What Every Woman in Singapore Should Know? - Breast Cancer Risk, Genetic Testing, and Screening

Breast cancer is the number one cancer among women in Singapore¹, and early detection can save lives. This article raises breast cancer awareness in Singapore and explores three critical aspects every woman should know: who is at risk for a breast cancer diagnosis, whether genetic testing is right for you, and the types of breast screening available locally. We’ll break down risk factors specific to Singaporean women, explain how genetic testing works and who should consider it, and provide a practical guide to mammograms and other screening options. Empower yourself with knowledge to take proactive steps toward prevention and early detection.

Who is at risk for a breast cancer diagnosis?

According to data from the World Health Organization (WHO), breast cancer is the most common cancer among women worldwide. It accounts for 23.8% of all cancers among women, with 43% of these cases diagnosed in Asia, where breast cancer incidence in some countries has continuously increased. 

Age and genetics are the leading risk factors for breast cancer.

• More than three out of four breast cancer cases occur in women over age 50.
• Those with a family history of the disease (mother, sister, aunts or grandmothers on both maternal or paternal side) are also at higher risk, as are women with dense breasts.
• Another genetic risk factor is a mutation of the BRCA1 or BRCA2 gene, or other genes.

Other risk factors for breast cancer include the following:

• being a current smoker or having smoked for 10 or more years
• having previously had breast cancer or a benign breast condition
• having had radiation to the chest or breast between the ages of 10 and 30
• increased exposure to the female hormone estrogen — for instance, having a first menstrual period before age 13, entering menopause after age 51, or using estrogen replacement therapy for more than five years
• never having been pregnant or having a first pregnancy after age 30
• being overweight, especially after menopause
• drinking alcohol (cancer risk doubles with three or more drinks per day)
• having a sedentary lifestyle with little regular exercise
• having undergone a prior breast biopsy.

Having several risk factors doesn't mean a woman will inevitably develop breast cancer. Likewise, having fewer risk factors doesn't offer 100% protection against it.

Should I get genetic testing for breast cancer?

Only 5% to 10% of breast cancers result from an inherited genetic mutation. But when mutations are present — most commonly in the BRCA1 and BRCA2 genes — a woman's risk for breast cancer can increase by as much as 80%. If you have a family history of breast cancer (mother, sister, grandmother or aunt), you’re a candidate for genetic testing, especially if your family member was diagnosed at 50 or younger. (Note that the person diagnosed should be tested first, as their results will likely mirror yours.)

Other factors women should consider include whether they've had any previous bouts with breast or ovarian cancer, a family history of male breast cancer or BRCA1 or BRCA2 gene mutations.

Rest assured, family history doesn't mean you'll definitely develop breast cancer. Similarly, the absence of family history doesn't mean you won't get it. Talk to your doctor about your concerns and see a genetic counselor to learn your options and the benefits and risks of testing.

What type of breast screening do you need?

You've undoubtedly heard the mantra: mammograms save lives. And it's true — screening mammograms lower breast cancer death rates in women 40 and older by 40% when compared with no screening. The imaging test is still considered the gold standard to find breast cancer early, when it's most treatable.

But that's only part of the picture. Even if you diligently schedule an annual mammogram, you might also need other types of imaging, depending on your individual risk factors.

"Women aren't always aware of this unless a physician has actually spoken to them about it," says Dr. Vandana Dialani, chief of breast imaging and co-director of the Breast Care Center at Harvard-affiliated Beth Israel Deaconess Medical Center. "It's important they know who should be getting additional tests."

Who's at higher risk?

In 2022, about 2.3 million women were diagnosed with breast cancer worldwide. Who's at greater risk? Chief among us are the nearly 50% of women over 40 whose mammograms indicate dense breasts. This means your breasts have a relatively high proportion of glandular and connective tissue compared with fat. Women with dense breasts are up to twice as likely to develop breast cancer as are those whose breast tissue is more on the fatty side, according to the National Cancer Institute.

In some countries, women whose breasts are deemed dense after a mammogram may receive a recommendation for additional screening — typically with either ultrasound or magnetic resonance imaging (MRI). "Ideally, that's when you should be having a conversation with your physician about what supplemental tests should be done," Dr. Dialani says.

In addition to dense breasts, certain women are prime candidates for extra screening because they have other breast cancer risk factors, such as

• a mother or sister who developed breast cancer before menopause
• a genetic mutation known to increase breast cancer risk (such as in the BRCA gene)
• significant radiation to the chest before age 30

Your doctor should devise a personal breast cancer screening strategy for you that takes this information into account, Dr. Dialani says.

Breast cancer remains the number one cancer among women in Singapore, but knowledge and proactive action can make all the difference. A thorough breast cancer risk assessment helps you understand your personal risk factors, considering genetic testing when appropriate, and following a tailored screening plan are powerful steps toward early detection and prevention. Early detection not only saves lives but also opens the door to more effective breast cancer treatment options in Singapore. If you’re unsure where to start, speak with your doctor to create a plan that works for you. Remember: early detection saves lives — and the best time to act is now.

This article is part of our collaboration with Harvard Health Publishing, a trusted source of medical expertise from Harvard Medical School. Content has been adapted for local audiences.

Copyright © 2025 by Harvard University. Original work prepared by Harvard Health Publishing. This content is for informational purposes only and does not replace professional medical advice, and do not represent the views of Manulife (Singapore) Pte. Ltd.

¹ https://www.singaporecancersociety.org.sg/learn-about-cancer/types-of-cancer/breast-cancer.html