[Doctor’s Advice vol.5] Let’s learn more about the “breast cancer examination.”


One out of 15 Japanese women is said to suffer from breast cancer. Even in other Asian nations, as women’s lifestyles change with the advancing westernization of eating habits, and the new tendency to marry later in life, breast cancer is said to be one of the types of cancer whose incidence rate is increasing every year.

In recent years, and thanks to the “Pink Ribbon Movement,” an international awareness program that aims to spread correct knowledge regarding breast cancer, and to encourage women to undergo breast cancer examinations, more people have become increasingly aware of breast cancer. Also, the fact that in 2013 the Hollywood actress Angelina Jolie had her mammary glands removed (actually in a total mastectomy) and reconstructed as a way to “prevent possibly suffering from breast cancer in the future,” put breast cancer in the spotlight again.

Today we will be hearing about the “breast cancer examination” from Dr. Hiroshi Nabeshima from Raffles Japanese Clinic.

People at high risk for developing breast cancer…

  • Women under 40 years old 40 with blood relatives who have developed breast cancer
  • Regardless of age, women with blood relatives who have suffered from ovarian cancer
  • Regardless of age, women with blood relatives who have developed primary breast cancer more than twice
  • Women with blood relatives who have developed male breast cancer
  • Women with more than 3 blood relatives, including herself, that have developed breast cancer
  • Women with blood relatives who have been found to carry BRCA, an inheritable genetic mutation that causes breast cancer
  • Women with blood relatives suffering from breast cancer who have been told that all of the following treatments would be difficult: anticancer drugs, molecular target drugs and hormone therapy (triple negative.)
  • (Quote from:http://www.nikkei.com/article/DGXNASFK03012_T00C13A6000000/?df=3

    Besides this, women who had their first menstruation at an early age (less than 11 years old,) women who had a late menopause (later than 55 years old,) women who have never given birth, women who gave birth for the first time after 30, and women categorized as obese due to a high protein / high fat diet are at a high risk for developing breast cancer as well.

    By the way, in Angelina Jolie’s case, not only her own mother had passed away from a combination of both breast cancer and ovarian cancer, but her maternal grandmother passed away from ovarian cancer, and Jolie herself had been found to carry the BRCA genetic mutation. She was diagnosed to have an 87% probability of developing breast cancer in the future, and more than 50% probability of developing ovarian cancer. Because of this, she took the plunge and went ahead with the breast removal surgery to prevent breast cancer (at the same time, she underwent breast reconstruction surgery as well.)

    About the breast cancer examination

    The main methods to check for breast cancer are “clinical examinations,” “ultrasounds” and “mammographies.”

    Clinical examination

    The doctor will first check visually whether there are any hollow places and then will proceed to palpate to check for stiffness, swellings of lymph nodes and secretions from the nipples.


    In this examination, the doctor will have a look at the inside of the breasts using an ultrasound. This type of examination is characterized for its high efficiency in finding small cysts and tumors.


    This is an X-ray examination that is done with an X-ray machine especially designed to check the breasts. For this examination, the breasts are placed on a transparent sheet, and then pressurized so they become flat and thin to take the X-ray. This type of examination is especially useful to find small issues such as calcifications.
    However, since the mammary glands appear in white in mammographies, it is difficult to diagnose cancer with them until the patient is in her 20s or 30s, when the mammary glands are fully developed, for before this the whole breast will show in white. Because of this, mammographies are most reliable after the patient is 40 years old, when the mammary glands have shrivelled.

    Women in their 20s and 30s, should have a clinical examination or an ultrasound (or a combination on both,) leaving the option of a mammography only for cases in which it is actually necessary.
    It is recommended for women in their 40s, which is said to be the age when breast cancer develops the most, to have a mammography (or ultrasound) examination done at least once every two years. The probabilities of developing breast cancer even after their 50s or 60s, when the majority of women reaches the menopause, is not low, so it is recommended for women to check themselves by palpating at least once a month.
    [Reference: How to do a self breast exam] When breast cancer develops, painless and small hard lumps appear inside of the breasts. These lumps can be felt even by doing a self check. The most usual place for breast cancer to develop is the top outer side of the breast, followed by the top inner side, the low outer side and the surroundings of the nipples, so it is recommended to do a self check focusing on those areas about once a month.
    *Have a look at how to do a self breast exam here.
    (English) http://www.pinkribbon.org/BreastCancer/BreastExaminations/SelfBreastExam.aspx

    Breast cancer is different from other types of cancer that affect the internal organs in the fact that the lumps can be found by the patient herself and it is easy to become aware of it. Also, when found in an early stage, the treatment probabilities are high and, since there are various treatment methods to choose from, it is said that patients are more likely to live longer when compared with patients who suffer from lung cancer or cancer of the digestive organs. If you ever find something that feels unusual in your breasts, avoid self-diagnosing and have yourself checked with a medical specialist.

    Information provided by

    Raffles Japanese Clinic
    Doctor Hiroshi Nabeshima

    ph_ooiWriter:Ayumi Ooi
    Editor in chief http://singapore.keizai.biz/


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