From Mother to Daughter: Shaping Breast Cancer Awareness for Generations

Mothers are often the heart of the family—steady hands of quiet strength who guide, support and shape the lives of those they love. One of the most powerful ways mothers can care for their daughters is by passing down healthy habits, including those related to breast health. Why Early Action Matters When breast cancer is found early, survival rates can exceed 90%. Breast cancer remains the most common cancer affecting Singaporean women, with cases rising fourfold to around 76 per 100,000 population in 2018-2022 [1] [2]. It’s also the leading cause of cancer-related deaths for women, accounting for 17.1% of female cancer deaths [1].  Being aware of how one’s breasts look and feel and going for regular screenings such as mammograms can make all the difference. Early detection often leads to simpler treatments and better outcomes, including survival rates of over 90% [3][4].  Still, some women are missing these important checks. Participation in breast cancer screening dropped from 37.6% in 2022 to 34.7% in 2023 in Singapore [1]. What’s Stopping Women from Being Breast Aware? Self-care often takes a backseat to caregiving. A common reason women may skip screenings is busyness. Between work, caring for their families and managing daily life, it is easy for mothers to put their own needs last [5] [6].  For others, it’s fear. Breasts are deeply tied to identity and femininity [7]. The thought of a diagnosis, or the possibility of losing one’s breasts, can overshadow the importance of regular screenings [6].  And because breast cancer can sometimes develop without noticeable symptoms, this makes early detection difficult [8]. Women who feel healthy might mistakenly believe they do not need a mammogram [5].  Breast Awareness as Self-Care A mother's health is not just for her family—it's for herself too. Mothers rush loved ones to the clinic at the first sign of illness, yet hesitate when it comes to their own health. Taking time for a screening can feel like stepping away from their caregiving role, sometimes leading to feelings of guilt [9].  Some mothers go for screenings to stay healthy for their families and avoid being a burden [10]. But their well-being should be valued not just for others – it deserves to be prioritised for themselves.   Breast awareness is an act of self-love; a way for mothers to tune into their bodies, and show themselves the compassion they offer so freely to others.  Creating a Legacy of Care Healthy habits today become healthy generations tomorrow. While breast cancer is often seen as a disease in older women, data from three Singaporean healthcare centres show that around 10-13% of diagnosed patients are under 40 [11]. That’s why breast health conversations should begin early - even at a younger age.  Talking about breast health can feel awkward or distressing. But creating an open, supportive space within families builds trust and empowers everyone to take proactive steps.   The mother-daughter relationship strongly influences how young women view and care for their bodies [12] [13]. When mothers model positive health behaviours and attitudes, they leave an enduring legacy that daughters often carry into adulthood [12,13,14].  Signs to Watch For Help daughters recognise these potential warning signs [15]: A lump or swelling in the breast, chest or armpit that doesn’t go away Skin changes such as dimpling, redness or irritation Change in breast size or shape Persistent nipple discharge Nipple changes such as rashes or inversion Persistent pain in the breast or armpits Your Health is Their Future By normalising breast awareness, mothers pass down a legacy of care and bodily ownership that empowers future generations to own their breast health.  Every choice you make ripples through the generations. This Mother’s Day, let’s celebrate women who lead by example – women who prioritise their breast health, spark important conversations, and empower their daughters to own their well-being.  Schedule your breast health check today. You’re not just protecting yourself – you’re shaping generations to come. References: [1] Ministry of Health Singapore, National Population Health Survey 2023  [2] Singapore Cancer Registry Annual Report 2022  [3] Cancer Research UK, Symptoms of breast cancer [4] Ministry of Health - Health Promotion Board, Breast Cancer: Learn How Early Detection and Lifestyle Changes Could Help Protect Yourself  [5] Ministry of Health Singapore, National Population Health Survey 2022  [6] Qualitative factors influencing breast and cervical cancer screening in women: A scoping review  [7] “Voices of Fear and Safety” Women’s ambivalence towards breast cancer and breast health: a qualitative study from Jordan [8] Cancer Council, Breast Cancer [9] Put MY mask on first: Mothers’ reactions to prioritizing health behaviours as a function of self-compassion and fear of self-compassion  [10] Understanding Barriers and Facilitators of Breast and Cervical Cancer Screening among Singapore Women: A Qualitative Approach [11] Beating breast cancer: How these women in their 20s, 30s and 40s survived and thrived [12] Helping Mothers and Daughters Talk about Environmental Breast Cancer Risk and Risk-Reducing Lifestyle Behaviors [13] The Mother-Daughter Relationship and Daughter's Positive Body Image: A Systematic Review  [14] Adult daughters’ reports of breast cancer risk reduction and early detection advice received from their mothers: an exploratory study  [15] NHS, Symptoms of breast cancer in women 
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Do Scars really matter in Breast Cancer Treatment?

