Breast cancer is the most common cancer of women in Hong Kong. Early detection and treatment are critical for improving the survival rate of patients.

Risk Factors

Women with the following risk factors are at increased risk of developing breast cancer:

• Confirmed carrier (or family history) of certain gene (e.g. BRCA1 or BRCA2 ) mutations
• Family history of breast cancer or ovarian cancer, such as first-degree relatives (mother, sister or daughter) diagnosed with breast cancer before age of 50
• History of receiving radiation therapy to the chest before age of 30

Other risk factors include:

• Lack of physical activity
• Alcohol consumption
• Obesity after menopause
• Advancing age
• No childbirth, late first live birth (after age of 30) or no breastfeeding
• Early menarche (before age of 12) or late menopause (after age of 55)
• History of breast cancer or ovarian cancer
• History of benign breast conditions or lobular carcinoma in situ
• Prolonged intake of contraceptives or having hormonal replacement therapy

Symptoms

The symptoms of breast cancer may not be easily noticed at an early stage.

Common symptoms include:

• Breast lump
• A change in the size or shape of the breast
• A change in skin texture of the breast or nipple (e.g. red, scaly, thickened or “orange-skin” appearance)
• Rash around, in-drawing of, or discharge from the nipple
• New and persistent discomfort or pain in the breast or armpit
• A new lump or thickening in the armpit

You should consult a doctor as soon as possible if you develop any of the above symptoms.

Prevention

• Have regular physical activity
• Avoid alcohol consumption
• Have a balanced diet
• Maintain a healthy body weight and waist circumference

Every woman should be breast aware and familiar with the normal look and feel of their breasts at all time. Be aware of any unusual changes of their breast. If women notice unusual changes in the breast, they should see a doctor as soon as possible.

Breast Cancer Screening

The purpose of breast cancer screening is to detect breast cancer before it gives rise to symptoms, so that early treatment can be initiated. Mammography is a widely used screening tool which is an X-ray examination of the breasts.

The Government’s Cancer Expert Working Group on Cancer Prevention and Screening (CEWG) makes the recommendations on breast cancer screening for women at different risk profiles as follows:

(1) Women at high risk (e.g. carriers of confirmed BRCA1/2 gene mutations, with strong family history of breast cancer or ovarian cancer, history of receiving radiation therapy to the chest before age of 30, etc.) should seek doctor’s advice for annual mammography screening and starting age for screening.

(2) Women at moderate risk (i.e. with family history of ONLY one first-degree female relative with breast cancer diagnosed at age ≤50 OR two diagnosed at age >50) should have mammography screening every 2 years.

(3) Other women at general population in which women aged 44-69 years with certain combinations of personalised risk factors putting them at increased risk of breast cancer are recommended to consider mammography screening every 2 years. A risk assessment tool for local women (e.g. one developed by The University of Hong Kong (HKU)) is recommended to be used for estimating the risk of developing breast cancer with regard to the personalised risk factors.

Of note, all screening tests have their limitations and they are not 100% accurate. There are false-positive and false-negative results. All women who consider breast cancer screening should discuss with doctors on the potential benefits and harms before undergoing screening.

More information can be found from:-

Cancer Online Resource Hub: www.cancer.gov.hk

Change for Health Website: www.change4health.gov.hk