Pinktober has always been about raising awareness on breast cancer, celebrating survivors and marking new milestones. But it is also equally important to ensure that the efforts that goes into the initiatives continue well past October. We sat down with two experts at Hospital Picaso —Dr. Farhana Fadzil, Consultant Breast Radiologist & Nuclear Medicine Specialist and Dr. Christina Lai Nye Bing, Consultant Clinical Oncologist—to discuss what really happens when breast cancer is detected and why catching it early changes everything.

While our conversation took place on the last day of the official awareness month, we believe that the essential message of screening, early detection, and proactive health management needs to be constant. It should not be a message tied solely to the calendar. Our goal is to ensure this vital information remains front of mind, helping women make informed decisions throughout the year.

Why early detection saves more than breasts

Both doctors agree that early detection is very critical. Finding cancers at the smallest size, or before they have spread to lymph nodes, yields a much better prognosis because the patient has more treatment options.

For the patient, the biggest immediate gain is the chance for breast-conserving surgery, a procedure that removes the cancer while preserving as much normal breast as possible. Dr. Christina notes that the fear of a full mastectomy often causes women to ignore symptoms.

Beyond surgery, early detection debunks the myth that cancer always means chemotherapy. If detected earlier, a patient may not need chemotherapy, having the option to be on hormone therapy—five to ten years—instead. Dr. Christina explains that if a patient has many lymph nodes involved, indicating stage two or stage three cancer, chemotherapy will usually be required. The key takeaway is clear, “The more advanced the stage, the more complicated your treatment may be”.

The changing face of breast cancer in Asia

Cancer, traditionally seen as a disease of older people, is being diagnosed in startlingly young women at Picaso Hospital. Dr. Christina’s youngest patient was 28 years old, while Dr. Farhana has treated a patient as young as 18 years old. These cases were not found via standard screening, which typically begins at 40, but because the patient felt a lump and sought treatment.

This trend of younger patients is notable in Asia, as Caucasian populations typically see breast cancer ages around 50 and above. Dr. Christina calls the recent surge in younger patients “quite scary”. The doctors also confirmed they have encountered male breast cancer cases, which account for about one percent of all cases.

This issue is deeply personal for young patients, as illustrated by a case by Dr. Christina. A 25-year-old lady who had just married and was planning to start a family was diagnosed with a breast lump. Her primary concern was future fertility. The team was able to offer her embryo preservation and protect her ovaries by administering a medication that suppressed them during chemotherapy. Four years later, she successfully conceived and gave birth with assisted conception.

AI as the “Second Eye”

Technological advancements drive both diagnosis and treatment precision, profoundly changing the doctors’ workflows.

Dr. Farhana confirms that Picaso’s ultrasound machines feature in-built AI. The core function of this technology is the detection of lesions within the breast tissue and the suggestion of BI-RADS classification, which assists in early cancer detection. She notes that this AI works as a “second eye” and helps to speed up the work, particularly in a high-volume centre.

The collective advancements — including 3D mammography (tomosynthesis) and MRI — mean that cancers are being detected at earlier stages, sometimes at sizes less than 1 cm. This increased accuracy fundamentally changes the diagnostic process.

Meanwhile, the shift is just as drastic for oncology. Dr. Christina states that from the oncology standpoint, the new technology does not change the treatment per se — they still treat according to disease stage at diagnosis. However, advanced imaging allows for earlier and more accurate diagnosis, which leads to treatment starting sooner. This is critical, as patients diagnosed at an earlier stage have a higher chance of successful curative treatment.

The biggest change is the advancement of targeted therapies. For example, in the HER 2 positive breast cancer subtype, the use of targeted HER 2 therapy has greatly improved our patient’s prognosis and outcome. This has been consistently proven and show in multiple clinical trials and also real world studies.

Despite the technological revolution, both doctors were adamant that the human element remains irreplaceable.

Dr. Farhana cautions that AI, while working as a “second eye”, is “not something that can be relied on completely”; the radiologist must still be present. The AI focuses on suspicious features common to lesions classified as BI-RADS 4 and above. 

This is sentiment is echoed by Dr. Christina where she emphasises that technology can never fully replace clinical intuition and empathy. Having treated many patients, She argues that a doctor’s experience is necessary to provide balance and tailored advice. Simply relying on an AI model to list 100 side effects is unhelpful; the doctor tailors the information to the patient’s likelihood and needs.

The power of collaboration

The ultimate success of modern treatment lies in the collaboration between departments at Picaso.

This is best illustrated by the tissue marker technique, which Dr. Farhana previously shared. This process begins because the Oncologist’s (Dr. Christina’s) powerful chemotherapy can destroy large tumours, making them non-palpable for the surgeon. To solve this, the Radiologist (Dr. Farhana) inserts a tissue marker to precisely mark the spot where the tumour was located. This marker then acts as a guide, ensuring the Surgeon can still accurately perform a successful breast-conserving surgery, demonstrating perfect synchronisation between the oncology, imaging, and surgical teams.

Beyond the operating theatre, Dr. Farhana also addressed a major barrier to care: screening comfort. She explains that new technology allows radiographers to control the amount of pressure during a mammogram, applying the least amount of pressure required for a good image. This accessibility is critical for public health.

Dr. Farhana finds it heart-warming to see women with breast cancer being open about their condition and encouraging other women to come forward for health screening, particularly mammograms. Many patients who attend the breast imaging in Picaso have been moved to do so by family and friends who have gone through breast cancer.

As noted by Dr. Christina, one young breast cancer survivor was so motivated to encourage and support others that are going through their treatment, that she set up a patient support group herself with a few others. Many patients have found this very helpful to chat to someone who has gone through what they are going through and to advise them. This cycle of survival and outreach is what reinforces the hope for a future free of breast cancer.

The conversation with the experts at Picaso Hospital makes one truth undeniable: the prognosis for breast cancer is no longer determined by fate, but by proactivity. The advancements shared—from AI-assisted detection that spots tiny tumours to targeted therapies that protect a young woman’s fertility—all hinge on the patient taking the first step.

The message is simple, constant, and clear: don’t be afraid to come forward. By seeking screening and treatment early, we are choosing the simpler path, the most effective technology, and the highest chance of cure. This commitment to early knowledge is the real legacy of Pinktober, providing undeniable hope for a breast cancer-free future.