For many women undergoing breast cancer treatment, one of the most significant concerns is the impact of surgery on their appearance, particularly when it comes to the visibility of scars. While the primary goal of breast cancer surgery is to effectively remove cancerous tissue, aesthetic considerations cannot be overlooked in a patient’s emotional and psychological recovery. So, do scars really matter for breast cancer patients? The answer is complex and deeply personal, as it encompasses both physical healing and emotional well-being. The Emotional and Psychological Impact of Scars The idea of scars can evoke strong emotional responses. For some, they symbolise survival and strength after a life-altering experience, while for others, they may bring feelings of loss, fear, or diminished self-worth. ‘Correspondingly, the first group of patients may be ambivalent about their scars or even embrace them; whereas a second group of patients prioritise reconstruction options that minimise visible reminders’, says Dr Wong Manzhi, Senior Consultant Plastic Surgeon at The Aesthetic & Plastic Surgery Clinic. Physical changes, including scars, can lead to feelings of anxiety, depression, and a reduced quality of life. Many women report that scars on their chest can be a constant reminder of their cancer diagnosis, affecting their self-esteem and sexual identity [1]. Importantly, emotional recovery is just as crucial as physical recovery. For many patients, the ability to feel “whole” again is tied not only to the success of the surgery but also to the way they perceive their bodies after the procedure. Scars, even when minimal, may alter how women feel about their body image and their sense of femininity. Scar Minimisation: The Role of Surgical Technique Not all scars are created equal. Advances in surgical techniques, such as nipple-sparing mastectomies (NSM) and keyhole surgeries, aim to reduce the visibility of scars while maintaining effective cancer treatment. Nipple-sparing mastectomies, for instance, have become increasingly popular, as they preserve the nipple-areolar complex (NAC) during surgery, resulting in a more natural post-operative appearance. For many women, the preservation of the NAC is a powerful tool in preserving their body image and reducing the emotional impact of the surgery. Additionally, keyhole surgeries—also known as minimal access surgeries—are another option that reduces scar size by using smaller incisions and specialised instruments like endoscopes and robotic systems. These procedures are gaining traction in breast cancer treatment, with studies showing that keyhole surgeries leave smaller scars (usually about 4 cm in length compared to 9 cm for traditional mastectomies) and promote faster healing [4]. Beyond these techniques, oncoplastic surgery – which combines cancer removal with reconstructive techniques – also plays a key role in minimising scarring while preserving or even enhancing the breast contour. Skilled oncoplastic surgeons strategically place incisions and use tissue rearrangement methods to achieve better cosmetic outcomes with less visible scarring. However, it’s important to note that these options aren’t universally applicable. Some patients may not be candidates for nipple-sparing, keyhole, or oncoplastic surgeries due to the size of their tumours or other medical considerations. In these cases, conventional mastectomy may still be the best option for ensuring complete cancer removal. Aesthetic and Functional Considerations: Why They Matter When considering mastectomy options, both aesthetic and functional outcomes play a crucial role in the decision-making process. For many patients, immediate breast reconstruction after mastectomy can help restore a sense of normalcy, offering both psychological and physical benefits. The location and size of surgical scars can play a significant role in the reconstruction process. For instance, a larger incision may provide more flexibility for more complex reconstruction procedures. It is essential to discuss your options with your breast surgeon to determine the best approach for your specific condition. The Global Perspective: Mastectomy Rates and Cultural Attitudes Mastectomy rates and cultural attitudes toward breast cancer surgery vary widely around the world. In countries like the United States, mastectomy rates have been rising, especially with the trend of preventive double mastectomies among women with a higher genetic risk, such as those with BRCA mutations. A 2017 study found that mastectomy