This brought tears to my eyes ... :'(

Fatum SG

She sacrificed her life for her unborn child

Mrs S, a 35-year-old woman in her second pregnancy, was diagnosed with breast cancer. She was then four months pregnant and was offered a termination of pregnancy by a gynaecologist. But she delayed her decision to abort the baby. She told her husband: 'I am going to take my chance and let my baby live.'

She came to see me in her sixth month of pregnancy and said that she had felt a painless lump in her right breast while bathing. She was then in her third month of pregnancy.

The lump was firm to the touch and grew rapidly from the size of a small fishball to a golf ball within a month. Soon, there were lumps appearing in the right armpit. She consulted a surgeon who told her that she had advanced breast cancer and she was referred to a gynaecologist for an abortion prior to surgical removal of the cancer.

Breast cancer is the most common cancer among women in Singapore. One in five cancers occurring in Singaporean women is breast cancer. Every year, about 1,100 new cases of breast cancer are diagnosed.

That means three women are diagnosed with breast cancer each day. And about 270 die from the disease each year.

Breast cancer occurs in about one in every 3,000 pregnancies and most often when the mother is between the ages of 32 and 38, as in the case of Mrs S. It usually appears as an innocuous lump and may cause retraction of the nipple as it grows.

Breast cancer is usually difficult to detect early in pregnant women, whose breasts are often tender and swollen. By the time the patient presents herself to the doctor, the cancer is usually at the advanced stage. This is what happened in MrsS, whose cancer had spread to the lymph nodes in the armpit.

When I examined her, she appeared anxious, but was firm about her decision to continue with her pregnancy even though this was contrary to the surgeon's advice. She knew very well that the cancer would grow more rapidly during pregnancy due to the increase in female hormones. This would make the management of her condition difficult.

After many sessions of prolonged discussion with her and her husband, I was moved by her willingness to risk her life for the sake of her baby.

A holistic approach was required in this unique case as I worked closely with my surgical colleagues. Mrs S underwent removal of her breast with clearance of the lymph nodes in the armpit during the seventh month of her pregnancy. The cancer was found to be aggressive in nature.

A baby boy was delivered in the eighth month of her pregnancy by Caesarean section. He was discharged after a week in the neo-natal intensive care unit.

Soon after the delivery, Mrs S had radiotherapy and adjuvant chemotherapy. This was more palliative than curative as the cancer was found to have spread to the brain. This information was passed on to the patient's husband. It was to prepare him for the inevitable.

A difficult time
Three months later, I received a phone call from her husband and was informed that she had passed away in her sleep. At that juncture, I could only be reminded of the brave decision she had made and her love for her unborn son.

It was a difficult time for me as I thought of the days when we journeyed together during her pregnancy. I constantly encouraged her and affirmed her determination to proceed with her pregnancy even though the odds were against her.

When I attended the funeral, I met the patient's admirable husband who was looking after the two children.

I was surprised when he approached me and put a note in my hands. He said that Mrs S wrote this note about a week before her death. It took me a while before I decided to read it. I was on the verge of tears after reading the touching note which said:

'Dear Doctor Chew, I appreciate your concern and care. You have certainly provided me with the opportunity of motherhood even though it may be a short one.'

As an obstetrician, I have encountered numerous cases but it is these instances that render the fruits of my labour worthwhile and continue to inspire me as a health-care professional. I have kept the note till this day and it has been a source of motivation when the going gets tough.

from the straits times ... linkie

ceecookie SG

Tsk..alot of codings

Detached SG

Rhonda SG

Tsk..alot of codings

After reading the article, is that all you have to say about it?!

maurizio13 SG

After reading the article, is that all you have to say about it?!

I only have this advice for women,

have children b4 you hit 30.

When you hit 30, everything deteoriates.

Rhonda SG

I know of ladies in their 30's, a few in their late 30's, who gave birth to healthy babies.

I also know of young ladies in their early 20's who gave birth to not-too-healthy babies.

So there! Age is not the one and only factor... lifestyle, etc will affect fertility too. However, in any case, this article is not about fertility in the first place! Have you even read the article?

Anyways, cancer strikes all age groups too.

maurizio13 SG

I know of ladies in their 30's, a few in their late 30's, who gave birth to healthy babies.

I also know of young ladies in their early 20's who gave birth to not-too-healthy babies.

So there! Age is not the one and only factor... lifestyle, etc will affect fertility too. However, in any case, this article is not about fertility in the first place! Have you even read the article?

Anyways, cancer strikes all age groups too.

ScienceDaily (Apr. 17, 2007) — Breastfeeding can offset the increased risk of invasive breast cancer for women who had their first full-term pregnancy after the age of 25, a study led by researchers at the University of Southern California (USC) suggests.

