Midnight feeds and broken sleep can leave any new mum feeling tired and lethargic. But new mum Siti Nur Aishah Bte Jamil,31, had this nagging thought that there had to be something more behind her constant tiredness and frequent headaches. Before long, she also discovered a persistent lump in her chest. She made an appointment at a polyclinic nearby, and two weeks later, she was given the news that she had Stage 4 breast cancer. Until then, Siti had thought this was a disease that only affected people in their 40s. “I told myself that I needed to move forward and embrace this journey. I knew that I did not want to be stuck feeling sad and hopeless, so I focused on being positive,” she says.

Fellow new mum Yvonne Chua, 33, also thought the lump in her chest was due to a blocked duct, but the lump began to grow. After a biopsy, Chua diagnosed with Stage 2 breast cancer. Now, three years later, after surgery and chemotherapy sessions, Chua sees that she can continue to live a normal life. “Life can be and will be better after cancer,” she says. “You may feel like you have hit rock bottom, but the only way to go after this phase is up. Once you have overcome this, you will emerge stronger,” adds Yvonne.

One of the biggest misconceptions about breast cancer, as Siti herself admits, is that it does not affect younger women. A report released in 2020 by Breast Cancer Foundation (BCF) proves otherwise. It revealed that one in six breast cancer cases in Singapore are diagnosed in women below the age of 45, and it is one of the most common cancers among women under the age of 35 years.

Both Siti and Yvonne were proactive in identifying their symptoms and acting immediately – which is the key to beating the disease, says Dr Wong Chiung Ing, chair, BCF Medical Advisory Panel. She is also senior consultant, medical oncologist at Parkway Cancer Centre.

Fighting chance

“The most common symptom of breast cancer is a breast lump that is hard and will not go away,” says Dr Wong. But there may be other indicative symptoms such as “nipple inversion or nipple discharge, which could be bloody or coloured”. The person may also experience skin changes such as a rash, redness, dimpling or puckering of the skin, she adds.

It is imperative to seek immediate help if you experience any of the above symptoms. In fact, you should always consult a doctor if you have any unusual symptoms that are of concern, insists Dr Wong: “This could be your general physician or breast specialist.”

Be aware

There are five different stages of breast cancer. “Stage 0 is non-invasive breast cancer, where abnormal cells are found in the lining of the breast milk duct, while Stage 4 means the cancer has spread to distant organs,” says Dr Wong. So the earlier you can catch the disease, the better your chances are of fighting it.

In the ’70s, women with breast cancer were only 50 per cent as likely to survive the next five years compared with their healthy peers. Today, this figure has risen to 80 per cent. Advancement in medical science aside, early intervention is one of the main reasons for the increase in survival rates. In fact, Dr Wong says that when diagnosed at an early stage and localised, this five year survival rate is more than 90 per cent.

Yet, many women fail to exercise due diligence when it comes to their health and well-being. Psychologist Diana, who goes by a single name, of Annabelle Psychology says that women tend to neglect their health because historically, they tend to play a more nurturing role by taking care of others and meeting their needs.

“Some may feel guilty that focusing on their own health may interfere with their responsibilities, while others may feel ashamed for talking about their health-related issues,” says Diana. This perceived lack of time to focus on oneself leads to many women self-medicating or seeking alternate therapies instead of seeking formal medical help, she adds.

However, scheduling in a breast self-examination should not affect their daily responsibilities, says Dr Wong. This is especially important as, in most cases, early breast cancer does not have symptoms. Women from the age of 20 upwards should carry out a self-examination once a month, advises Dr Wong.

“The best time to do this examination is seven to 10 days after the start of your period, when the breasts are least tender and swollen. If you no longer have periods, choose a fixed date every month for self-examination,” she says. In addition, women 40 years and above should schedule regular mammogram checks to catch any tumours while they are small.

Focus on yourself

Women who have been diagnosed with breast cancer face many psychological challenges – chiefly having trouble making sense of their perceptions of femininity, social roles and identity. This may often lead to them not being able to articulate their condition to their family members, who may be facing their own challenges in dealing with the diagnosis. It is important for women to remember to put the focus on themselves and their recovery at this point, says Diana. “If your family members are not coping well with your condition, consider asking them to seek help in order to better support you during this difficult period,” she adds.

Singapore’s first Breast Cancer Care Centre, set up by BCF, is one such space for patients, and their families and caregivers. Located at Sin Ming Court, it has counselling rooms, a social space, wig-loan and positive appearance room, as well as a kitchen where chefs share healthy menus, and a fitness studio that holds yoga and Pilates classes. Dr Wong refers to it as a safe space for Singapore’s breast cancer community, “where they can forge connections that will help them to overcome this illness from a place of solidarity and empowerment”.

This story first appeared in the October 2021 issue of Her World.