rates in the U.S. have increased to 31% overall, with some regions seeing rates as high as 49% for double mastectomies [5]. In countries like Singapore, mastectomy rates have remained consistently high. A review conducted over a decade found mastectomy rates ranging from 43% to 59%. These numbers may reflect cultural attitudes toward breast cancer, where mastectomy is seen as a necessary and life-saving procedure. Despite the availability of equivalent alternatives like breast-conserving surgery, many women opt for mastectomies due to the perceived greater oncologic safety and the desire for peace of mind [3]. Looking Ahead: The Future of Scar Minimisation As technology continues to advance, it’s likely that breast cancer surgeries may become even less invasive, with smaller incisions and better healing outcomes. Robotic surgery, for example, holds the promise of greater precision, leading to even smaller scars and potentially faster recovery times. Additionally, the use of tissue engineering and regenerative medicine may offer new ways to minimise the appearance of scars and even restore lost tissue [2]. Furthermore, psychological support for breast cancer patients is gaining recognition as an integral part of treatment. Many hospitals now provide counselling and support groups specifically focused on body image, helping women navigate the emotional challenges that come with scarring and physical changes. These resources are critical for empowering patients to accept their bodies and find ways to heal emotionally and physically. Conclusion: Scars and the Journey of Recovery While scars may be a visible reminder of a challenging chapter in a patient’s life, they also represent survival and the strength it takes to overcome cancer. However, minimising the impact of scars, both physically and emotionally, is an important consideration in breast cancer treatment. With advances in surgical techniques, increased awareness of emotional support, and a growing focus on personalised care, the future looks promising for breast cancer patients seeking to heal not only their bodies but also their spirits. Ultimately, what matters most is that patients feel empowered to make choices that align with their values, health goals, and sense of self. Scars, though unavoidable in many cases, do not have to define their journey—how they heal and move forward does. Article reviewed by Dr Esther Chuwa, Senior Consultant and Breast Surgeon at Solis Breast Care & Surgery References: [1] Fobair, P., Stewart, S. L., Chang, S., & D’Onofrio, C. N. (2006). Body image and sexual problems in young women with breast cancer. Psycho-Oncology, 15(7), 579-589. https://doi.org/10.1002/pon.1023 [2] Haidar, M., Saeed, H., & Elhassan, F. (2020). Tissue engineering and regenerative medicine for breast reconstruction. Journal of Stem Cells, 25(4), 351-360. [3] Lee, W. T., Tan, S. K., & Kwek, S. K. (2015). Mastectomy rates and breast cancer treatment trends in Singapore. Singapore Medical Journal, 56(8), 444-448. [4] Lin, Y., Wang, Y., & Tsai, C. (2020). Keyhole mastectomy: Outcomes and benefits. Breast Cancer Research and Treatment, 182(3), 567-575. https://doi.org/10.1007/s10549-020-05793-z [5] Veronesi, U., Boyle, P., & Goldhirsch, A. (2017). Mastectomy versus breast-conserving surgery in early breast cancer: Meta-analysis of trials. The Lancet, 373(9680), 569-577. https://doi.org/10.1016/S0140-6736(09)60256-7
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Breast Changes in Young Women: What Do They Mean and When to Seek Medical Advice

Breast cancer is often seen as a disease that only affects older women. However, recent statistics from three healthcare centres in Singapore show that approximately 10-13% of diagnosed breast cancer patients are under 40[1]. Not all changes are breast cancer. Breast self-examinations are a simple yet powerful way for younger women to be breast aware. Whether it’s a lump, breast pain or nipple discharge, what should you do if you notice something that doesn’t look or feel right? Firstly, do not panic. Many breast changes do not necessarily mean cancer, and can instead be due to natural bodily changes or medication[2]. . Periods can cause breasts to feel swollen or tender due to hormone changes[3]. . This is normal and is usually not a cause for concern. Other examples of breast changes include: Breast Lumps A breast lump can often feel like a solid feeling in or near your breast or under your arm. While they can sometimes be a sign of breast cancer, studies show that about 