No family history, no symptoms. At 29, she had breast cancer

Ask most people to picture a breast cancer patient, and they’ll likely imagine someone older – but that exact assumption is what makes breast cancer so dangerous for younger women in Singapore.

In recent years, breast cancer has remained the most common cancer among women aged 30 to 39 here. According to the Singapore Cancer Society, it accounts for around 30 per cent of all female cancer diagnoses, and about 1 in 12 women here will develop breast cancer in their lifetime. However, subsidised routine screening only kicks in once you turn 40. That’s not an oversight – younger women have denser breast tissue, which can make mammograms less accurate. That’s why Dr Celene Ng, an oncoplastic breast surgeon at The Breast Practice, Gleneagles Hospital, notes that breast cancer screening below 40 should be based on individual risk, not a one-size-fits-all approach.

A Breast Cancer Foundation survey last year found that 91.5 per cent of young women are not taking active steps to monitor their breast health. Only 14 per cent know how to perform a self- examination, and just 22 per cent know what to look out for.

Dr Ng has watched more young women walk into her clinic in recent years than before. “We don’t have all the answers as to why we’re seeing more young patients with breast cancer, but we know it’s multifactorial – lifestyle factors like obesity, diet and alcohol, shifting reproductive patterns, exogenous oestrogen exposure and environmental factors all play a part,” she explains.

She points out that population programmes must weigh the benefit of early detection against the harm of overtesting, which includes unnecessary biopsies, false positives, and the anxiety and cost that come with them. But only 5 to 10 per cent of breast cancers are genetic, meaning most women diagnosed had no family history to warn them – just changes in their own bodies they might not have thought to check.

For Ms Wang (not her real name) that step came only after her cancer had already progressed. In early 2025, she was found to have a benign growth in her breast, spotted incidentally on an unrelated scan. A follow-up months later found nothing alarming, but something still felt off. She trusted that instinct, sought a second opinion, and only then was the cancer found. She was only 29.

“I never thought cancer would happen to me at a young age,” she says. The diagnosis reshaped how she relates to her own body.

Wang, who is still in recovery, is learning “to see my body as something that carried me through an incredibly difficult period, rather than something that has failed me. It has been through a lot, and perhaps it deserves more kindness from me than I have given it”.

For women who do not meet the criteria for routine mammogram screening, Dr Jesse Hu of The Aeden Surgeons points to a free teleconsultation, fully funded by Manulife, with a breast specialist before recommending the next assessment. “The specialist will consider factors such as your age, personal and family medical history, as well as other risk factors, before recommending the appropriate next step. This could include a clinical examination, ultrasound, mammogram or another form of assessment,” she says.

It’s the same gap that MammoXpress – a three-year partnership by Manulife Singapore, the Breast Cancer Foundation and Parkway Radiology – was designed to close, bringing free mammogram screening to women regardless of age via a mobile bus. Michelle Fang, chief marketing officer of Manulife Singapore, says: “The programme is available to women regardless of age or residency status in Singapore.”

Looking back, Wang wonders if more regular self-checks might have changed her story, and hopes that other women wouldn’t have to wonder the same thing. “Nobody knows your body better than you do,” she says. “If something doesn’t feel right, get it checked sooner rather than later. Early detection saves lives. Mine wasn’t picked up the first time. Don’t be afraid to go back.”