biopsies that have shown abnormal results
Had specific types of radiotherapy for lymphoma.
Breast cancer risk is also increased, though
less markedly, if a woman:
Has never been pregnant or had her first pregnancy after the age of 30
Began to menstruate before the age of 12, or reached menopause after the age of 55
Do bear in mind that breast cancer can affect anyone at any time, even in the absence of high-risk factors.
Early signs of breast cancer to watch out for
Early detection saves lives. When breast cancer is detected early, there are more treatment options, less radical surgery required and better chances of complete recovery.
The most common symptom of breast cancer is a lump in the breast. It is usually single, firm and often painless. Other tell-tale signs include:
Swelling on a part of the breast or underarm;
A previously protruding nipple that becomes inverted;
A persistent rash at the nipple or areola;
Bloodstained discharge from the nipple; and
A change in the size or shape of the breast=
A change in the colour or appearance of the skin of the breast such as redness, puckering or dimpling
Is preventive mastectomy advisable?
Back in 2013, famous Hollywood actress Angelina Jolie made headlines when had both her breasts removed to reduce her high genetic risk of developing breast cancer. How common is preventive mastectomy in Singapore?
"In Singapore, preventive mastectomy is performed for rare patients who carry specific mutated genes," explains
"Carriers of mutations in the BRCA1 or BRCA2 genes have more than a 50 per cent risk of developing breast cancer in their lifetime. When that mutation is detected, one of the recommendations would be to perform a preventive double mastectomy, usually when the woman is in her 30s," Dr Lim added.
For breast cancer symptoms, diagnosis and treatments, visit the SingHealth Conditions and Treatments page
Ref: I23 (ed)
More articles on breast cancer:
Breast Cancer: Symptoms and Risk Factors
Breast Cancer Treatment Options
Does Obesity Increase Breast Cancer Risk?
What's Next After an Abnormal Mammogram?
8 Top Cancer-Fighting Foods
How a Husband Can Support His Wife If She Has Breast Cancer