Kanser payudara (breast cancer) is the most common cancer in Malaysian women, making up about 1 in 3 cancers diagnosed in women. The most common early sign is a new lump or swelling in the breast or armpit, but changes in the skin, nipple or breast shape also matter, and early breast cancer is often painless. Most breast lumps are not cancer, yet nearly half of breast cancers in Malaysia are found at a late stage. Knowing what is normal for your breasts, seeing a doctor quickly about any change, and having a mammogram every 2 years from age 50 (earlier if you are at higher risk) give you the best chance of finding it early, when it is easier to treat.
How common is breast cancer in Malaysia?
According to GLOBOCAN 2024 estimates for Malaysia from the International Agency for Research on Cancer, the World Health Organization's cancer agency:
- there were 9,611 new cases of breast cancer, making it the most common cancer in the country;
- breast cancer made up 33.6% of all cancers in women, far ahead of colorectal cancer (12.0%) and cervical cancer (6.9%);
- it caused 3,942 deaths, the second-highest number of cancer deaths after lung cancer.
The bigger problem in Malaysia is late diagnosis. A 2021 policy review reported that the share of breast cancers found at a late stage (stage 3 or 4) rose from 43% in 2011 to 48% in 2016. In a nationwide survey of 813 Malaysian women aged 40 and above, 7 in 10 believed breast screening was only needed if they had symptoms.
Stage at diagnosis makes a real difference. A study comparing a public hospital and a private hospital in Malaysia found a five-year survival rate of 71.6% in public hospital patients compared with 86.8% in private hospital patients, a gap largely explained by public patients being diagnosed at a later stage.
Tanda awal kanser payudara: what are the early signs?
According to the NHS, symptoms of breast cancer in women can include:
- a lump or swelling in your breast, chest or armpit;
- a change in the skin of your breast, such as dimpling that looks or feels like orange peel;
- a change in the colour of the skin: on brown skin it may look darker than usual, on lighter skin it may look red;
- a change in the size or shape of one or both breasts;
- nipple discharge when you are not pregnant or breastfeeding, which may contain blood;
- a change in the shape or look of your nipple, such as it turning inwards, or a rash on it that looks like eczema.
These changes can happen with or without pain. Breast pain on its own is not usually a sign of breast cancer.
Most breast lumps are not cancer. They are often caused by something harmless, such as a non-cancerous growth (fibroadenoma) or a fluid-filled cyst. But you cannot tell the cause by feeling a lump, so always get a new lump checked by a doctor.
Men can also get breast cancer in the breast tissue of the chest, so any new lump or change there should be checked too.
Punca kanser payudara: who is at higher risk?
It is not always clear what causes breast cancer, and many women who get it have no obvious risk factors. The NHS says you may be more likely to get breast cancer if you:
- are over 50;
- have dense breast tissue;
- have close relatives who have had breast or ovarian cancer, or have inherited a faulty gene such as BRCA;
- have had certain breast conditions before, such as some types of benign breast disease;
- started your periods before age 12 or reached menopause after 55;
- have not given birth, or had your first child after 30;
- did not breastfeed;
- have used the contraceptive pill in the last 10 years or take hormone replacement therapy (HRT); these only slightly increase the risk, and for many women the benefits outweigh the risks.
Ways to lower your risk, according to the NHS, include cutting down on alcohol, losing weight if you are overweight (see our weight loss guide for Malaysians), and not smoking. Breastfeeding also helps: a large analysis of 47 studies in 30 countries found that the risk of breast cancer fell by 4.3% for every 12 months a woman breastfed, on top of a 7.0% fall for each birth.
If breast or ovarian cancer runs in your family, talk to your doctor. You may be referred for genetic counselling or earlier screening.
How to check your breasts
The NHS recommends checking your breasts about once a month so you learn what is normal for you:
- Look at your breasts in a mirror, first with your arms by your sides and then with your arms raised. Look for changes in size, shape, skin or nipples.
- Feel each breast in a circular motion, all the way up to your collarbone and under each armpit, using a mix of light and firmer pressure.
- Feel around and over each nipple.
