Breast Cancer series

“I detected my lumps during my annual check-up.” ” My hubby detected mine.”
“Mr. Maniam is so clever. What have you been feeling?” “Huh? Your breasts, of course!”

Breast cancer

According to World Health Organization1,2 , the most frequent and greatest number of cancer-related death among women is breast cancer, that is, about 627,000 women, or about 15% of all cancer deaths among women in 2018.

Early detection in primary care settings for timely treatment, is important to improve breast cancer outcomes and survival. Screening of women before any symptoms appear includes:-

– organized population-based mammography,

– clinical breast examination by trained healthcare professionals and

– breast self-examination.

The above clips are true, though rare. But how often women actually do their own breast self examination? Are there guided steps one must follow? 3,4

References : 

1.Breast cancer. Accessed on 18 Sept, 2020 from https://www.who.int/cancer/prevention/diagnosis-screening/breast-cancer/en/

2.WHO PEN Protocol 4 (Package of essential noncommunicable disease), accessed on 18 Sept, 2020 from https://www.who.int/ncds/management/Protocol4_1_BreastCancerAssessment_and_referral.pdf?ua=1

3.Breast Self Examination, accessed on 19 Sept, 2020 from https://www.singaporecancersociety.org.sg/get-screened/breast-cancer/breast-self-examination.html

4.Breast Self- examination [Breast Cancer], accessed on 19 Sept, 2020 from http://www.myhealth.gov.my/en/breast-self-examination-breast-cancer/

[below] Google translated with minor editing by author.

Pemeriksaan payudara sendiri.

Menurut Pertubuhan Kesihatan Sedunia1,2, jumlah kematian yang berkaitan dengan barah yang paling kerap dan paling banyak di kalangan wanita adalah barah payudara, iaitu sekitar 627,000 wanita, atau sekitar 15% dari semua kematian akibat barah di kalangan wanita pada tahun 2018.

Pengesanan awal dalam rawatan primer untuk rawatan tepat pada masanya, penting untuk meningkatkan hasil dan kelangsungan hidup barah payudara. Pemeriksaan wanita sebelum gejala muncul termasuk: –

– mamografi berasaskan populasi yang teratur,

– pemeriksaan payudara klinikal oleh profesional penjagaan kesihatan terlatih dan

– pemeriksaan payudara sendiri.

Klip di atas adalah benar, walaupun jarang berlaku. Tetapi berapa kerap wanita melakukan pemeriksaan payudara sendiri? Adakah terdapat langkah berpandukan yang mesti diikuti? 3,4

Rujukan : 

1.Breast cancer. Accessed on 18 Sept, 2020 from https://www.who.int/cancer/prevention/diagnosis-screening/breast-cancer/en/

2.WHO PEN Protocol 4 (Package of essential noncommunicable disease), accessed on 18 Sept, 2020 from https://www.who.int/ncds/management/Protocol4_1_BreastCancerAssessment_and_referral.pdf?ua=1

3.Breast Self Examination, accessed on 19 Sept, 2020 from https://www.singaporecancersociety.org.sg/get-screened/breast-cancer/breast-self-examination.html

4.Breast Self- examination [Breast Cancer], accessed on 19 Sept, 2020 from http://www.myhealth.gov.my/en/breast-self-examination-breast-cancer/

“Lights, lights, everywhere! What a waste of electricity!” “…the ambience of her clinic is like a nightclub cafe.”

Night Shifts and Breast Cancer Risk

According to Kristin (2018), working night shifts was associated with an average of 32% increase for breast cancer, and particurlarly higher for night nurses, with a significant 58% increased risk for breast cancer. 1, 2

Studies have shown that the underlying mechanism of cancer risks induced by night-shift work may be due to the exposure to unnatural light at night, suppression of melatonin or disruption of internal ‘body clock (circadian clock), physiological changes, lifestyle disturbances, and decreased vitamin D levels (resulting from lack of sunlight). 1,2 However, findings from some epidemiological cohort and case-control studies have been shown to be inconclusive 1, 2, 3

Dr Xuelei Ma, in Kristin Jenkins (2018) proposed that long term night shift workers should be scheduled for regular physical examinations and cancer screenings. 1, 2

References:

  1. Kristin Jenkins, K. (2018). Night shifts increase breast cancer risk, especially for nurses. Medscape, accessed on 19 Sept, 2020 from https://www.medscape.com/viewarticle/891048
  2. Jones, M.E., Schoemaker, M.J., McFadden, E.C. et al. Night shift work and risk of breast cancer in women: the Generations Study cohort. Br J Cancer 121, 172–179 (2019). https://doi.org/10.1038/s41416-019-0485-7
  3. Aishe Dun, Xuan Zhao & Haifeng Hou, et al. (2020). Association between night-shift work and cancer risk: updated systematic review and meta-analysis, Frontiers in Oncology, accessed on 19 Sept, 2020 from https://doi.org/10.3389/fonc.2020.01006

[below] Google translated below [with minor editing by author]

Bekerja Malam Meningkatkan Risiko Kanser Payudara
 
Menurut Kristin (2018), pergeseran malam bekerja dikaitkan dengan kenaikan 32% untuk barah payudara, dan lebih tinggi terutamanya untuk perawat malam, dengan peningkatan risiko kanser payudara 58%. 1, 2
 
Kajian telah menunjukkan bahawa mekanisme risiko kanser yang disebabkan oleh kerja shift malam mungkin disebabkan oleh pendedahan cahaya yang tidak wajar pada waktu malam, penekanan melatonin atau gangguan jam badan dalaman (jam sirkadian), perubahan fisiologi, gangguan gaya hidup, dan penurunan kadar vitamin D (akibat kekurangan cahaya matahari). 1,2 Walau bagaimanapun, penemuan dari beberapa kohort epidemiologi dan kajian kawalan kes telah terbukti tidak meyakinkan 1, 2, 3
Dr Xuelei Ma, (dalam Kristin Jenkins, K. , 2018) mencadangkan agar pekerja shift malam jangka panjang harus dijadualkan untuk pemeriksaan fizikal dan pemeriksaan kanser secara berkala. 1, 2

Rujukan:
1. Kristin Jenkins, K. (2018). Night shifts increase breast cancer risk, especially for nurses. Medscape, accessed on 19 Sept, 2020 from https://www.medscape.com/viewarticle/891048
2. Jones, M.E., Schoemaker, M.J., McFadden, E.C. et al. Night shift work and risk of breast cancer in women: the Generations Study cohort. Br J Cancer 121, 172–179 (2019). https://doi.org/10.1038/s41416-019-0485-7
3. Aishe Dun, Xuan Zhao & Haifeng Hou, et al. (2020). Association between night-shift work and cancer risk: updated systematic review and meta-analysis, Frontiers in Oncology, accessed on 19 Sept, 2020 from https://doi.org/10.3389/fonc.2020.01006

Published by Chen S. P. @ TPTan

Serena Chen @TPTan, Master degree in nursing (Monash) . Serena teaches local and overseas nurses in a stomaltherapy program. She had presented papers internationally. Serena is a member of the ‘Golden Key International Society (Monash). She was an editor of a mental health bulletin and she enjoys pottery works, cartoons, painting and poems. She shares insightful experiences about being a carer for people with mental illness and cancer in this defining society.

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