【Breast Cancer Part 1】Lump in Your Breast — Is It Cancer? The Complete Guide from Check-Up to Diagnosis: Explained by Malaysia’s Oncologist Dr. Teo Yin Keong
- drteoyinkeong
- Oct 10
- 9 min read
Updated: Oct 11
Johor Bahru, Malaysia
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Today, more and more women are taking proactive steps by going for regular breast screenings, such as mammograms (breast X-rays) and ultrasound scans. These tests play a vital role in early detection, helping to reduce the risk of cancer spreading before diagnosis. They can also detect high-risk benign lumps that, if removed early, may help prevent future malignancy.
Still, many women find themselves uncertain after a screening. What if you feel something unusual, but the scan report says “normal”? Does that mean there’s nothing to worry about? How soon should you return for a follow-up, and which doctor should you see next? These are questions that often leave women feeling confused and unsure about their next step.
Let me break down the process into 3 clear stages — explaining who to see, what tests to expect, and what actions to take at each stage.
Step 1: Not sure if it’s a lump
➜ See a General Practitioner (GP)
If you suspect there might be something unusual in your breast but aren’t certain what it is, your first step should be to visit a General Practitioner (GP) — also known as a family doctor. The family doctor’s role is to assess whether a suspicious lump is present and to decide whether you need further investigations.
What Your Family Doctor May Do:
Physical examination of the breasts
Breast ultrasound
Mammogram (Breast X-ray)
The Family Doctor’s Main Role:
To check if there is a lump in your breast
To evaluate whether the lump looks suspicious
‼️ Important Note: An ultrasound or mammogram is only a preliminary screening. A family doctor cannot confirm whether a lump is a tumour or cancer just based on these results. Their role is to serve as the first line of assessment — helping you decide whether you should be referred to a specialist for further investigation.
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Step 2: Lump confirmed and looks suspicious
➜ See a Surgeon for confirmation
Once your family doctor confirms there’s a lump that could be a tumour, the next step is to consult a surgeon or breast surgeon for further diagnosis and confirmation.
What Happens Next: Tests a Surgeon Will Arrange
To determine whether the lump is cancerous and how far it may have developed, the surgeon will usually recommend the following:
Imaging Tests: A repeat ultrasound and mammogram may be performed to re-examine the lump’s characteristics in more detail.
Biopsy (Tissue Sampling): This is the most important test. The surgeon will remove a small sample of tissue from the lump for pathology testing, which is the only way to confirm whether it is breast cancer and to identify its specific type and features.
Staging Scans (CT or PET Scan): If breast cancer is confirmed, further scans help determine the stage of the disease and whether it has spread to other parts of the body.
The Surgeon’s Role
At this stage, the surgeon’s main role is to confirm the diagnosis and, when necessary, refer you to a Clinical Oncologist. A Clinical Oncologist (also known as a cancer specialist) will then develop a comprehensive treatment plan — which may include chemotherapy, targeted therapy, radiotherapy, or surgery — depending on your condition.
However, in Malaysia, the number of Clinical Oncologists is very limited. Hence, for many early-stage or low-risk breast cancer cases, patients are often managed directly by surgeons. In such situations, the surgeon’s expertise lies in precisely removing the tumour through surgery. Since early breast cancer is usually localized, surgery alone is often sufficient to control the disease.
‼️ However, if you suspect that your cancer seems complex or shows possible signs of spread, it’s strongly recommended that you consult a Clinical Oncologist first before deciding on surgery or any treatment approach.
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Step 3: Confirmed breast cancer
➜ See a Clinical Oncologist for full treatment planning
When a biopsy confirms breast cancer (especially if the case is complex or there are signs that the cancer may have spread), it is crucial to consult a Clinical Oncologist.
A Clinical Oncologist’s role is not merely to “treat the visible tumour,” but to act as the master planner of your entire cancer treatment journey.
The Oncologist’s Role: The Strategist of Your Treatment Plan
A Clinical Oncologist takes into account multiple factors, including your cancer stage, immunohistochemistry (IHC) report, hormone receptor status, and your overall health condition to strategise a personalised treatment plan.
This plan typically combines several treatment approaches such as surgery, chemotherapy, radiotherapy, hormone therapy, targeted therapy. The sequence and combination of these treatments vary from person to person, depending on your cancer’s biology and your body’s response.