Many women find it easier to do this in the shower or lying down. Breasts naturally feel different at different points in your menstrual cycle, during pregnancy and breastfeeding, and after menopause, so get to know how they feel at different times.
Checking your breasts is about knowing your normal, not replacing screening. A Cochrane review of two large trials with 388,535 women found that a formal, taught breast self-examination programme did not reduce deaths from breast cancer, and it led to almost twice as many biopsies that turned out to be harmless. Being familiar with your breasts and acting quickly on any change is still important, alongside mammograms at the recommended ages.
Mammogram and breast screening in Malaysia
A mammogram is a breast X-ray that can pick up cancers that are too small to see or feel. Malaysia's Clinical Practice Guidelines on the Management of Breast Cancer (3rd edition, 2019), as summarised in a 2021 policy review, recommend:
| Who | Recommended screening |
|---|---|
| All women from 35 | Clinical breast examination by a doctor or nurse |
| Women aged 50 to 74 (average risk) | Mammogram every 2 years |
| Moderate risk (for example, some family histories or gene changes) | Mammogram every year from 40 to 49, every 1 to 2 years from 50 to 59, then every 2 years |
| High risk (for example, BRCA gene change, strong family history, previous breast cancer, chest radiotherapy at a young age) | Screening may start from 30 to 39; yearly mammograms from 40, and MRI for some women with gene changes |
Where to go. Clinical breast examinations are available at klinik kesihatan and private clinics. Mammograms are offered at government hospitals and clinics with mammogram facilities and at private hospitals. The National Population and Family Development Board (LPPKN) also runs a subsidised mammogram programme at selected private facilities for eligible women; ask your doctor or LPPKN about eligibility.
Screening is for women without symptoms. If you already have a lump or another change, do not wait for a screening appointment: see a doctor now. Our guide to the Pap smear and HPV test covers the other key cancer screening for women in Malaysia.
Kanser payudara tahap 1 to 4: what do the stages mean?
The stage describes how big the cancer is and how far it has spread. It helps doctors choose the best treatment. In simplified terms, according to Cancer Research UK:
- Stage 0: abnormal cells inside the milk ducts that have not spread into the surrounding breast tissue (ductal carcinoma in situ, DCIS).
- Stage 1 (tahap 1): a small cancer, 2 cm or smaller, in the breast, sometimes with a few cancer cells in nearby lymph nodes. This is early breast cancer.
- Stage 2 (tahap 2): the cancer is larger (up to 5 cm, or bigger without lymph node spread) and/or has spread to 1 to 3 lymph nodes. This is still early breast cancer.
- Stage 3 (tahap 3): the cancer has spread to more lymph nodes, or to the skin of the breast or the chest wall. This is called locally advanced breast cancer.
- Stage 4 (tahap 4): the cancer has spread to other parts of the body, most often the bones, liver, lungs or brain. This is called secondary or advanced breast cancer.
Secondary breast cancer can cause general symptoms such as tiredness, loss of appetite, weight loss without trying, and feeling unwell for no clear reason. It usually cannot be cured, but treatment can control it and help you feel better.
A study at a district hospital in Johor found that 59.6% of women were diagnosed at stage 3 or 4. Having a breast lump for more than 3 months before seeing a doctor was linked to a later stage. The researchers suggested that lack of awareness, difficulty reaching health services and beliefs in alternative medicine may play a part.
How is breast cancer treated?
If a doctor thinks a change could be cancer, you will be referred for tests, which may include a breast examination, mammogram, ultrasound and a biopsy (a small sample of cells taken with a needle). Treatment depends on the size and type of cancer, whether it has spread, and your general health. According to the NHS, the main treatments are:
- Surgery, usually the main treatment: removing only the area with cancer (breast-conserving surgery) or the whole breast (mastectomy), and sometimes lymph nodes in the armpit. Breast reconstruction may be possible.
- Radiotherapy, often after surgery to lower the chance of the cancer coming back.
- Chemotherapy, before surgery to shrink the cancer or after surgery if it has spread to lymph nodes or is growing quickly.
- Hormone therapy, for cancers that are fuelled by hormones.
- Targeted medicines and immunotherapy for certain types of breast cancer.
