BREAST cancer is the most common cancer in women. Statistics show that one in 17 women in Singapore will develop this disease. And the bad news is that it has been diagnosed more frequently, especially over the last 15 to 20 years.

The possible reasons for this include more women undergoing medical screening, changes in diet and lifestyle as well as getting pregnant for the first time at a later age.

The first sign of breast cancer is a lump in the mammary tissue. When this shows up, it is crucial to see a doctor who may then refer the patient to a specialist. The specialist performs what is known as “triple assessment”.

The good news is that not all lumps in the breast are cancerous. However, when a lump is discovered, it is important to check it out.

Once we know a lump is not cancerous, we can rest easy and sometimes we don’t even have to remove it. A common non-cancerous lump is a fibroadenoma, which may occur on its own or multiply. These lumps are removed only if they cause discomfort or pain or increase in size.

The triple assessment, found to be the most accurate in diagnosing whether the lump is cancerous or not, starts with a physical examination of the lump. The next step involves radiological imaging (mammogram done on a machine like the one pictured on the left or an ultrasound scan).

It is the third step, where a fine needle is inserted into the lump to extract some cells for examination under a microscope, that can finally determine the presence of cancer. If all three steps show negative results, we can be 98 per cent sure there is no cancer.

If any of the steps don’t provide clear results, then further tests may be necessary. For instance, if the mammogram shows areas of calcium deposits, sometimes magnified X-ray views are required to have a closer look at the calcium. If the needle test is unclear, then some patients are recommended surgical removal of the lump.

An unfortunate consequence of these tests is the anxiety felt by the patient while awaiting the results. This isn’t helped if the result is ambiguous, preventing the doctor from determining if the lump is cancerous or not.

However, there is no more accurate way of assessing breast lumps so the steps should not be changed. In fact, the best way to reduce anxiety is to perform all the tests quickly so that the waiting time between tests and results is greatly reduced.

Source: AsiaOne