2 weeks Ago
Breast cancer remains the most common cancer among women worldwide. While medical science has made significant progress, the journey remains complex, particularly for younger women. During a recent visit to Bangladesh, Dr Ma Jun, Consultant Medical Oncologist at the National Cancer Centre Singapore, and Dr Tan Si Ying, Consultant Surgical Oncologist specialising in breast surgery, shared valuable insights into the evolving landscape of breast cancer treatment, challenges faced by young women, and the importance of early detection.
Dr Ma Jun emphasised that understanding the subtype of breast cancer is critical in determining treatment. "We now classify breast cancer not just by how it looks under the microscope, but by whether it is hormone receptor positive, HER2-positive or triple negative," she explained. These classifications help determine whether a patient will benefit from chemotherapy, targeted therapy, or the increasingly used immunotherapy.
Particularly in triple-negative breast cancer, immunotherapy has become a promising addition. For early-stage breast cancer, surgery remains the cornerstone of treatment. "Surgery is still considered curative in stages one to three," said Dr Ma.
In contrast, for advanced stage-four cancers, the goal shifts to disease control with systemic therapies, and surgery is often not required. A notable concern in Bangladesh is the late presentation of breast cancer cases. Dr Ma highlighted a lack of awareness, cultural stigma, and limited access to screening facilities as major barriers.
"Many women ignore early warning signs, and without national screening programmes, cancers are often detected only when advanced," she noted. Dr Tan Si Ying, who leads initiatives focused on young women with breast cancer in Singapore, added that younger patients face a distinctly different set of challenges. "The cancers tend to be more aggressive, and the psychosocial impact is much greater," she said.
Younger women often face fears around fertility, body image, and the implications of surgery on their personal lives, including marriage and motherhood. Dr Tan also discussed advanced surgical options now available, including minimally invasive and oncoplastic techniques. "We work with patients to ensure both oncological safety and aesthetic outcomes," she explained.
Reconstruction is often done in the same operation, reducing hospital stays and emotional distress. Fertility preservation is another vital concern for young patients. Dr Tan said, "We counsel women on options like egg freezing or ovarian suppression before chemotherapy, as treatment can lead to premature menopause.
" She stressed the importance of discussing fertility early in the treatment process, especially if chemotherapy is to begin quickly. Genetic testing plays a growing role in managing breast cancer, especially for young patients and those with a family history. "Identifying BRCA gene mutations not only informs treatment but also helps in risk assessment for family members," said Dr Ma.
In Singapore, those with positive BRCA mutations may be offered risk-reducing surgeries, which have shown to improve survival. The doctors agreed that survivorship is an often-overlooked aspect of care. From managing side effects to returning to work, the path after treatment can be daunting.
Singapore's healthcare system provides dedicated support, including psychological counselling and rehabilitation. Public education remains key. In Singapore, campaigns target both adults and adolescents, promoting monthly self-examinations and school outreach programmes.
"We created animated videos and digital content to raise awareness among secondary school students," Dr Tan shared. Both experts urged for greater investment in awareness, screening, and multidisciplinary care in countries like Bangladesh. "Catching cancer early significantly improves survival," Dr Ma concluded.
"And with the right support, even young women can live full, healthy lives after breast cancer." Breast cancer remains the most common cancer among women worldwide. While medical science has made significant progress, the journey remains complex, particularly for younger women.
During a recent visit to Bangladesh, Dr Ma Jun, Consultant Medical Oncologist at the National Cancer Centre Singapore, and Dr Tan Si Ying, Consultant Surgical Oncologist specialising in breast surgery, shared valuable insights into the evolving landscape of breast cancer treatment, challenges faced by young women, and the importance of early detection. Dr Ma Jun emphasised that understanding the subtype of breast cancer is critical in determining treatment. "We now classify breast cancer not just by how it looks under the microscope, but by whether it is hormone receptor positive, HER2-positive or triple negative," she explained.
These classifications help determine whether a patient will benefit from chemotherapy, targeted therapy, or the increasingly used immunotherapy. Particularly in triple-negative breast cancer, immunotherapy has become a promising addition. For early-stage breast cancer, surgery remains the cornerstone of treatment.
"Surgery is still considered curative in stages one to three," said Dr Ma. In contrast, for advanced stage-four cancers, the goal shifts to disease control with systemic therapies, and surgery is often not required. A notable concern in Bangladesh is the late presentation of breast cancer cases.
Dr Ma highlighted a lack of awareness, cultural stigma, and limited access to screening facilities as major barriers. "Many women ignore early warning signs, and without national screening programmes, cancers are often detected only when advanced," she noted. Dr Tan Si Ying, who leads initiatives focused on young women with breast cancer in Singapore, added that younger patients face a distinctly different set of challenges.
"The cancers tend to be more aggressive, and the psychosocial impact is much greater," she said. Younger women often face fears around fertility, body image, and the implications of surgery on their personal lives, including marriage and motherhood. Dr Tan also discussed advanced surgical options now available, including minimally invasive and oncoplastic techniques.
"We work with patients to ensure both oncological safety and aesthetic outcomes," she explained. Reconstruction is often done in the same operation, reducing hospital stays and emotional distress. Fertility preservation is another vital concern for young patients.
Dr Tan said, "We counsel women on options like egg freezing or ovarian suppression before chemotherapy, as treatment can lead to premature menopause." She stressed the importance of discussing fertility early in the treatment process, especially if chemotherapy is to begin quickly. Genetic testing plays a growing role in managing breast cancer, especially for young patients and those with a family history.
"Identifying BRCA gene mutations not only informs treatment but also helps in risk assessment for family members," said Dr Ma. In Singapore, those with positive BRCA mutations may be offered risk-reducing surgeries, which have shown to improve survival. The doctors agreed that survivorship is an often-overlooked aspect of care.
From managing side effects to returning to work, the path after treatment can be daunting. Singapore's healthcare system provides dedicated support, including psychological counselling and rehabilitation. Public education remains key.
In Singapore, campaigns target both adults and adolescents, promoting monthly self-examinations and school outreach programmes. "We created animated videos and digital content to raise awareness among secondary school students," Dr Tan shared. Both experts urged for greater investment in awareness, screening, and multidisciplinary care in countries like Bangladesh.
"Catching cancer early significantly improves survival," Dr Ma concluded. "And with the right support, even young women can live full, healthy lives after breast cancer.".
