Breast cancer accounts for about 17.7% of all cancer diagnoses in the Philippines, according to 2020 data from The Global Cancer Observatory. Accordingly, the disease accounts for 27,163 or 31.4% of new cancer cases among women in the country.
Although effective screening programs, prevention strategies, and treatment options already exist, most Filipinos try to manage their illnesses by self-monitoring of symptoms or by determining the possible causes; while some even try to ignore their symptoms for a long time and only consult a doctor when their cancer is in its advanced stage. They also consider the severity and threat to their functional capacity or their families’ financial and emotional burden.
In the case of breast cancer, having further knowledge about the disease, and doing regular examination of the breasts can help with early diagnosis and intervention.
Understanding breast cancer
Breast cancer is a disease that starts when cells in the breast grow out of control. Cancer can begin in different parts of the breast and can spread outside the breast through blood vessels and lymph vessels. Consequently, it can metastasize, which means spread to other parts of the body.
There are different types of breast cancer, and each would depend on the specific cells in the breast that are affected and grow uncontrollably into cancer.
Here are some of the types of breast cancer:
Ductal Carcinoma In Situ (DCIS)
Ductal carcinoma in situ, also known as intraductal carcinoma or stage 0 breast cancer, is a non-invasive or pre-invasive type of breast cancer. It affects the cells that line the breast milk ducts, changing it to cancer cells.
As DCIS is a very early cancer stage, it is likely highly treatable . If left untreated or undetected, however, it may still spread.
Invasive Ductal Carcinoma (IDC)
Like the DCIS, invasive ductal carcinoma, also called infiltrative ductal carcinoma, affects the breasts’ milk ducts. However, the difference is that IDC can spread beyond the ducts and invade surrounding breast tissues.
There are four less common types of invasive ductal carcinoma:
Medullary ductal carcinoma –
This breast cancer type accounts for about three to five percent of all invasive breast cancer cases, which typically affects women in their late 40s and early 50s and is more common in women who have BRCA1 gene mutation. It is called medullary carcinoma because, under the microscope, the tumor looks like the medulla part of the brain, which has a soft, fleshy mass.9
Medullary carcinoma is a rare subtype of triple-negative breast cancer because medullary tumors often test negative for estrogen and/or progesterone receptors and also negative for hormone epidermal growth factor receptor 2 (HER-2)
Mucinous ductal carcinoma –
Mucinous carcinoma accounts for less than two percent of breast cancers. This type of breast cancer occurs when the microscopic evaluation of the cancer cells is surrounded by mucus. Mucinous carcinoma typically tests positive for estrogen and/or progesterone receptors but negative for the HER-2 receptor.
Papillary ductal carcinoma –
This type of breast cancer accounts for fewer than one percent of all breast cancer cases and is typically diagnosed in older, postmenopausal women. It is called papillary carcinoma because the cells are made up of small, finger-like projections, or papules, when seen under the microscope.
Papillary ductal carcinoma usually tests positive for estrogen and/or progesterone receptors and negative for HER-2 receptor.
Tubular ductal carcinoma –
This is another rare type of IDC, accounting for less than two percent of breast cancer diagnoses. It is called tubular carcinoma because the cells are usually small and made up of tube-like structures called “tubules” when seen under the microscope.
Tubular carcinoma often tests positive for estrogen and/or progesterone receptors but negative for HER-2 receptor.8
Inflammatory Breast Cancer (IBC)
Inflammatory breast cancer (IBC) is a rare breast cancer type and only accounts for 1-5% of all breast cancers. Although it is often distinguished as a type of IDC, due to its aggressiveness; its symptoms, outlook, and treatment differ from other types of breast cancers.
IBC symptoms of inflammation, such as swelling, redness, or thickening of the breast’s skin, begin to appear when cancer cells infiltrate and block the lymph vessels of the breasts.
On the other hand, knowing the breast cancer symptoms can also help early intervention for cancer. These are some of the unusual changes in the breast that can be a symptom of the cancer:
- swelling of all or part of the breast
- skin irritation (redness, scaliness, or thickening of the nipple or breast skin)
- skin dimpling
- breast pain
- nipple pain or the nipple turning inward
- bloody nipple discharge
- a hard lump in the underarm area
What is a Breast Cancer Map?
