Key to survival: Early detection of breast cancer What’s the big deal about early detection of breast cancer?Since breast cancer cannot be prevented, the best that can be done to control it is early detection, diagnosis and treatment. There’s a great difference to 5-year survival rates (aka cure!) between breast cancer detected in the early stages compared to the late stages. For example, if you detect cancer in its earliest stages (Stage 1), your chance of cure could be as high as 90%. However, if you detect cancer very late, when it has spread to other organs, then, your chance of cure is 10% or less!!! So detecting breast cancer early could save your life!! Early detection also means you may not need “mutilating” surgery and lose the whole of your breast, and you may not need to undergo chemotherapy. Traditional and natural therapy are unproven and precious time is wasted while trying them out. However, there may be no harm using them as an adjuvant or complement to standard “western” therapy. Remember to let both your doctor and natural therapist know about the different therapies so that they are not taken together to nullify or cancel out each other’s effects. The table below shows the difference sizes of breast lumps picked up by chance, occasional self breast examination, regular self breast examination, one random mammogram or regular mammography!!! Again, there is a difference between the various “methods” of detection. 
In a study conducted in University Malaya Medical Centre (UMMC) (formerly known as University Hospital, Kuala Lumpur) from 1993 to 2000, the researchers found that the majority of women discovered their own breast lumps but the average size of the lump discovered by women was 4.2cm!!! Women also waited about 3 months before seeking treatment on discovery of a breast lump. Over the 7-year period from 1993 to 2000, the size of the lump on presentation at the doctor did not change significantly. In the West, over 80% of the women present with breast cancer in the early stage where the size is about 2cm. It has been found in a study in USA that regular screening mammography from age 40 shifts at least 30% of the people who would otherwise be diagnosed in the later stages to the very early stages, which are more easily cured and far less expensively treated. Therefore it is cost effective as early breast cancer is easier to treat and less expensive to treat. Why are Malaysian women presenting at such a late stage?Although it is not entirely reflective of the whole Malaysian population, the results of the UMMC breast clinic experience have raised a big question. Why are women, even in urban areas, presenting at such a late stage? The researchers postulate that the main reason is FEAR and IGNORANCE! Only 2% practise self breast examination (from a study in their well women’s clinic) regularly and even fewer women go for screening mammography! As we know, mammography can pick up lesions even before they can be felt. When a woman finds a breast lump, she is usually too frightened to see the doctor. She does not realise that 9 out of 10 breast lumps are NOT cancer. In addition, many times, the woman just has lumpiness of the breast but no real lump. This can be diagnosed by clinical examination by an experienced doctor or health provider. When in doubt, the woman will be referred to the radiologist, either for a mammogram or an ultrasound or both depending on the age of the patient. It may be anecdotal evidence but some women keep their referral for a mammogram for months before summoning enough courage to actually undergo a mammogram. There is also widespread belief that traditional medicine, be it herbs or spiritualism, can cure all ills. Food fads appear to be the latest cure all but unfortunately all these methods are unproven. Then, there is also fear of the treatment or surgery. Losing the breast can be devastating to a woman especially if this destroys their self-esteem and potentially their relationship with their spouse or partner. Unfortunately women do not realise that they may not need to lose their whole breast if they come in the early stage. Conservation surgery is practised wherever possible. Key Message Ladies, DO NOT LET FEAR OVERCOME YOU. See your doctor immediately if you feel there is something wrong with your breast. This applies also to men who through ignorance do not realise that breast cancer also can strike them!
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