By IAN YEE and NASA MARIA ENTABAN

Rachael Lim has never had a breast examination. She is 26 years old.

She’s never had one done in a clinic, and she’s never even done a breast self-examination (BSE).

She knows about the risks of breast cancer, particularly the fact that at her age, she’s not considered part of the high risk group.

While she admits that there is a possibility she could develop breast cancer even in her 20s, she’s never been for an examination because they “sound scary”.

“I’ve been told there is a machine involved and it’s very painful,” she said.

It came as a surprise to her that the routine clinical breast examinations women above 25 are advised to get annually do not involve any machines, but just a medical practitioner feeling the breasts for lumps or bumps.

Melissa Raj had also heard from friends that clinical breast exams were painful procedures, but she has done a BSE “once or twice” before.

“But that was a long time ago. I wasn’t sure if I was doing it right, and most of the time I just forget because it is not a daily habit like brushing your teeth,” said Melissa, 25.

“When I see booths or campaigns in malls that have to do with breast cancer, I sometimes take the pamphlets but I don’t actually read them.”

It seems that breasts can still be a sensitive topic among young women in Malaysia, at least according to Angela Yap, 24.

“You’d be very surprised how many young people are reserved about it, even in this modern society,” said the Law graduate.

Women as young as 18 should perform breast self-examination

“A lot of parents won’t talk about it either. The only way these girls can find out more about breast cancer and doing self-examinations is through friends, or campaigns. That’s how I had to find out – through some brochures. My parents never talked to me about it.”

Perhaps the most common reason why young people don’t know as much as they should about breast cancer, and don’t bother finding out more, is because it doesn’t seem relevant to them at their age.

Rachael, for one, doesn’t think she is at risk of getting breast cancer, because she is young. “I don’t know of anyone my age who got breast cancer, but I know it is possible,” she shared.

Young at risk

Breast cancer is the number one cause of cancer deaths among women in Malaysia, according to the National Cancer Council (MAKNA).

Based on current statistics, one in 20 Malaysian women are at risk of getting breast cancer in their lifetimes, and it will most likely occur when they are between 45 and 55 years old.

But according to Dr Patricia Alison Gomez, consultant breast surgeon at the Breast Care Centre of Pantai Hospital Kuala Lumpur, that risk group seems to be getting younger.

“We’re still waiting for the latest statistics on this, because the latest numbers we’ve seen in Malaysia were from 2006; but clinically, we’ve been seeing a lot more younger patients.

“Maybe it’s because of the lifestyle today, or the increase in pollutants in the environment, we don’t know – but I think a good 10% of breast cancer patients now are below 40 years of age,” she said.

In fact, Dr Patricia has treated a breast cancer patient as young as 17, and that particular case didn’t end well.

“It was a sad story. She already knew there was something wrong (with her breast), but she didn’t do anything. She was shy.

“When she finally got treatment, during chemotherapy, she got pregnant out of wed-lock. The mother gave the baby to a foster family. After that, she went into depression, gave up and passed away,” she said.

But whether she was pregnant and depressed or not, Dr Patricia says her chances of beating the cancer were already slim for two reasons: Firstly, the disease was detected too late, and secondly, she was young.

Getting yourself checked could save your life

Patricia explains that cancer that occurs in young people tends to progress faster.

“It’s hard to explain why, but older women tend to get non-aggressive cancers, while younger patients tend to get the more aggressive cancers – especially when it comes to breast cancer,” she said.

Start early

To be safe, young women are encouraged to start doing BSE every month once they turn 18, and to get annual clinical breast examinations by a medical practitioner when they reach 25.

Though the chances of women in that age group developing breast cancer is relatively remote – something like a “one in 20,000” chance according to Dr Patricia – the examinations are important to establish a routine.

“You need to familiarise yourself with what feels normal, so you can feel when something’s abnormal,” said Dr Patricia. “Once you’ve made it a habit, the chances are higher of you detecting anything earlier.”

And early detection is everything in the battle against breast cancer.
Breast Cancer Welfare Association (BCWA) Malaysia chief executive officer Ranjit Kaur, a cancer survivor herself, says early detection can not only save your breasts, but your life as well.

Ranjit says many women are afraid of getting breast exams due to the “psychosocial and psychosexual impact” of a breast cancer diagnosis.

“Women are associated with breasts, and if they lose them, they feel like it changes their sexuality, like they’ve become less of a woman,” she said.

“But if you detect it early, you won’t lose the whole breast. If you ignore it, you might lose more than your breasts – you could lose your life.”

Unfortunately, according to statistics on the PRIDE Foundation website (www.pride.org.my), nearly 40% of new breast cancer cases identified in Malaysia are already in the “very advanced stages” of the disease.

That’s why Dr Patricia recommends women ask for breast examinations every so often when they visit their general practitioner or GP.

As for mammograms, the painful “machines” Rachael, Melissa and so many misinformed young women out there fear so much, Dr Patricia says most hospitals now use digital mammograms that are virtually pain-free.

But as Ranjit puts it: “They might say the exam is painful, but breast cancer will cause them much more pain.”