This cancer occurs in the breast area and surrounding areas. The breast is a part of the body that is mainly composed of fat tissue. Inside, there are small structures, like tubes and storing mammary glands. This part is called lobule. There are also small ducts that connect the glands of milk to channel milk to the nipple.

In the breast, besides fat tissue, there are blood vessels and lymph vessels.

About 90% of breast cancers originate in the ducts (ducts) or glands (lobes) in the breast

In Indonesia, breast cancer is the No. 1 highest incidence (Globocan 2018). It is estimated that every year 23,140 new cases occur.

Ranking No.1 New cases of cancer in WOMEN in Indonesia in 2018

Who is at risk of developing breast cancer?

Risk factors for breast cancer include:

• Having your first period at a young age (under 12 years)
• Menopause at an older age (over 50 years)
• Never breastfeed a child
• Give birth to a first child at an older age (over 35 years)
• There was a benign mammary tumor
• Family history of cancer
• Following hormone therapy for a long time
• Obesity
• Exposed to radiation

As for women said to have a high risk of developing breast cancer, if:

• Has a 20-25% increase in risk based on family history
• There are certain genetic conditions (changes in the BRCA1 or BRCA2 gene)
• There is a biological family with a condition of changing genes (parents, siblings, siblings, children) BRCA1 or BRCA2
• Have a history of radiation to the chest area at the age of 10-30 years
• Have certain disease conditions, such as Li-Fraumeni Syndrome, Cowden Syndrome, or Bannayan-Riley-Ruvalcaba Syndrome, or biological families that have the disease.

Symptoms of Breast Cancer

In Indonesia, unfortunately many breast cancer patients come for medical treatment when the stadium is already advanced. Indeed, this cancer in the early stages without complaints felt by patients. There are lumps, but just ignored because they are small (the size of green beans) and do not cause interference or pain, even not felt.

Complaints arise when breast cancer has entered an advanced stage marked:

• Lump, not visible but can be felt
• Changes in breast skin. Looks drawn inward or constricted
• Changes to the nipples. The shape is like being drawn inside)
• Fluid from the nipple comes out
• Arising red sores or scabs (crusts) in the breast area.

Breast cancer at an advanced stage also makes the size of the tumor bigger, wounds caused that do not heal, in the body occurs the spread of cancer cells to lymph nodes and through the blood also spread to other organs, such as to the lung, liver, brain, and spine.

REQUIRED! Early detection of breast cancer

If you routinely make regular early detection for breast cancer, the cancer will be detected early. So even though you have cancer, you:

• there is probably no need for chemotherapy or radiation
• may not need to lift the lymph nodes, so avoid lymphedema (swelling due to lymph flow is not smooth)
• surgery can be performed that can still maintain the function and aesthetics of the breast
• avoid large funding for the treatment of breast cancer

Detection of breast cancer is done by:

1. Mammary ultrasound screening
2. screening with Mammography
3. BSE (breast self-examination).

Women can do breast self-examination by looking and touching to check:

• are there any bumps
• whether the nipple is pulled inward
• is there any skin drawn inside
• are there any skin changes
• is there any redness / skin injury
• if there is discharge from the nipple

Treatment of breast cancer

The procedure for treating breast cancer depends on:

• Tumor Size (T)
• Invasive type or in situ
• Lymph node involvement (N)
• Spread to other organs (M)

For the treatment of breast cancer itself there are several ways, namely:

✓ Surgery to remove cancer cells or organs

✓ Radiotherapy to ensure cancer cells are gone

✓ Chemotherapy to kill cancer seeds

✓ Hormone Therapy

✓ Target Therapy

Source: Breast Cancer presentation paper in the Training of Speakers event as a series of WORLD CANCER DAY 2019 organized by the KPKN, Ministry of Health Republic of Indonesia, RSCM, FKUI