Breast cancer is the most common cancer among women in Malaysia, accounting for approximately 34% of all cancers in Malaysian women. When detected early, survival rates are significantly higher — making awareness, regular screening and prompt investigation of symptoms essential.
What is Breast Cancer?
Breast cancer occurs when cells in the breast tissue grow abnormally and uncontrollably. It most commonly begins in the milk ducts (ductal carcinoma) or milk-producing glands (lobular carcinoma). While breast cancer predominantly affects women, men can also develop it, though this is rare.
Symptoms and Warning Signs
Early breast cancer often has no symptoms. As it progresses, warning signs may include:
- A new lump or thickening in the breast or armpit
- Change in breast size or shape
- Dimpling or puckering of the skin
- Nipple inversion or discharge (especially blood-stained)
- Redness, rash or scaling of the nipple or breast skin
- Persistent breast pain (though most breast pain is not cancer)
Important: If you notice any of these changes, see a doctor promptly. Most breast lumps are benign — but early investigation is always the right course of action. Do not wait.
Risk Factors
Risk factors for breast cancer include:
- Age — risk increases with age; most cases occur over 40
- Family history — first-degree relative with breast cancer doubles risk
- BRCA1 or BRCA2 gene mutations — significantly elevated lifetime risk
- Dense breast tissue — harder to detect cancer on mammogram
- Early menstruation or late menopause — longer oestrogen exposure
- Hormone replacement therapy (HRT) — combined oestrogen-progesterone HRT
- Obesity — especially after menopause, as fat tissue produces oestrogen
- Alcohol consumption
- Lack of physical activity
Screening in Malaysia
The Malaysian Ministry of Health recommends:
- Breast self-examination — monthly from age 20
- Clinical breast examination — every 3 years from age 20–39, annually from 40
- Mammography — annually or every 2 years from age 40 onwards, or earlier for high-risk women
Laboratory Tests in Breast Cancer Diagnosis
| Test | Purpose |
|---|---|
| Core needle biopsy / Fine Needle Aspiration | Tissue sample from the lump for definitive diagnosis |
| Histopathology | Microscopic examination of tissue — confirms cancer type, grade |
| Hormone Receptor Testing (ER/PR) | Determines if cancer is driven by oestrogen/progesterone — guides treatment |
| HER2 Testing (IHC/FISH) | Identifies HER2-positive cancers — eligible for targeted therapy (trastuzumab) |
| BRCA1/BRCA2 Genetic Testing | Identifies hereditary mutations — important for patient and family risk assessment |
| Tumour Markers (CA 15-3, CEA) | Used to monitor treatment response and detect recurrence — not for initial diagnosis |
| Full Blood Count, Liver & Kidney Function | Baseline tests before chemotherapy to assess organ health |
Treatment Overview
Breast cancer treatment depends on the type, stage and molecular characteristics of the tumour. Options include surgery (lumpectomy or mastectomy), radiotherapy, chemotherapy, hormone therapy (for ER/PR-positive cancers) and targeted therapy (for HER2-positive cancers). Treatment decisions are made by a multidisciplinary team including surgeons, oncologists and pathologists.
Molecular oncology: Advanced genomic profiling of breast cancer tissue can identify which specific gene mutations are driving the cancer, enabling highly personalised treatment choices. Ask your oncologist about comprehensive genomic profiling if standard testing has not identified clear treatment targets.
Medical disclaimer: This article is for general health education only. Please consult a qualified doctor for personal medical advice.