Skip to main content

Advertisement

Log in

Breast cancer in Singapore: some perspectives

Breast Cancer Aims and scope Submit manuscript

Abstract

Breast cancer is the commonest malignancy among Singapore women, accounting for 29.7% of all female cancers, with an age-standardized rate of 54.9 per 100,000 per year. It has been the most frequent cancer in Singapore women for the last 30 years, with the highest rates previously reported in those aged between 45 and 49 years, but with a more recent observation of a change in peak age group to women in their late 50s. About 1,100 new cases are diagnosed annually and approximately 270 women die in Singapore each year from breast cancer. In the multiethnic population of Singapore, it has been noted that rising breast cancer incidence is consistent across all three ethnic groups (Chinese, Malays, and Indians). Singapore has among the highest breast cancer incidence in Asia. Possible explanations include rapid urbanization, improvement in socio-economic status, and adoption of a western lifestyle. Our experience with the Singapore breast screening pilot project (1994–1997) and the national breast-screening program (BreastScreen Singapore) has led to increased understanding of this disease in the country. Data from the pilot project showed that breast screening is just as effective in a predominantly Asian population as in the west. Early breast cancer accounted for most breast cancers detected, with pre-invasive ductal carcinoma in situ (DCIS) comprising 26% of all screen-detected cancers in the pilot study. In the currently on-going BreastScreen Singapore, DCIS forms >30% of all breast cancers among pre-menopausal women, a relatively high proportion probably accounted for partially by the greater participation of women aged between 40 and 49 years. Despite the ready availability of subsidized mammographic screening, there are still women in Singapore who present with locally advanced breast cancer. Clinical management of an increasing number of women with breast cancer embraces a multidisciplinary team-based approach, with regular discussions of therapeutic strategies at tumor boards. In order to improve breast cancer diagnostics and therapeutics in our country, it is important that there are continual breast cancer and breast disease-related educational activities for medical professionals engaged in diagnosing and managing breast cancer. The role of public education in raising awareness is also essential.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Singapore Cancer Registry Interim Report. Trends in Cancer Incidence in Singapore 2002–2006, National Registry of Diseases Office.

  2. International Agency for Research on Cancer. Cancer incidence in five continents volume, vol. VIII. Lyon: IARC; 2002.

    Google Scholar 

  3. Wang H, Seow A, Lee HP. Trends in cancer incidence among Singapore Malays: a low-risk population. Ann Acad Med Singapore. 2004;33:57–62.

    PubMed  Google Scholar 

  4. Sim X, Ali RA, Wedren S, Goh DL, Tan C-S, Reilly M, et al. Ethnic differences in the time trend of female breast cancer incidence: Singapore, 1968–2002. BMC Cancer. 2006;6:261.

    Article  PubMed  Google Scholar 

  5. Chia KS, Lee JJM, Wong JLL, Gao W, Lee HP, Shanmugaratnam K. Cancer incidence in Singapore, 1998 to 1999. Ann Acad Med Singapore. 2002;31:745–50.

    CAS  PubMed  Google Scholar 

  6. Wee SB. The case for breast cancer screening in Singapore. Singapore Med J. 2002;43(5):221–3.

    CAS  PubMed  Google Scholar 

  7. Wang SC. The Singapore National Breast Screening Programme: principles and implementation. Ann Acad Med Singapore. 2003;32:466–76.

    CAS  PubMed  Google Scholar 

  8. Ng EH, NG FC, Tan PH, Low SC, Chiang G, Tan KP, Seow A, Emmanuel S, Tan CH, Ho GH, Ng LT, Wilde CC. Results of intermediate measures from a population-based randomized trial of mammographic screening prevalence and detection of breast carcinoma among Asian women: the Singapore Breast Screening Project. Cancer. 1998;82(8):1521–8.

    Google Scholar 

  9. Tan PH, Chiang GS, Ng EH, Low SC, Ng FC. Screen-detected breast cancer in an Asian population: pathologic findings of the Singapore breast-screening project. Breast. 1999;8(3):120–5.

    Article  CAS  PubMed  Google Scholar 

  10. Tan SM, Evans AJ, Lam TP, Cheung KL. How relevant is breast screening in the Asia/Pacific region? Breast. 2007;16(2):113–9.

    Article  CAS  PubMed  Google Scholar 

  11. Jara-Lazaro AR, Tan PH. Patterns and spectrum of morphology referrals in breast pathology. Pathology. 2008;40(6):564–72.

    Article  PubMed  Google Scholar 

  12. Wu AH, Koh W-P, Wang R, Lee H-P, Yu MC. Soy intake and breast cancer risk in Singapore Chinese Health Study. Br J Cancer. 2008;99:196–200.

    Article  CAS  PubMed  Google Scholar 

  13. Inoue M, Robien K, Wang R, Van Den Berg DJ, Koh W-P, Yu MC. Green tea intake, MTHFR/TYMS genotype and breast cancer risk: the Singapore Chinese Health Study. Carcinogenesis. 2008;29(10):1967–72.

    Article  CAS  PubMed  Google Scholar 

  14. Ali AB, Iau PT, Putti TC, Sng JH. BRCA1 disease-associated haplotypes in Singapore Malay women with early-onset breast/ovarian cancer. Breast Cancer Res Treat. 2007;104:351–3.

    Article  CAS  PubMed  Google Scholar 

  15. Wu AH, Seow A, Arakawa K, Van Den Berg D, Lee H-P, Yu MC. HSD17B1 and CYP17 polymorphisms and breast cancer risk among Chinese women in Singapore. Int J Cancer. 2003;104(4):450–7.

    Article  CAS  PubMed  Google Scholar 

  16. Lee HP, Gourley L, Duffy SW, Esteve J, Lee J, Day NE. Dietary effects on breast-cancer risk in Singapore. Lancet. 1991;338(8760):186–7.

    Google Scholar 

  17. Duffy SW, Jakes RW, Ng FC, Gao F. Interaction of dense breast patterns with other breast cancer risk factors in a case-control study. Br J Cancer. 2004;91:233–6.

    CAS  PubMed  Google Scholar 

  18. Jakes RW, Duffy SW, Ng FC, Gao F, Ng EH. Mammographic parenchymal patterns and risk of breast cancer at and after a prevalence screen in Singaporean women. Int J Epidemiol. 2000;29:11–9.

    Article  CAS  PubMed  Google Scholar 

  19. Lim SE, Back M, Quek E, Iau P, Putti T, Wong JEL. Clinical observations from a breast cancer registry in Asian women. World J Surg. 2007;31:1387–92.

    Article  PubMed  Google Scholar 

  20. Tan BK, Lim GH, Czene K, Hall P, Chia KS. Do Asian breast cancer patients have poorer survival than their western counterparts? A comparison between Singapore and Stockholm. Breast Cancer Res. 2009;11:R4. doi:10,1186/bcr2219.

    Article  PubMed  Google Scholar 

  21. Tey J, Baggarley S, Lee KM. Cancer care in Singapore. Biomed Imaging Interv J. 2008;4(3):e38.

    Article  Google Scholar 

  22. Seow A, Koh WP, Chia KS, Shi LM, Lee HP, Shanmugaratnam K. Trends in cancer incidence in Singapore 1968–2002. Singapore Cancer Registry 2004.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Puay Hoon Tan.

About this article

Cite this article

Jara-Lazaro, A.R., Thilagaratnam, S. & Tan, P.H. Breast cancer in Singapore: some perspectives. Breast Cancer 17, 23–28 (2010). https://doi.org/10.1007/s12282-009-0155-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12282-009-0155-3

Keywords

Navigation