<TABLE border=0 cellSpacing=0 cellPadding=0 width="100%"><TBODY><TR>Breast cancer: Wait & see tack 'too risky'
</TR><!-- headline one : end --><TR>S'pore docs refute foreign study's claims of needless treatments; no telling how fast tumour will grow </TR><!-- Author --><TR><TD class="padlrt8 georgia11 darkgrey bold" colSpan=2>By Nur Dianah Suhaimi
</TD></TR><!-- show image if available --></TBODY></TABLE>
<!-- START OF : div id="storytext"--><!-- more than 4 paragraphs -->There is no such thing as 'overdiagnosing' of breast cancer patients, say Singaporean doctors in response to an overseas study which claims that a third of breast cancer patients are treated needlessly.
The study by Scandinavian experts, reported by the British Medical Journal last Friday, said not all cancer tumours are life-threatening and some will remain dormant or even shrink over the years.
Yet, in treating all patients diagnosed with the tumour, doctors tend to use powerful drugs, radiotherapy or surgery which may cause harm, the study said.
Based on data from breast cancer screening programmes done in Australia, Britain, Canada, Norway and Sweden, the study looked at trends seven years before the programmes were implemented, and seven years after.
While Singapore oncologists interviewed yesterday conceded that there may be a small group of breast cancer patients who may have been 'overdiagnosed', adopting a wait-and-see approach is extremely risky, they said.
This is because there is no definite way to tell how fast the cancer tumour will grow.
Dr Wong Seng Weng, consultant medical oncologist at The Cancer Centre in Paragon Medical Centre, said: 'The risk of not treating it is death. It is a risk that is very difficult to take. Most patients, when diagnosed with breast cancer, will immediately want to remove the tumour.'
Even the smallest and slowest-growing breast cancer tumour should be removed, said Dr Wong Zee Wan, medical oncologist at Mount Elizabeth Medical Centre. She was speaking yesterday to The Sunday Times at the Singapore Medical Association's medical convention, which focused on cancer prevention, at Suntec City.
'We will never know if the cancer will be harmful if left alone. So it's best to remove it altogether and do so early, when the treatment is easier,' she said.
Only 10 per cent to 15 per cent of breast cancer patients here have slow-growing cancer tumours compared to the 20 per cent to 30 per cent with high-grade, fast-spreading cancer, said Dr See Hui Ti, consultant oncologist at Parkway Cancer Centre.
While biopsies can reveal whether the cancer is slow- or fast-growing, there is no guarantee that a slow-growing cancer will not turn harmful later. By then, it might be too late for the patient to get effective treatment.
She also pointed out that not all Western data applies to Asians because of genetic differences.
Asian women, for example, tend to be at risk of getting breast cancer from as young as 40 years old. In Scandinavian countries, the women at risk are those in their 50s and 60s.
'There is a higher likelihood for older women there to die with the cancer, but not of the cancer. In this case, treatment might not be the best thing for them,' she said.
'But in Singapore, where a majority suffering from breast cancer are in their 40s, you need to treat them.'
How a patient will be treated - whether it is by surgery, chemotherapy or radiotherapy - depends on her age, health and the seriousness of the cancer, said doctors.
According to the study, women were urged to undergo breast cancer screening or mammograms but were not informed of the risks involved.
These risks include the exposure to radiation and having to go through unnecessary treatment should cancer be detected.
Local doctors refuted this, saying that the benefits of doing a mammogram outweigh the risks. Early detection and treatment of breast cancer usually lead to higher cure rates. Also, the radiation exposure from mammograms is minimal.
Said Dr Wong Seng Weng: 'The amount of radiation you get is the same from outer space if you fly to the United States for a holiday and back. There is really nothing to worry about.'
The bottom line, then, is this: Go for regular mammograms; and if you are tested positive for breast cancer, get treated early.
Said Dr Wong Zee Wan: 'Breast cancer is highly curable, but only if detected early. And mammograms are the best and cheapest way to get an early diagnosis.'
[email protected]
<HR SIZE=1 width="50%">
Playing it safe
'The risk of not treating it is death. It is a risk that is very difficult to take. Most patients, when diagnosed with breast cancer, will immediately want to remove the tumour.'
