Breast cancer remains the most prevalent cancer among women in Malaysia, posing a significant public health challenge.1,2 Despite advancements in medical technology and awareness campaigns, breast cancer continues to affect thousands of lives and families each year. However, early detection through mammography and timely treatment have proven to be powerful tools in reducing breast cancer mortality.
Breast Cancer Prevalence in Malaysia
According to the Malaysia National Cancer Registry, breast cancer consistently ranks as the most common cancer among Malaysians, with a prevalence rate of 17.6%.1,2 The overall cancer burden in Malaysia remains high, while the lifetime risk of cancer is 1 in 8 for both men and women.2 These figures underscore the urgent need for effective screening and treatment strategies to tackle breast cancer in Malaysia.
Mammography as Early Screening for Breast Cancer
Mammography is an X-ray imaging technique specifically designed to detect abnormalities or changes in breast tissue, which has now become the gold standard for breast cancer screening.3,4 In Malaysia, the Ministry of Health makes several recommendations.5
The Malaysia CPG guideline also recommends that women with high risk of breast cancer (strong family history of breast/ovarian cancer, or personal history of cancer) but no known genetic variant identified may consider mammography screening from 30-39 years of age, performed annually from 40-59 and biennially from 60 onwards.5 As for carriers of pathogenic or likely pathogenic variants in BRCA1, BRCA2 and PALB2, annual MRI and mammography should be offered from 30-49 years of age, annual mammography from 40-69 and biennial mammography from 70 onwards.5 Early detection through mammography can lead to less aggressive treatment, lower healthcare costs, and most importantly, higher survival rates.4,5
Treatment and Survival Rates of Breast Cancer
Treatment for breast cancer typically involves a combination of surgery, chemotherapy, radiotherapy, and hormone therapy, depending on the stage and type of cancer.5 The Malaysian CPG guideline emphasises a multidisciplinary approach to ensure optimal outcomes.5 However, survival rates of breast cancer vary significantly by stage at diagnosis.6
Another issue is the rise in late-stage diagnoses: over 50.5% of cases are diagnosed at stage III or IV, up from 47.9% in the previous five-year period.6 This late-stage diagnosis trend is particularly concerning and points to gaps in screening coverage and public awareness. Furthermore, Malaysia records a 5-year relative survival rate around 67% for breast cancer patients.6 This data is notably lower than in high-income countries, where survival rates range from 80% to 90%, highlighting disparities in early detection and treatment access.6
Moving Forward: Strengthening the Fight Against Breast Cancer
To further reduce breast cancer mortality in Malaysia, several key actions are needed.7-11
Breast cancer is a formidable burden to our healthcare system. With continued investment in screening programs like mammography and comprehensive treatment strategies, Malaysia can make significant strides in lowering mortality rates. Empowering women with knowledge and access to care is the cornerstone of this effort.
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