Oct. 22--SEOUL -- Ahn, a 29-year-old designer, heaved a sigh of relief after a recent health checkup. During a mammogram test, a tiny tumor was detected in her left breast but it was not a malignant one that should be removed.
"I hadn't imagined that I could suffer breast cancer at my age. I'm still worried because the doctor advised me to receive an examination again in six months for any progression of the tumor," she said.
Breast cancer is the most common type of cancer among Korean women. Over the past 10 years, the number of breast cancer patients here has almost tripled.
In the U.S., about 75 percent of breast cancer patients are women in menopause. However, Korean patients are younger, with those aged 35 or younger making up 15 percent of the total.
Teenage girls start their first period at younger ages, while adult women now delay marriage and motherhood. The longer lifetime exposure to the hormone estrogen may feed some breast tumors, doctors say.
Like other cancers, early detection is most important. The five-year survival rate of early stage breast cancer reaches 76 percent. That of stage one cancer is 90 percent.
However, the tumor removal surgery inevitably leads to a feeling of loss in many female patients.
In April, the Korea Breast Cancer Society surveyed 153 patients who received a mastectomy. According to the survey, most breast cancer patients were struggling psychologically as well as fearing a recurrence of the disease.
Among them, 75.7 percent said they don't visit swimming pools or the beach; 58.8 percent said they feel inconvenienced doing daily activities due to pain in their shoulder or arms; and 43.8 percent said they tend to avoid sex.
Most of the responding women said they feel "they are not attractive as a woman any more (71.2 percent)," "women without breasts are like disabled people (68.4 percent)," and "they get angry when they see the surgery spot (28.1 percent)."
"Breasts have a symbolic meaning to women. People suffering gastric or colon cancers would feel inconvenience in their daily lives as well. But breast cancer patients face their disease and loss every moment," said Lee Jeong-eon, breast cancer specialist at Samsung Medical Center.
Aimed at relieving the stress of cancer patients, some hospitals have started to offer psychological consultations by specialists, called "psycho-oncology."
Samsung Medical Center, the first to provide such services in Korea, screens every breast cancer patient through a questionnaire and recommends people at high risk of psychological difficulty to receive proper help.
With the improvement in the survival rate of breast cancer patients, many women are now given several options to maintain or reconstruct their breasts.
"In the past, most patients demanded their breasts be conserved regardless of the shape. Nowadays they take much care about the shape and many choose to receive reconstructive plastic surgery," Lee said.
At larger hospitals with a plastic surgery department, tumor removal and reconstruction can be carried out at the same time by a special team of doctors. There is no time for the patients to experience the feeling of loss.
Referring to the case of a 64-year-old woman who received reconstruction surgery, Lee said, people's choice and satisfaction goes beyond their age.
However, such aesthetic and psychological benefits of reconstruction are not widely enjoyed due to expensive costs ranging from 1 million won to 10 million won ($895-$8,950) here.
"I'm thankful to have survived the cancer. But I want to receive reconstruction surgery because I'm still young," a 34-year-old single mother of two daughters wrote in an online community where breast cancer patients share their experiences.
"Even though my tumor was completely removed in 2005, I feel depressed to see my body. I'm currently living with the government's livelihood subsidy. Is there any welfare institution that can help me?" she asked.
Doctors and healthcare officials agree that breast reconstruction can be considered a form of treatment. But it is still controversial whether the costs should be covered by the government under the national health insurance scheme.
"In Korea where the overall insurance coverage rate of life-saving surgeries is criticized for not being enough, social consensus is required to be made for the coverage of the breast reconstruction surgery," said Lee, the doctor, who is also a member of the American Society of Breast Surgeons and the secretary of the Korea Breast Cancer Society.
In the U.S., the Women's Health and Cancer Rights Act, signed in 1998, contains protection for patients who choose breast reconstruction in connection with a mastectomy.
Amid an increase in breast cancer patients here, a positive sign is that a growing number of cases are detected at earlier, curable stages.
Saying the self checkup is not enough to detect early stage tumors, Lee advised that when a woman reaches the age of 35, she should visit a specialist, and those aged 40 or older should go for an annual checkup.
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