No pain, no lump: Are you really safe from breast cancer?

A woman attended FV Hospital’s Pink Month event to meet an old friend and decided to book a breast screening while she was there. She had no pain, no noticeable lump, and no reason to think anything was wrong. That seemingly routine decision led to a life-changing diagnosis: cancer was found in both breasts.

An unexpected diagnosis

Dr Phung Ngoc Thu, Specialist Level I, still vividly remembers meeting Ms T., a close friend from secondary school, at FV Hospital’s Pink Month annual event.

In her forties and in good health, Ms T. had not had regular breast screenings for many years, postponing them due to a busy schedule. Her appointment that day was unplanned; she signed up for screening while attending the event.

A patient undergoes breast cancer screening. Image: FV Hospital

Everything appeared normal until Dr Thu reviewed the mammogram, which revealed a suspicious lesion in one breast requiring further investigation.

Following protocol, Dr Thu assessed both breasts and identified a second, smaller abnormal area. Biopsy confirmed cancer in both breasts.

After diagnosis, the multidisciplinary team developed a treatment plan that included BRCA genetic testing, surgery, and personalised breast reconstruction options.

Common myths about breast cancer screening

Ms T.’s story is far from unusual. Many women postpone breast screening because they are busy or believe that if they feel well, there is no reason to be concerned. However, this false sense of reassurance can delay diagnosis and reduce treatment options.

According to recommendations from leading medical organisations, including the American College of Radiology (ACR) and the National Comprehensive Cancer Network (NCCN), women should undergo a breast cancer risk assessment by the age of 25. At FV Hospital, women at average risk are advised to have annual breast ultrasounds, with mammography added from age 40. Higher-risk women, including those with a family history or BRCA1/BRCA2 mutations, may need earlier and more personalised screening, which can include breast MRI.

Common misconceptions often prevent women from attending regular screenings. Many women seek medical advice only after discovering a lump, experiencing pain, or noticing breast changes. However, early-stage breast cancer often causes no symptoms. Waiting for warning signs can mean missing the best chance for early treatment.

Dr Phung Ngoc Thu consulting with a patient. Image: FV Hospital

Some women believe they are protected because they are young, have no family history, or maintain a healthy lifestyle. While these factors may reduce risk, they do not eliminate it. Breast cancer can still occur in women with no clear risk factors.

Dr Thu emphasises that breast screening should not be a single event. Instead, it should be a regular part of a woman’s healthcare, tailored to her age, breast density, and individual risk profile.

More tests do not necessarily mean better care

Various imaging techniques serve distinct roles in detecting breast cancer. Mammography, including 3D mammography, is effective at identifying microcalcifications. Ultrasound is valuable for assessing abnormalities, especially in women with dense breast tissue. MRI offers additional detail when needed, while biopsy remains the definitive method for diagnosing cancer.

The most appropriate test depends on clinical findings, breast tissue characteristics, and the specialist’s assessment. A benign lesion may need only regular monitoring; conversely, if a biopsy is recommended, patients should not delay out of fear.

Dr Thu often observes two opposing reactions. Some patients delay a recommended biopsy due to fear of the results. One patient returned 18 months later to find a tumour had grown from 6 mm to over 20 mm and had spread to the lymph nodes. Others become anxious after being told they have a benign lesion. Despite a recommendation for routine six-month follow-up, they seek repeated consultations and unnecessary tests, increasing their anxiety.

“Good medicine is not about doing more tests,” says Dr Thu. “It’s about doing the right test, at the right time, for the right patient.”

When breast cancer is diagnosed, specialists assess tumour number and location, lymph node involvement, and disease characteristics to determine the best treatment plan. At FV Hospital, each case is reviewed by a Multidisciplinary Tumour Board of specialists in radiology, pathology, surgery, oncology, and related fields. They determine the best treatment approach, including options such as breast-conserving surgery, chemotherapy, radiotherapy, or targeted therapies.

Breast MRI performed on FV Hospital’s new-generation Philips 3.0 Tesla MRI system. Image: FV Hospital

For Pink Month 2026, Dr Thu shares a simple message:

“Screening should not be driven by fear. It is an act of self-care and self-respect. No matter how busy you are, take the time to see a specialist and develop a breast health plan that is right for you.”