What about the level of breast cancer awareness in the Philippines? It does not only end with knowing the cancer types, risk factors, and symptoms, but continues with the understanding of screening and treatment options.
Here is a step-by-step patient journey guide to help patients and caregivers in their fight against breast cancer:
Start with a Breast Self-Exam (BSE).
A breast self-exam is a procedure for women to examine their breasts and underarm areas for changes. Although BSE is a convenient and useful screening tool for breast cancer, it should not be used in place of clinical breast examination, which is performed by a healthcare provider, and mammography. Instead, it should be included as a part of women’s breast cancer awareness strategy, allowing them to become familiar with their breasts’ normal look and feel.13
A breast self-exam should be done regularly and can be done before a mirror, lying down, and in the shower. It would be best to look for the usual size, shape, and color of breasts without visible distortion or swelling. Additionally, it would help if you looked out for breast cancer symptoms such as dimpling, puckering, or bulging of the skin.14
2. Know who to ask if you find a lump in your breast.
If you notice a lump or other breast change, do not panic and do not hesitate to call your gynecologist or primary care doctor.14
You can also seek the advice of other medical oncologists, licensed physicians who specialize in screening, diagnosing, and treating cancer.15 These specialists may act as your primary care physician and will recommend clinical breast exams, mammograms, ultrasound, and other laboratory tests to confirm a diagnosis or rule out breast cancer.13
Treating cancer requires a multidisciplinary approach; hence, you will need to have a team of the doctors on your side to help you with your breast cancer fight.
In looking for breast cancer doctors in the Philippines, you should remember that your primary care physician will lead the development of your cancer treatment plan and coordinate with other oncology specialists and clinicians. Your team may consist of medical oncologists, surgical oncologists, radiologists, psychologists, and clinical nurses.15
3. Request for a complete panel testing.
Besides clinical breast exam, mammogram, and ultrasound, you may also request for a complete panel testing. Panel testing is a type of genetic testing that looks for changes or mutations in several genes in one test.16
A complete panel genetic test can help your doctor confirm if you have breast cancer and determine the type of breast cancer you have. The results of the test can also serve as a guide for your cancer prevention or treatment plan.16
4. Understand your results and find out more about your breast cancer diagnosis.
It is crucial to understand your laboratory test results to know more about the status of your disease. Your doctor will explain your results to help you find out more about your breast cancer diagnosis.
5. Ask about available treatment options.
Surgery, radiation therapy, chemotherapy, hormonal therapy, and targeted therapy are the available treatment options for breast cancer.17
Choosing a treatment for breast cancer depends on the type of breast cancer you have. Hence, it is best to consult with your doctor to know which can be more useful for your fight. You can also ask your doctor about the possible hospitals for breast cancer in the Philippines.
6. Learn more about cancer medical assistance.
Most Filipinos often pay health care costs out of their own pockets. Thus, if someone from the family is diagnosed with cancer, they face a high probability of encountering a financial catastrophe and impoverishment.2
Therefore, it is essential to know more about the national government’s medical and financial assistance. There are also breast cancer organizations such as ICanServe Foundation, Philippine Cancer Society, Philippine Foundation for Breast Cancer, and Philippine Breast Cancer Society, which provide awareness and financial assistance to breast cancer patients.
7. Learn more about innovative treatment and screening options for breast cancer.
With the advances in medical screening and treatment options for breast cancer as well as the availability of cancer medical assistance from the national government and other breast cancer organizations, more women are recovering from the disease and looking forward to more hopeful tomorrows.
Don’t leave breast cancer untreated, or suspicions thereof unchecked. Women should take proper care of their bodies, do self-examinations, and consult with the best breast cancer doctors in the Philippines to act swiftly upon the illness.
It is essential to know more about breast cancer, its types, its symptoms, and what can be done to prevent or treat it. Consult with your doctor immediately if any breast cancer risks become evident. Follow the breast cancer map of Hope From Within for a handy guide on the patient journey as well.