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The Pink and Blue Ribbon Cancers

In Singapore, breast cancer accounts for almost 30% of cancer diagnoses among women, while prostate cancer accounts for 14.1% of cancer diagnoses among men. These terrifying statistics tell us how common these cancers are in our community, but how well do you know about them?

Does a breast lump always mean it is breast cancer?

Breast cancer is the leading cancer in Singapore women and the number of new breast cancer cases has risen more than three times since 1968. Breast cancer occurs when breast cells begin to grow abnormally. These cells usually form a tumour that can often be seen on an x-ray or felt as a lump. Most of the time, the tumour is not cancerous. However there is a slight chance that it may develop into cancer. Sometimes, doctors may advise patients to have sizeable lumps removed. If you have a benign lump in your breast, it is advisable for you to speak with your doctor.

What are the symptoms?

Breast cancer may be painless and there may be few or no symptoms during the early stage. Changes in the breast are often the first signs and women should watch out for: 

  • A change in the nipple or areola, such as scaliness, persistent rash or nipple turning inward 
  • Discharge from the nipple 
  • A persistent lump in the breast or underarm area 
  • A change in the size or shape of the breast 
  • A change in the colour or appearance of the breast such as redness, puckering or dimpling 
  • “Orange peel skin” or change in texture of skin (Peau d’orange) 
  • A persistent pain in the breast or nipple 
  • Irritation of skin on the breast


Does an enlarged prostate always indicate prostate cancer?

The prostate is a small gland located below the bladder and found only in men. When cells in the prostate gland start to grow abnormally, they may become cancerous. Prostate cancer is the third most common cancer diagnosed in Singapore men and has seen an eight-fold increase from 1968 to 2017. The rising incidence is likely due to factors such as lifestyle changes and population ageing. Having an enlarged prostate does not mean that it is prostate cancer, nor does it increase one’s risk of the cancer. However, it can cause symptoms that are similar to prostate cancer. The cause of this enlargement is usually benign prostatic hyperplasia (BPH).

What are the symptoms?

Prostate cancer may cause no symptoms in its early stages. Signs and symptoms that may show at the advanced stage include: 

  • Trouble urinating 
  • Decreased force in the stream of urine 
  • Blood in semen 
  • Discomfort in the pelvic area 
  • Bone pain 
  • Erectile dysfunction

It is important to keep in mind that most of these symptoms can also be due to conditions other than cancer. However, one should consult a doctor if they experience these symptoms .

Am I at risk?

The risk of both breast cancer and prostate cancer increases with age, however multiple factors do affect the risk.

Here are some of the risk factors of breast and prostate cancers:

Breast CancerProstate Cancer
Increased age
(risk increases after age 40)​
Increased age
(risk increases after age 50)​
​Family history of breast and/or prostate cancer, especially in a first-degree relative (parents, siblings), or two or more close relatives such as cousins
Family history of genes that increase the risk of breast or prostate cancer (BRCA1 or BRCA 2)​
Personal history of breast cancer​Personal history of prostate cancer​
Never had children or late childbearing
(after the age of 30)​
​Excessive alcohol consumptionSmoking​
​Use of combinedhormonal replacement therapy for a long period of time
​Early onset of menstruation
(before the age of 12)
Late menopause
(after the age of 55)​
Excessive weight gain in post-menopausal women

That said, not all people with breast or prostate cancer have the above risk factors. Similarly, not having any of these risk factors does not mean that you will not get these cancers. 

What are the survival rates?

Fortunately, even though the incidence of breast cancer is on the rise, more women are surviving the disease. Survival has increased from 50% in the 1970s to 80% in 2010s. This is likely due to improvement in treatments and more women going for breast cancer screening.

The chances of surviving breast cancer increase with early detection. In 2013-2017, almost three-quarters of breast cancer cases were diagnosed at stages 1 and 2, with more than half of these women between 45 and 64 years old. The five-year survival rates for the women diagnosed at stage 1, 2 and 3 are 91%, 81% and 66% respectively.

Similarly, more men are surviving prostate cancer and continuing to lead active and quality lives after treatment because of greater awareness, early detection and advanced treatment. The five-year survival rate for prostate cancer diagnosed at stages 1 to 3 is above 98%.

When should I go for breast/ prostate cancer screening?

The Health Promotion Board (HPB) recommends that women aged 50 years and above should go for mammography screening once every two years. Due to the current COVID-19 situation, some women who discover new breast changes or lumps may hesitate to see their doctor because of fear about the COVID-19 pandemic.

The national mammogram screening programme has resumed, and precautions are being taken to ensure the safety of women during mammograms. “Because of the need for safe distancing at screening centres, some mammogram appointments may be rescheduled by the centres. It is ok if your mammogram appointment is delayed by a short few months,” advised Dr Jack Chan, Consultant, Division of Medical Oncology, National Cancer Centre Singapore (NCCS).

“Many Singaporeans got into the habit of exercising during the Circuit Breaker. This is good because regular physical exercise of at least 150 minutes of moderate aerobic activity per week can help to reduce one’s risk of developing breast cancer. We also urge women to perform breast self-examinations at home, every month,” Dr Chan said.

Prostate cancer screening, however, is not for all men as it can lead to both benefits and harms. “The prostate specific antigen (PSA) test, which measures the level of PSA protein in the blood, may not always provide an accurate result. To rule out cancer, most men with elevated PSA levels will opt for unnecessary biopsies, which may carry some risks,” explained Dr Ravindran Kanesvaran, Deputy Head and Senior Consultant, Division of Medical Oncology, NCCS.

Hence, Dr Ravi advises that men aged 50 years and above with risk factors, such as a strong family history of prostate cancer, should consult their General Practitioner (GP) to discuss the pros and cons of prostate cancer screening before deciding whether to proceed.


Breast Cancer Awareness Month (BCAM) takes place every October and is often marked globally with the wearing of pink ribbons, while Prostate Cancer Awareness Month happens in November and is often marked by the wearing of blue ribbons.

Each year in October, the BCAM Committee engages the community in fun activities to increase awareness of breast cancer. This October, NCCS is leading the first virtual national Breast Cancer Awareness Month (BCAM) campaign, themed Make Time for Breast Health. The Campaign will feature virtual activities including a digital “Pink Plank Challenge”, online webinars and group exercise sessions.

For more details on online webinars, Get Fit in Pink online fitness classes and the Pink Plank Challenge, please click here.

Singapore Cancer Registry 50 th Anniversary Monograph (1968 – 2017)