Breast Lump & Screening Treatment in Johor Bahru

Five-year survival from breast cancer in Malaysia, by the stage at which it is found: **Stage I — 88%. Stage II — 81%. Stage III — 60%. Stage IV — 23%.** And the second number: the Malaysian National Cancer Registry recorded that **50.5% of breast cancers in 2017–2021 were detected at an advanced stage.** More than half. Earlier work put late diagnosis around 48%, so this is not improving. Between those two facts sits the entire case for screening, and there is no version of that argument that requires exaggeration. There is a third finding that explains the second, and it is the one worth acting on. A nationwide Malaysian study found that **seven in ten women believed breast cancer screening was only necessary when experiencing symptoms.** That belief is the problem in a sentence. Screening exists precisely to find cancer *before* it produces symptoms — because a cancer you can feel has already grown to a size where it can be felt, and a cancer that has caused symptoms has often had time to spread. By the time there is something to notice, the odds have already shifted from the 88% column towards the 60% one. Waiting to feel something is not caution. It is the mechanism by which Malaysian women arrive at Stage III.

About a quarter of Malaysian women in that same study said they expected to feel anxious about attending screening, and avoided it for that reason. Telling someone to be less anxious does not work. Describing what actually happens does. **Mammography** is an X-ray of the breast, recommended annually from age 40 in Malaysian practice, and earlier or more frequently where there is significant family history. The breast is compressed between two plates for a few seconds while the image is taken. It is briefly uncomfortable and for some women genuinely painful, and that is worth saying honestly rather than describing it as "mild pressure". The whole appointment takes about fifteen to twenty minutes. Booking in the week after your period, when breasts are least tender, makes a real difference. Compression is not gratuitous — it spreads the tissue so that small changes are visible and reduces the radiation dose needed. The dose is low. **Ultrasound** is often used alongside or instead of mammography in younger women, because denser breast tissue — more common under 40 and in Asian women generally — makes mammograms harder to read. It is painless. **Clinical breast examination** by a doctor takes a few minutes. Malaysian screening uptake depends substantially on doctors offering this opportunistically when women attend for something else, which is why we raise it here rather than waiting to be asked. Two anxieties worth naming directly. **"What if they find something?"** Most findings are not cancer. Cysts, fibroadenomas and benign changes are far more common than malignancy. And if it is cancer, this is the good version of that news — found early, in the 88% column, with treatment that is shorter and less aggressive than it would be six months later. **"I'd rather not know."** This is understandable and it is the position that costs the most. Breast cancer does not pause while you are not looking at it. Not knowing does not mean not having. Privacy and modesty concerns are legitimate and are usually accommodated — you can request a female practitioner, and it is reasonable to ask when booking.

Breast self-awareness is not a formal monthly ritual with a technique to get right. It is simply knowing what is normal for you, so that a change registers. Look and feel in the shower, or when dressing, at roughly the same point in your cycle. **See a doctor for:** A new lump or thickening in the breast or armpit, particularly one that persists beyond one menstrual cycle. Any change in size or shape. Skin changes — dimpling, puckering, or an orange-peel texture. Nipple changes — new inversion, a rash or scaling on the nipple, or discharge that is bloodstained or occurs without squeezing, especially from one side. Persistent pain in one specific area, unrelated to your cycle. Redness, swelling and warmth of the breast — which can be infection but, if it does not settle promptly on treatment, must be reassessed rather than treated again. **Most breast lumps are not cancer.** Fibroadenomas are common in younger women and feel smooth and mobile. Cysts fluctuate with the cycle. Generalised lumpiness that changes across the month is normal breast tissue. None of that means a lump should be watched at home indefinitely — it means the likely answer is reassuring and it still needs establishing rather than assuming. The assessment is straightforward: examination, then imaging appropriate to your age — ultrasound, mammogram, or both — and, if indicated, a needle biopsy. That sequence is called triple assessment and it is how the question gets settled properly rather than left open. **Men get breast cancer too.** Rarely, and it is dismissed even more often because neither patients nor clinicians expect it. A lump behind the nipple in a man is not automatically benign and should be examined. Two things that are not causes, despite persistent belief: underwired bras and bruising or knocks to the breast. Deodorant and antiperspirant have not been shown to cause breast cancer either.

Risk is not evenly spread, and knowing where you sit changes when screening should start. **Higher risk** if: a first-degree relative — mother, sister, daughter — has had breast or ovarian cancer, particularly if diagnosed young or if there are several affected relatives; you have a known BRCA1 or BRCA2 mutation in the family; you have had chest radiotherapy; or you have had certain breast biopsies showing high-risk changes. Family history on the father's side counts and is routinely forgotten. **Modest contributors**: starting periods early and menopause late; not having children, or first pregnancy after 30; long-duration combined HRT; alcohol; obesity after menopause; and physical inactivity. **Protective**: breastfeeding, physical activity, and maintaining a healthy weight after menopause. The honest framing on lifestyle: it shifts risk, it does not determine outcome. Plenty of women who did everything right develop breast cancer, and being told to eat better is not a substitute for being screened. Nobody develops breast cancer because they deserved it. If your family history is significant, say so explicitly at your next visit — screening may need to begin earlier than 40, and genetic assessment may be appropriate. **What this clinic does:** clinical breast examination, which we will offer rather than wait to be asked for; assessment of any lump or change, with referral for triple assessment where indicated; arranging mammography and ultrasound; taking a proper family history and advising when screening should start for you specifically; and following up results rather than leaving you to chase them. We are at No. 62, Jalan Kiambang, Taman Bunga Raya, 81700 Masai, Johor, open Monday to Thursday and Saturday 9AM to 9PM, Friday and Sunday 9AM to 3PM. Walk in, or call +60 7-251 1162 — and if you are reading this because you have found something, come this week rather than waiting to see whether it goes away.