By Eduardo Gonzales, MD
How common is breast cancer in the Philippines? Is it true that this cancer is curable? —firstname.lastname@example.org
The Philippines has the highest incidence of breast cancer in Southeast Asia, and the ninth highest in the world. With about 10,000 new cases discovered every year, the disease is already the most common form of cancer among Filipinos, having overtaken lung cancer in recent years. It accounts for 16 percent of all reported cancer cases in the country and nearly 30 percent of all female cancers. Experts project that that three out of every 100 Filipinas will develop breast cancer in their lifetime.
Breast cancer is curable
Breast cancer is curable, but only if detected and treated at an early stage, i.e., stage 0 or stage 1, when the tumor is smaller than the size of a peanut (l2 centimeters or smaller). Statistics bear this out—the 10-year survival rate of stages 0 and 1 breast cancer patients who underwent standard treatment is 100 percent.
Currently, the 10-year survival rate among Filipinas with breast cancer is only 40 percent, very much lower than the 80 to 98 percent in developed countries. According to experts, this low survival rate is primarily due to the lack of awareness about the disease resulting in a high proportion of women presenting with late-stage disease, and only secondarily to the lack of adequate diagnosis and treatment facilities.
The key to beating breast cancer
Evidently, awareness about the disease is the key to beating breast cancer. Hence, every woman should be familiar with how her breasts normally look and feel and report any changes to her physician right away. The most common manifestation of breast cancer that a woman should be wary of is a mass or a lump in the breast. Other common signs and symptoms include breast pain and skin changes such as redness and dimpling, and dimpling of, or unusual discharge from, the nipple.
Likewise, all women should be aware of the need to undergo periodic screening test for breast cancer as well as the benefits and limitations of screening.
Screening tests for breast cancer
Currently, the only breast cancer screening tests recommended by the American Cancer Society (ACS) for women with average risk for breast cancer is mammography. Incidentally, women at average risk of breast cancer are those who are without a personal or a family history of breast cancer, a suspected or confirmed genetic mutation known to increase risk of breast cancer (e.g., BRCA), or a history of previous radiotherapy to the chest at a young age while those who possess any of the mentioned factors are at high risk.
Mammography is simply x-ray examination of the breast, a procedure that detects breast tumors long before they can be felt by the fingers. Mammography, however, is not perfect. It can miss some cancers and sometimes additional test will be needed to find out if something found on a mammogram is cancer or not. There’s also a small possibility of being diagnosed with a cancer that never would have caused any problems had it not been found during screening.
Latest (2015) Recommendations on Breast Cancer Screening
The following are the current screening recommendations of the American Cancer Society (ACS) for women with an average risk for breast cancer:
1. Women age 45 to 54 should get mammograms every year.
2. Women age 55 and older should switch to mammograms every two years, or have the choice to continue yearly screening.
3. Women ages 40 to 44 should have the choice to start annual breast cancer screening with mammograms if they wish to do so.
The ACS also recommends that women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or longer.
Incidentally, women who are at high risk for breast cancer should plan their screening test in consultation with their doctor. Often, among these women, an MRI exam as an adjunct to mammography is indicated.
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