DR WONG SENG WENG, consultant medical oncologist at The Cancer Centre in Paragon Medical Centre
</TR><!-- headline one : end --><TR>S'pore docs refute foreign study's claims of needless treatments; no telling how fast tumour will grow </TR><!-- Author --><TR><TD class="padlrt8 georgia11 darkgrey bold" colSpan=2>By Nur Dianah Suhaimi
</TD></TR><!-- show image if available --></TBODY></TABLE>
<!-- START OF : div id="storytext"--><!-- more than 4 paragraphs -->There is no such thing as 'overdiagnosing' of breast cancer patients, say Singaporean doctors in response to an overseas study which claims that a third of breast cancer patients are treated needlessly.
The study by Scandinavian experts, reported by the British Medical Journal last Friday, said not all cancer tumours are life-threatening and some will remain dormant or even shrink over the years.
Yet, in treating all patients diagnosed with the tumour, doctors tend to use powerful drugs, radiotherapy or surgery which may cause harm, the study said.
Based on data from breast cancer screening programmes done in Australia, Britain, Canada, Norway and Sweden, the study looked at trends seven years before the programmes were implemented, and seven years after.
While Singapore oncologists interviewed yesterday conceded that there may be a small group of breast cancer patients who may have been 'overdiagnosed', adopting a wait-and-see approach is extremely risky, they said.
This is because there is no definite way to tell how fast the cancer tumour will grow.
Dr Wong Seng Weng, consultant medical oncologist at The Cancer Centre in Paragon Medical Centre, said: 'The risk of not treating it is death. It is a risk that is very difficult to take. Most patients, when diagnosed with breast cancer, will immediately want to remove the tumour.'
Even the smallest and slowest-growing breast cancer tumour should be removed, said Dr Wong Zee Wan, medical oncologist at Mount Elizabeth Medical Centre. She was speaking yesterday to The Sunday Times at the Singapore Medical Association's medical convention, which focused on cancer prevention, at Suntec City.
'We will never know if the cancer will be harmful if left alone. So it's best to remove it altogether and do so early, when the treatment is easier,' she said.
Only 10 per cent to 15 per cent of breast cancer patients here have slow-growing cancer tumours compared to the 20 per cent to 30 per cent with high-grade, fast-spreading cancer, said Dr See Hui Ti, consultant oncologist at Parkway Cancer Centre.
While biopsies can reveal whether the cancer is slow- or fast-growing, there is no guarantee that a slow-growing cancer will not turn harmful later. By then, it might be too late for the patient to get effective treatment.
She also pointed out that not all Western data applies to Asians because of genetic differences.
Asian women, for example, tend to be at risk of getting breast cancer from as young as 40 years old. In Scandinavian countries, the women at risk are those in their 50s and 60s.
'There is a higher likelihood for older women there to die with the cancer, but not of the cancer. In this case, treatment might not be the best thing for them,' she said.
'But in Singapore, where a majority suffering from breast cancer are in their 40s, you need to treat them.'
How a patient will be treated - whether it is by surgery, chemotherapy or radiotherapy - depends on her age, health and the seriousness of the cancer, said doctors.
According to the study, women were urged to undergo breast cancer screening or mammograms but were not informed of the risks involved.
These risks include the exposure to radiation and having to go through unnecessary treatment should cancer be detected.
Local doctors refuted this, saying that the benefits of doing a mammogram outweigh the risks. Early detection and treatment of breast cancer usually lead to higher cure rates. Also, the radiation exposure from mammograms is minimal.
Said Dr Wong Seng Weng: 'The amount of radiation you get is the same from outer space if you fly to the United States for a holiday and back. There is really nothing to worry about.'
The bottom line, then, is this: Go for regular mammograms; and if you are tested positive for breast cancer, get treated early.
Said Dr Wong Zee Wan: 'Breast cancer is highly curable, but only if detected early. And mammograms are the best and cheapest way to get an early diagnosis.'
[email protected]
<HR SIZE=1 width="50%">
Playing it safe
'The risk of not treating it is death. It is a risk that is very difficult to take. Most patients, when diagnosed with breast cancer, will immediately want to remove the tumour.'
DR WONG SENG WENG, consultant medical oncologist at The Cancer Centre in Paragon Medical Centre