The Oncologist's Role: Beyond Just Survival
A Clinical Oncologist’s responsibility is not only to prolong life, but also to:
Reduce the risk of recurrence
Minimise side effects
Help you maintain a good quality of life
In some cases, your oncologist may recommend chemotherapy or targeted therapy before surgery. The benefits of this approach include:
Shrinking the tumour for easier removal
Increasing the chances of a successful operation
Preserving more healthy breast tissue, especially for women who wish not to undergo mastectomy.
‼️ That’s why I always remind patients: Even if you were not referred, you should proactively request to see a Clinical Oncologist at least once before starting any treatment.
Breast cancer treatment is not just about “removing the tumour.” It’s a medically structured and strategic process, where the sequence of treatments can make a major difference in your recovery outcome. This is where your Clinical Oncologist help you see the bigger picture and strategise the most effective, tailored treatment pathway for you.
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Conclusion: Found a Breast Lump?
The Key Is Seeing the Right Doctor
Many women panic after discovering a lump in their breast, visiting multiple clinics and seeing several doctors, only to become more confused. The issue isn’t that the doctors are unskilled — it’s that each doctor has a different area of expertise and is responsible for a different stage of the diagnostic and treatment process.
If you’ve found a lump or any abnormality in your breast, here’s the clear sequence of doctors you should see to get the right answers and treatment:
Step 1: Unsure if it’s a lump → See a Family Doctor (GP)
(Note: A family doctor can tell you whether the lump looks suspicious, but cannot confirm if it’s cancer.)
Step 2: Lump confirmed and looks suspicious → See a Surgeon
(Note: If breast cancer is confirmed, surgery is only one part of treatment, and not necessary the first step of treatment.)
Step 3: Confirmed Breast Cancer → See a Clinical Oncologist
(Note: The most expensive or advanced treatment isn’t always the most effective, what matters is finding what works best for you.)
When detected early and treated correctly, most breast cancers can be effectively controlled, and even cured.
⚠️ Unfortunately, many patients go astray at this very point. Why? Because they are often misled by advice that sounds right but isn’t. Here are some common myths that not only confuse you, they can also delay proper treatment and, in some cases, lead to irreversible consequences.
Breast Cancer Myths & Truths Every Woman Should Know
Myth 1: Seeing a breast surgeon and a clinical oncologist is the same thing.
Truth: A breast surgeon and a clinical oncologist play different but complementary roles in breast cancer care.
A breast surgeon’s main responsibility: to confirm the diagnosis and remove the tumour if necessary.
They perform key procedures such as biopsies to determine whether a lump is cancerous. Once the diagnosis is confirmed, the surgeon will usually refer the patient to a Clinical Oncologist for a comprehensive treatment plan. If surgery is required later on, the oncologist will then refer the patient back to the surgeon to perform the tumour removal. Procedures such as breast reconstruction and other surgery-related treatments after cancer removal are also handled by surgeons.
‼️ In Malaysia's context: Due to the shortage of Clinical Oncologists in Malaysia, many cases of early, low-risk, and localised breast cancer are often treated directly by surgeons. In these situations, a simple surgical removal of the tumour is usually adequate and can effectively complete the course of treatment.
A Clinical Oncologist main responsibilities: to strategise and plan a personalised and systemic treatment plan. If the cancer is more complex or shows signs of spread, the oncologist’s role becomes even more crucial.
That’s because surgery can only remove tumours that are visible and localised, but microscopic or hidden cancer cells may remain in the body. These require additional treatments such as chemotherapy, targeted therapy, hormone therapy or radiotherapy. All these treatment combinations and drug choices need to be analysed and coordinated by a Clinical Oncologist.
‼️ Therefore, every breast cancer patient (regardless of stage), should request to meet a Clinical Oncologist at least once before deciding on surgery or any treatment.
A proper oncologist consultation ensures your treatment plan is comprehensive, personalised, and strategically sequenced for the best outcome.
Myth 2: Once the breast tumour is removed, you’re completely cured
Truth: Surgery can only remove "visible" tumour, it cannot eliminate "hidden" cancer cells that may still exist in the body.
Even after the surgeon removes all the "visible" lumps in the breast, there may still be microscopic cancer cells that have already entered the bloodstream or lymphatic system. These cells can travel to other parts of the body and cause a recurrence or metastasis later on.
