3 new things to know about breast cancer risk

Here are 3 breast cancer facts you might not know yet:

1. Stage Zero Cancer – also known as Ductal Carcinoma in Situ

Early detection is crucial for surviving breast cancer, and mammography plays a vital role in this. It is particularly effective in identifying stage zero breast cancer, known as ductal carcinoma in situ (DCIS). Mammograms can detect tumors that are not yet palpable and identify microcalcifications that may indicate the presence of DCIS. Early detection through mammograms can help avoid the need for more aggressive treatments like mastectomy or extensive chemotherapy later on.

When and how often should we have mammograms?

Guidelines for mammograms vary. Previously, annual mammograms were recommended starting at age 45. However, in May 2024, a panel of US experts recommended that women at average risk for breast cancer begin mammograms at age 40 and continue screening every two years until age 74².

DCIS is considered the earliest form of breast cancer. It has very few symptoms and is non-invasive, meaning the cancerous cells are confined to the milk ducts and have not spread to surrounding tissues. If detected and treated at this stage, the prognosis is usually excellent. A study published in JAMA Oncology found that treatment for DCIS significantly reduces the risk of invasive cancer, underscoring the importance of early detection.

Mammography is a vital tool. By following screening guidelines, women can significantly improve their chances of excellent outcomes with relatively conservative treatment. This non-invasive technology remains the gold standard for breast cancer screening and a cornerstone of women’s preventive health care. 

Mammograms are not foolproof and are just one of many tools available. For example, in April 2023, actress Olivia Munn was diagnosed with breast cancer at age 42, shortly after a clean mammogram. Her doctor noted her unusually high score on an online breast cancer risk calculator and suggested further tests, which led to her double mastectomy and current recovery. These calculators have several caveats and should be used in consultation with a physician.

2. Gestational or pregnancy-related breast cancer

Women under 40 can also develop breast cancer. Pregnancy-associated breast cancer (PABC), also known as gestational breast cancer (GBC), is defined as breast cancer diagnosed during pregnancy or within one year after giving birth. Although relatively rare, it is the most common cancer diagnosed in pregnant women. Therefore, it is crucial for expectant mothers and healthcare providers to be aware of it.³

The causes of GBC are not fully understood. Some studies suggest that high hormone levels during pregnancy may create an environment that promotes tumor growth and survival. However, data is limited, and experts are divided. They do agree that GBC is more prevalent in women over 35, with a higher risk for first-time mothers. As more women delay childbearing, doctors expect GBC to become more common.⁴

If you are in this situation, it is best to take precautions. Lower your risk by maintaining a healthy diet and lifestyle, having regular check-ups, and performing diligent breast self-examinations. During pregnancy or nursing, include clinical breast exams in your regular pre- and postnatal check-ups. Contact your doctor immediately if you notice any unexpected or concerning changes in your breasts.

Detection and testing

Early detection is crucial. However, pregnancy and nursing often make breasts dense, tender, or lumpy, which can make small lumps and tumors harder to detect, delaying diagnosis and increasing risk. Symptoms like lumps, skin changes around the breast, and nipple discharge can have other pregnancy-related causes. But if you notice any issues with your breasts, don’t assume it’s normal—consult your OB right away.

What to do if you’re diagnosed

A multidisciplinary approach is essential, involving obstetricians, oncologists (cancer specialists), and sometimes pediatricians. Each case is unique, and treatment planning is highly individualized. Doctors must consider several factors: the tumor’s size and location, whether the cancer has spread, the stage of the pregnancy, and the mother’s overall health.

3. Increased breast cancer coverage via PhilHealth

As of March 2024, PhilHealth now covers breast cancer up to PHP1.4 million, through the Z Benefits package available through 21 medical institutions nationwide. The Z Benefits package is a huge improvement and does not require co-pay from patients in basic or ward-type accommodations.⁵ But this is still a very new initiative and PhilHealth is still expanding its network of medical institutions that will support it. But we all know the cost and duration of breast cancer care are unpredictable.

To protect your family’s finances, it might be worth considering getting a critical illness insurance like FWD BIG 3 Critical Illness Insurance which can provides cash benefit when you get diagnosed with any of the BIG 3 critical illnesses: cancer, heart attack, or stroke.

For more health coverage, FWD Vibrant and FWD Set for Health can give financial protection against 42 major critical illnesses. Being financially prepared will keep you stronger against breast cancer and other serious health challenges, so you can focus more on your health and recovery.

Sources:

¹Breast cancer 3rd ‘most fatal type’ among Filipino women - Philippine Star, Aug 2023

² Breast cancer is on the rise in women in their 40s – AP News, May 2024

³ Breast Cancer Guidelines – National Comprehensive Cancer Network, 2024

⁴ Breast cancers can be harder to find when you’re pregnant – American Cancer Society

⁵ Breast cancer benefit now up to Php 1.4 million – PhilHealth – PhilHealth, April 2024