60-80% of all breast lumps are non-cancerous[4]. Breast Pain Breast pain by itself is typically not a symptom of cancer. It can be caused by periods, pregnancy, menopause-related hormone changes, conditions like mastitis or medications like birth control pills[5]. Nipple Discharge This refers to fluid from the nipple that is not breast milk. While nipple changes and discharge can be a sign of breast cancer, it can result from birth control pills, medicine and infections[2]. Benefits of Seeking Medical Advice Earlier Sometimes, younger women may hesitate to speak to their doctor, assuming cancer to be unlikely at their age[6]. Other reasons people delay investigating symptoms include worrying about foolishly wasting the doctor’s time or fearing what might be found[7][8].  So they opt for the wait-and-see approach, hoping symptoms eventually go away[9]. While your symptoms might not be cancer, listening to your body and seeking clarity from your doctor are important for these reasons: 1. More Options with Early Detection If your symptoms turn out to be cancer, addressing them early can help reduce the likelihood of needing more intensive treatment in the future. Early detection can be helpful for improving treatment outcomes and survival rates. When caught early (Stages 0 and 1)—before it has spread to other parts of the body, treatment can result in survival rates of over 90%[10]. 2. Clarity and Peace of Mind Your worries are unlikely to go away if you don’t seek help [11]. . Getting advice from an experienced healthcare professional helps take away the guesswork, allowing you to move forward with confidence rather than anxiety over what might be happening. 3. Self-Care Your body is your partner for life, so treat it with kindness! Being proactive about unusual breast changes is a sign of good health management. Talking about your breasts may feel uncomfortable or embarrassing[11]. . But remember, your doctor is here to help you. They will do their best to put you at ease during the process. What Happens During Your Appointment When you meet with a breast surgeon, they will want to know more about your symptoms to better understand your health. If you’re feeling anxious about forgetting anything, it helps to jot down notes before your appointment, such as[11]. : When your symptoms started, how often they occur and any patterns you’ve noticed Anything that makes your symptoms better or worse Any family history of cancer Any other concerns or questions you may have This will help take some of the pressure off remembering everything. You can also bring a loved one to accompany you and help you ask questions or take notes. You may need to undergo screening such as an ultrasound[11]. . In Singapore, mammograms are generally not recommended for women below 40 years old[10]. . As everyone’s breasts and bodies are different, your doctor will determine what you need based on your personal circumstances and preferences. Your doctor will walk you through your screening results, answer any questions and advise you on next steps. Feeling scared is completely normal, and the experienced surgeons at Solis Breast Care & Surgery Centre are here to reassure you and give you the gift of clarity. You deserve a space where your concerns are heard and taken seriously. Breast health should be a priority, no matter the age.  If you pick up any changes in how your breasts look or feel, schedule an appointment with your doctor today. Early evaluation can make all the difference in your peace of mind and overall health and well-being. References [1] The Straits Times, Beating breast cancer: How these women in their 20s, 30s and 40s survived and thrived [2] National Cancer Institute, Understanding Breast Changes and Conditions: A Health Guide [3] Cancer Council Victoria, Normal Breast Changes  [4] National Breast Cancer Foundation, Breast Lump [5] NHS, Breast Pain  [6] Diagnostic delays in breast cancer among young women: An emphasis on healthcare providers [7] Worrying about wasting GP time as a barrier to help-seeking, a community-based, qualitative study [8] Cancer symptom awareness and barriers to symptomatic presentation in England—are we clear on cancer? [9] Awareness of symptoms, anticipated barriers and delays to help-seeking among women at higher risk of breast cancer: A UK multicentre study [10] Ministry of Health Singapore Health Promotion Board, HealthHub, Breast Cancer [11] Cancer Research UK, Seeing Your GP when you have symptoms of breast cancer
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