That’s why after surgery, your doctor will carefully assess:
Whether the tumour and surrounding tissues have been completely removed
Whether cancer cells have entered the lymph nodes or show signs of spreading
Whether additional treatments such as chemotherapy, targeted therapy, or hormone therapy are needed to suppress any remaining “invisible” cancer cells in the long term
‼️ Surgery alone does not mark the end of breast cancer treatment — it’s just one part of the whole treatment plan. To truly lower the chances of recurrence or spread, surgery must be combined with comprehensive systemic treatments such as chemotherapy, targeted therapy, or hormone therapy, tailored to each patient’s condition.
Myth 3: What is the “best” treatment for breast cancer?
Truth: There is no single “best” treatment for breast cancer — only the most suitable combination and sequence tailored to you.
Breast Cancer Types: Breast cancer isn’t one single disease. It’s an umbrella term that includes many different types of cancer cells, each with its own “personality.” Some cancer cells grow quickly, while others progress more slowly. Some respond well to hormone therapy, while others don’t react to it at all. This is why two breast cancer patients may need completely different treatment plans.
Treatment Options and Combinations: Breast cancer treatment typically involves 5 main approaches: surgery, chemotherapy, radiotherapy, hormone therapy, targeted therapy. In recent years, immunotherapy has also become an option for certain types such as triple-negative breast cancer. Each person’s treatment combination depends on their cancer type, stage, and response to medication. There is no one-size-fits-all formula — the best treatment is the one personalized to your condition.
Treatment Sequence: Should chemotherapy come before surgery or after? Even with the same treatment methods, the order in which they’re given can make a significant difference in outcomes.
‼️ That’s why it’s essential for every breast cancer patient to consult a Clinical Oncologist before starting treatment to evaluate your overall condition and design a personalised treatment strategy.
Myth 4: My report says it’s benign, so I’m safe, right?
Truth: A benign tumour doesn’t mean you’re permanently in the clear, it still requires ongoing monitoring and follow-up.
If your body is capable of developing a benign lump, it also means it has the potential to form new ones in the future. In some cases, these can evolve into malignant (cancerous) growths over time. Having had a benign tumour before should be seen as a warning sign to stay alert. While “benign” means non-cancerous for now, it does not mean zero risk.
‼️ If you’ve ever had a benign breast lump, it’s crucial to schedule regular follow-up checks and not take it lightly. Early and consistent monitoring is the best way to protect yourself from future complications.
Myth 5: I’ve had surgery and completed all my treatments, why did my breast cancer still relapsed?
Truth: Almost every type of cancer carries a risk of recurrence. The key to disease control lies in long-term follow-up and lifestyle management.
Genetic Mutations: Cancer usually develops because of genetic mutations within the body’s cells. Once cancer has occurred, it indicates that your DNA has already undergone certain changes.While treatment can control or destroy abnormal cells, it cannot reverse the genetic damage that triggered the cancer in the first place. As a result, the same biological process may reactivate later on, potentially causing the same or even a different type of cancer.
Presence of Cancer Cells: In reality, traces of cancer cells exist in every person’s body. The difference lies in how well our immune system can suppress them. Although treatment can dramatically lower their number, it cannot completely erase the risk of cancer developing in the future.
‼️ Cancer care doesn’t end when treatment ends. It’s a long-term journey that requires regular medical follow-ups and a healthy, well-balanced lifestyle. Only through continued vigilance and proactive management can you truly minimise the risk of recurrence.
Conclusion: Breast Screening and Cancer Treatment — The Earlier You Know, The Less You Regret
A breast check is only the first step. What truly matters is knowing what to do next. It's not about rushing to see multiple doctors or believing every piece of advice you hear. It's about finding the right answers and the right plan for your body.
Breast cancer itself isn’t what’s most frightening. What truly causes harm is hesitation, delay, or taking the wrong path. With early detection, the right questions, and the right doctor, most breast cancers can be well controlled — and many can even be cured.
If you know a mother, sister, or friend who’s worried or unsure, share this article with her. May every woman face this journey with clarity and courage —and never have to live with regret that could have been avoided.
Cancer / Oncology Care Brought To You By
👨⚕️Dr Teo Yin Keong
Clinical Oncologist, Johor, Malaysia
©️ TEOncology