Dr Nisha Shariff, Consultant Clinical Oncologist at Sunway Medical Centre, Sunway City (SMC)
In Malaysia, breast cancer is the most common cancer among women, with almost half of cases diagnosed at late stages (stage III and IV)i. Hearing the words “you have breast cancer” can feel grim, bringing thoughts of surgery, chemotherapy and a long journey ahead. However, that story is changing, as personalised care enables more precise and targeted approaches for patients.
This begins with understanding the specific nature of each diagnosis. Dr Nisha Shariff, Consultant Clinical Oncologist at Sunway Medical Centre, Sunway City (SMC) says knowing a woman’s breast cancer subtype can shape the treatment ahead. “Breast cancer is a group of different subtypes, and each behave very differently. Some are responsive to hormones or overproduce a protein called HER2 which drives cancer cell growth. Some have none of these markers which is known as triple negative breast cancer,” she said.
Same Stage, Different Treatment Paths
Dr Nisha gives a simple example: Two women in their 50s with the same-sized hormone receptor-positive tumour may need different treatments. For example, a woman with a HER2-negative, hormone receptor-positive tumour may be treated with surgery, radiotherapy and hormonal therapy. Another woman with HER2-positive disease, despite having a similar tumour, may also require chemotherapy and HER2-targeted therapy.
“What may look similar on paper can behave very differently. Understanding what is driving the cancer helps us determine which treatment is most appropriate for each patient. We are not simply treating breast cancer; we are treating the person and their specific type of cancer.” – Dr Nisha.
Age, overall health, menopausal status and personal preferences can all influence treatment decisions. In other words, treatment is tailored not only to the cancer itself, but also to the individual.
Understanding Aggressive Breast Cancer
Dr Nisha stresses that the term ‘aggressive’ may sound scary and concerning, but it refers to how a cancer behaves, rather than predicting a patient’s outcome. Triple-negative and HER2-positive cancers grow more quickly, but they are also very responsive to the right types of treatments. With a clearer understanding of the cancer’s biology, it helps doctors choose the appropriate treatment for each patient.
“In the past, HER2-positive breast cancer used to carry a poor prognosis. With targeted therapy, outcomes have transformed dramatically and improved survival in many women with breast cancer,” Dr Nisha says.
Another example of personalised care is genomic testing which can help doctors assess whether a patient is likely to benefit from chemotherapy, supporting more informed treatment decisions. At the same time, newer targeted treatments, more focused surgery and radiotherapy have also expanded treatment options for many patients with breast cancer. “We used to ask which treatment can give the best outcome. Now, the question is which treatment is most appropriate for my patient and our focus has also shifted to patient survivorship,” says Dr Nisha.
Why Screening Still Matters
Despite advances in treatment, many breast cancers in Malaysia are still diagnosed late. Fear of discomfort, embarrassment or finding something wrong can make women put off a mammogram but delaying screening can narrow the opportunity to act early.
“Don’t let fear make the decision for you. A lot of the fear is in the unknown. Knowledge is power,” urges Dr Nisha. She explains that a mammogram can offer reassurance when results are clear, while detecting cancer early is generally associated with better treatment outcomes and may allow more treatment options. For women who may feel nervous about screening, Dr Nisha suggests bringing along a friend or family member to make the experience feel more comfortable.
Beyond Treating the Cancer
For those already in treatment, breast cancer care today goes beyond treating the cancer itself. Modern breast cancer care often involves a multidisciplinary team, with different specialists addressing both the cancer and the patient’s wider needs. Support now extends beyond treatment, supporting women as they build their strength, emotional wellbeing, confidence, fertility, intimacy, and career. “Cancer doesn’t define you. It is one chapter of your life, not the whole story,” assured Dr Nisha.
In an era of personalised medicine, early assessment can provide more options and help women make informed decisions about their care. “If you notice a lump or unusual breast change, do not wait. Most lumps are not cancer, but getting checked can provide answers. Fear is understandable, but don’t let it stop you from taking that first step for your health,” urges Dr Nisha.
