Although regular breast screenings are recommended to women above the age of 40, this does not mean that it is not possible for younger women to be diagnosed with breast cancer. 1 in 6 cases of breast cancer in Singapore occur in women under the age of 45 years old. We speak to Dr Lee Wai Peng at Solis Breast Care & Surgery Centre to find out more about breast cancer and pregnancy in young women. Dr Lee specialises in treating benign and malignant breast conditions. Prior to joining Solis, she was a Senior Consultant and an Adjunct Assistant Professor at Changi General Hospital (CGH), a position she grew into following the completion of her advanced specialty training in general surgery in 2014. She strives to provide holistic and individualised care with a personal touch for ladies with breast conditions and is a strong advocate for encompassing cosmesis with surgical therapy. Q1: What are some symptoms that mothers may face during and after pregnancy that can be mistaken for breast cancer? Our breasts undergo multiple changes during and after pregnancy. Lumpy breast and even breast nodules\/lumps are common symptoms that are encountered that may be mistaken to be breast cancer. Uneven breast tissue (lumpy breast) can be due to the hormonal change that is happening in the lady and breast nodules\/lumps may be due to excoriation or injury to the nipple as a result of poor latching technique. This may be mistaken to be breast cancer where patients may also present with bloody nipple discharge. Q2: Once a woman contracts mastitis, will it become a reoccurring issue? Mastitis can recur at any point in time, particularly so in lactating women. In such instances, it may be attributed to one of more of these factors: breasts not emptied, unable to fully empty their breasts during breastfeeding or an injury to the nipple resulting in bacteria entering the breast. Women who have diabetes or conditions that may suppress their immunity will have increased risk of developing mastitis as well as having recurrent episodes. Q3: For women who were previously diagnosed with breast cancer but has completed their course of treatment\/chemotherapy: \tIs it advisable for them to try conceive? If the couple desire for a child, they are strongly encouraged to discuss with their oncologist on the appropriate\/suitable timing. Chemotherapy will affect the fertility of women hence, if fertility is desired possibly after their treatment or when cancer is in remission, it is advisable to discuss with their oncologist or breast specialist prior to the commencement of any treatment. \tHow long would they have to \u201crecuperate\u201d their body before they would like to try to have a baby? This would be largely dependent on the type of treatment that they have undergone and how mentally ready the couple is to move to another phase in their life. I would suggest a detailed discussion with your medical physicians to establish the best time interval for trying for a child. Q4: Have you been seeing more younger women (e.g., age could range from 20 to 35 years old) diagnosed with breast cancer and\/or other breast health issues in recent years? If so: \tAre they usually in the early or later stage of cancer? This often varies. This is because screening advice is often recommended for ladies above the age of 40. Hence, ladies below 40 most often present to a breast specialist when they feel a breast lump. If left ignored, should this lump be cancerous, the cancerous cells may progress further, resulting in ladies presenting at a later stage of cancer. However, we do see a fair number of younger ladies being diagnosed at an early stage and this finding is often incidental due to health screening. \tIf detected early, will most patients usually get through the \u201ccancer survival rate\u201d? As with any cancer, early detection saves lives. Similarly for breast cancers, the earlier we pick them up through screening (i.e. mammogram for those ladies above the age of 40 or breast self-examination), the better the chances for survival and the lower the risk for relapse. Breast cancer in a young lady (<40 years old) can potentially be associated with an underlying generic mutation. It may be advisable to seek your doctor\u2019s advice if genetic testing is required in such instances. \tBreast health issues \u2013 Are younger women getting more lumps and bumps (e.g., benign condition)? What could it possibly be due to? When biopsy is required, is there such a thing where there is a \u201cbest\u201d or \u201cless painful\u201d type of biopsy? Thankfully due to increased awareness of breast health, physicians may notice more ladies who discover lumps in their breasts during self-examination. At least 80% of breast lumps tend to be benign (non-cancerous). Such benign lumps are not genetically linked. Some of the common causes include fibroadenomas and breast cysts. Breast biopsies these days are done largely as an outpatient setting and local anaesthesia often suffices. The simplest technique is known as core (needle) biopsy where the different portions of the breast nodule are sampled. Vacuum assisted biopsy is currently the more popular technique for breast biopsy where a breast lump, if small enough, can also be removed at the same setting (minimally invasive method). In a vacuum biopsy, the wound is extremely small unlike the conventional breast lump removal (excision). The above two biopsy methods can be done fairly quickly, and pain is manageable with very minimal analgesics. Q5: Should a patient be diagnosed with breast cancer during her pregnancy, how are treatment plans best tailored for the patient? In such instances, a multidisciplinary team approach will be extremely beneficial for the care of this patient. The team would include her gynaecologist, breast specialist, medical oncologist, and radio oncologist. The priority of care and the wellbeing of her unborn foetus should be carefully discussed with the patient and her spouse. While the risk of breast cancer does increase with age, all women are at risk of getting diagnosed. Since young women are also susceptible to breast cancer and breast health issues, it is also important for young women to do regular self-checks and screenings in order to ensure that any breast health concerns are picked up early. Ultimately, early detection is always the best, and hence we hope to encourage women not to be afraid of getting a breast health check for their own wellbeing. With Solis, you will be provided with the expert care you need and deserve \u2013 in the most seamless way possible. Therefore, there is no need to fear, because with Solis, you know you will always be in good hands with the breast care you deserve.