Breast cancer is one of those diagnoses that’s often overlooked and classified as a taboo topic. In our conservative society, awareness is still lacking, as many regard the breast as a private matter best left unspoken. But this silence needs to end.
According to the Malaysia National Cancer Registry Report (2017-2021) by the National Cancer Institute (NCI), breast cancer is the most common cancer in the country, accounting for 17.6 per cent of all cases.
Recognising the global impact, the World Health Organisation (WHO) designated October as Breast Cancer Awareness Month — a time when communities and non-governmental organisations around the world unite under the “Pinktober” banner to honour those affected, raise awareness, and reaffirm the call for equitable access to care and improved survival rates.
WHO reports that breast cancer is the most commonly diagnosed cancer among women worldwide. In 2022, approximately 2.3 million women were diagnosed, and another 670,000 lost their lives to the disease. If the current trend continues, incidence and mortality are projected to rise by 40 per cent by 2050, hence the need for urgent and coordinated action.
With that said, in conjunction with Pinktober, Timberland Medical Centre’s General, Breast and Endocrine Surgeon, Dr Adibah Ali, shares insights on the key facts, common myths, and important developments in breast cancer detection, treatment, and patient care.
Q: How important is early detection, and what screening methods should women prioritise?
A: Early detection saves lives. A small cancer found early usually means simpler surgery and better survival. For instance, breast cancers detected at Stage 0 (precancerous) or those measuring less than 2cm (Stage 1) have a cure rate of over 90 per cent. However, once the cancer has spread to other parts of the body, the survival rate drops drastically — to around 22 per cent.
At what age should women start going for regular breast check-ups or mammograms?
For average-risk women, mammograms should start from age 40. If you have a strong family history, start earlier. But breast awareness should begin as early as the 20s. This includes educating women in their 20s on methods of regular self-breast examination and recognising the early signs and symptoms of breast cancer.
Can you explain the difference between lumpectomy and mastectomy, and how decisions are made?
A lumpectomy removes just the lump and is usually followed by radiotherapy, while a mastectomy removes the whole breast. Both can give the same survival rates when chosen appropriately. The decision is usually based on the size of the tumour in relation to the breast, the number of tumours in one breast, and whether the patient can undergo radiotherapy after surgery.
Are lifestyle factors such as diet, exercise, and stress management really impactful in reducing breast cancer risk?
Yes, lifestyle matters. Various studies have shown that staying active, eating well, limiting alcohol, and not smoking help reduce the risk of breast cancer.
Some women fear losing their “femininity” more than the disease itself. How do you respond to that fear in the consultation room?
I usually take quite some time to sit and explain to patients and their families. I tell them: your femininity, your identity, are not defined by a breast. There are also options of breast-conserving surgery or reconstruction surgery to help boost self-esteem.
When patients ask you, “Will I survive?”, how do you answer honestly but also with hope?
I reassure them with a simple statistic: breast cancer is curable and treatable if proposed treatments like surgery, chemotherapy, radiotherapy, and hormonal therapy are completed. I also share my experiences managing a high number of breast cancer patients and observing their survival. In fact, they can approach survivors active in NGOs to hear their journeys.
In your practice, what cultural silences or taboos around breast cancer do you feel actually cost women their lives?
In Malaysia, even educated women delay seeking help out of shame, fear of disfigurement, or reluctance to discuss breasts openly. Some rely first on traditional remedies. These delays cost precious time.
What are the most common misconceptions about breast cancer that you encounter in patients?
Many women think breast cancer is always inherited or only affects older women. In truth, most cases are not genetic, and it can affect younger women too. Most people also think all women diagnosed with breast cancer will need to remove the whole breast. They are not aware that there are options for breast-conserving surgery and reconstruction.
Breast cancer in men is rarely spoken about. What’s the reality here, and why is it still invisible in awareness campaigns?
It’s rare — male breast cancer occurs in less than 1 per cent of all cases — but it does happen. It is usually associated with genetics and often presents late. Yes, it should be more visible in awareness campaigns.
What are the biggest advancements in breast cancer treatment over the last decade?
Breast cancer treatment has evolved over the years. It started with radical surgery, which included the whole chest wall in earlier times, but now there are less invasive options like breast-conserving surgery. “Lesser is better”. Advanced systemic treatments aim to increase survival and reduce recurrence, such as targeted therapies and immunotherapy. Our approach is now more personalised to each patient. We also practise a multidisciplinary approach in managing breast cancer, involving surgeons, oncologists, radiologists, pathologists, and rehabilitation teams for better decisions and outcomes.
How has being a breast and endocrine surgeon changed the way you see your own life and mortality?
I’ve learned that health and time are really precious, and that relationships matter more than possessions. It reminds me how important it is to have a healthy and balanced lifestyle.