Be careful with unproven "cures". No supplement, herbal product or diet can treat breast cancer. Delaying medical treatment to try them can allow the cancer to grow and spread. If you want to use any supplement during treatment, discuss it with your cancer team first, and check that any product is registered (see how to verify KKM registration).
Frequently asked questions (FAQ)
What are the early signs of breast cancer (tanda awal kanser payudara)?
The most common early sign is a new lump or swelling in the breast, chest or armpit. Other signs include dimpled skin that looks like orange peel, a change in skin colour, a change in the size or shape of a breast, nipple discharge (sometimes with blood) when you are not pregnant or breastfeeding, and a nipple that turns inwards or has a rash. Early breast cancer is often painless.
Is a breast lump always cancer?
No. Most breast lumps are harmless and are often caused by a non-cancerous growth (fibroadenoma) or a fluid-filled cyst. But you cannot tell the cause by feeling it, so always get any new lump checked by a doctor.
Is breast pain a sign of breast cancer?
Breast pain on its own is not usually a sign of breast cancer, and breast pain linked to periods is common: it usually starts up to 2 weeks before a period and goes away when the period ends. See a doctor if the pain does not go away, or if it comes with a lump, skin or nipple changes, or you have a family history of breast or ovarian cancer.
What causes breast cancer (punca kanser payudara)?
The exact cause is not always clear. You are more likely to get breast cancer if you are over 50, have a close relative with breast or ovarian cancer, carry a faulty gene such as BRCA, have dense breast tissue, started periods early or reached menopause late, had no children or a first child after 30, or did not breastfeed. Alcohol, being overweight and smoking also raise the risk.
When should I get a mammogram in Malaysia?
Malaysia's clinical practice guidelines recommend a mammogram every 2 years for women aged 50 to 74. Women aged 40 to 49 at moderate risk, for example because of family history, are advised to have one every year, and women at high risk may start earlier. A clinical breast examination by a doctor or nurse is recommended from age 35.
What does kanser payudara tahap 4 mean?
Stage 4 (tahap 4) breast cancer means the cancer has spread from the breast to other parts of the body, most often the bones, liver, lungs or brain. It is also called secondary or advanced breast cancer. It usually cannot be cured, but treatment can help control it and ease symptoms.
How do I check my breasts at home?
About once a month, look at your breasts in a mirror with your arms down and then raised. Then feel each breast in a circular motion up to your collarbone and into each armpit, using light and firmer pressure, and feel around each nipple. Breasts change during your cycle, so learn what is normal for you and see a doctor about any new change.
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor. If you notice any change in your breasts, see a doctor. Health supplements are not intended to diagnose, treat, cure or prevent any disease.
References
- Symptoms of breast cancer in women — NHS
- Causes of breast cancer in women — NHS
- Tests and next steps for breast cancer in women — NHS
- Treatment for breast cancer in women — NHS
- How to check your breasts or chest — NHS
- Breast lumps — NHS
- Breast screening (mammogram) — NHS
- Breast pain — NHS
- Breast cancer in men — NHS
- Number stages of breast cancer — Cancer Research UK
- GLOBOCAN 2024: Malaysia fact sheet — Global Cancer Observatory, International Agency for Research on Cancer
- Htay MNN, et al. Breast cancer screening in Malaysia: a policy review. Asian Pac J Cancer Prev. 2021;22(6):1685-1693.
- Tan MM, et al. Breast cancer and breast cancer screening use-beliefs and behaviours in a nationwide study in Malaysia. BMC Public Health. 2023;23(1):1319.
- Kong YC, et al. Advanced stage at presentation remains a major factor contributing to breast cancer survival disparity between public and private hospitals in a middle-income country. Int J Environ Res Public Health. 2017;14(4):427.
- Cheng ML, et al. Factors influencing late stage of breast cancer at presentation in a district hospital - Segamat Hospital, Johor. Med J Malaysia. 2015;70(3):148-52.
- Kösters JP, Gøtzsche PC. Regular self-examination or clinical examination for early detection of breast cancer. Cochrane Database Syst Rev. 2003;(2):CD003373.
- Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries. Lancet. 2002;360(9328):187-195.