"Breastfeeding may have a protective effect that negates the increased risk of breast cancer associated with late pregnancies," says Giske Ursin, M.D., Ph.D, associate professor of preventive medicine at the Keck School of Medicine of the University of Southern California. "As more women may choose to delay pregnancy until after 25, it is important to note that breastfeeding provides protection against both estrogen and progesterone receptor positive and negative tumors."

While having a first full-term pregnancy before the age of 25 and having many children protect against the type of breast cancers that express estrogen and progesterone receptors, these factors do not protect against the rarer tumors that do not have these receptors. Breastfeeding, however, appears to protect against both types of breast tumors, Ursin says.

Researchers analyzed data for women aged 55 and older--including 995 invasive breast cancer patients--who participated in the Women's Contraceptive and Reproductive Experiences (CARE) Study. The women varied by their age at first birth, their breastfeeding history and hormone receptor status.

Previous results from the Women's CARE Study have shown that early age at first pregnancy (younger than 25) and having many children (defined as four or more) are associated with a lower risk of breast cancer, Ursin says. Researchers sought to gain a better understanding of the associations between reproductive factors and breast cancer risk in women with a late age at first birth, she says.

Breastfeeding appears to have a protective effect regardless of when women started giving birth, Ursin says. This is important since having many children was only protective among women who gave birth early, she says. Giving birth after age 25--the average age that women in the U.S. first give birth, according to Census data--was associated with increased risk of hormone receptor negative breast cancer.

"Evidence suggests that women who have children after age 25 can reduce their risk of breast cancer by choosing to breastfeed," Ursin says.

The study was funded by the National Institute of Child Health and Human Development and by the National Cancer Institute.

The findings of the study were presented at a news conference on Monday, April 16 at the 2007 annual meeting of the American Association for Cancer Research held in Los Angeles.

Reference: Sarah J. Lord, Leslie Bernstein, Karen Johnson, Kathi Malone, Linda Weiss. Jill McDonald, Giske Ursin, "Parity, breastfeeding and breast cancer risk by hormone receptor status in women with late age at first birth--A Case Control Study."

Adapted from materials provided by University of Southern California, via EurekAlert!, a service of AAAS.

http://www.sciencedaily.com/releases/2007/04/070416193310.htm

So if you have birth early and breastfeed your child, the risk of developing breast cancer is reduced.

Most breast cancer start to develop after 30 y.o.

Rhonda SG

"Evidence suggests that women who have children after age 25 can reduce their risk of breast cancer by choosing to breastfeed," Ursin says.

The study was funded by the National Institute of Child Health and Human Development and by the National Cancer Institute.

The findings of the study were presented at a news conference on Monday, April 16 at the 2007 annual meeting of the American Association for Cancer Research held in Los Angeles.

Adapted from materials provided by University of Southern California, via EurekAlert!, a service of AAAS.

http://www.sciencedaily.com/releases/2007/04/070416193310.htm

So if you have birth early and breastfeed your child, the risk of developing breast cancer is reduced.

Most breast cancer start to develop after 30 y.o.

Well, sweet to know, but you know what, this won't send women rushing to get married and give birth and subsequently breastfeed just to keep Breast Ca at bay. In fact, ladies who rush into bad marriages and then give birth and breastfeed just so they have a lower risk of Breast Ca might die of several other factors from the stress of being in an unhappy marriage, and of having to take care of so many kids, who may or may not be easy to take care of!

Anyways, we are hijacking the original thread liao.

maurizio13 SG

An interesting article I found, interesting read for women and maybe men too.

http://www.cancer.org/downloads/STT/BCFF-Final.pdf

maurizio13 SG

An interesting statistic from that article.

When a woman is 20 y.o. her risk is 0.05%

when that woman hits 30 y.o. her risk is 0.43%,

an increased risk of 9 times. (ie 0.43% ÷ 0.05%)

Rhonda SG

The patient I took care of yesterday had a double mastectomy done. What's worse, the Breast Ca had spread to her brain.

What's sad is that she's one of the sweetest patients I've come across in my entire nursing career spanning a good six years!

So... ok, I'm on Annual Leave today, I'm going to take a respite from this topic.

maurizio13 SG

ok.

That would put into perspective the kind of industry you are in, which is all so obvious with your avatar.

maurizio13 SG

Lifestyles have changed in the Asian context with the advent of women in the workforce (thereby gaining financial independence)

and the adoption of western ideologies.

Fatum SG

I'm not sure if the mother made the right decision though .....

she has to live for her hubster and her first child as well .....

I'm not sure if her decision to give birth to the child before chemo was a correct one ....

airgrinder SG

I'm not sure if the mother made the right decision though .....

she has to live for her hubster and her first child as well .....

I'm not sure if her decision to give birth to the child before chemo was a correct one ....

I thought so too. However think there is really no right or wrong. She put her child's life before hers.