Local women urged to be more vigilant in checking for breast cancer

PUBLISHED : Monday, 14 October, 2013, 12:00am
UPDATED : Monday, 14 October, 2013, 8:57am

With breast cancer being the most common cancer among Hong Kong women, you'd think people would be vigilant about examining themselves regularly for the disease.

Unfortunately, the opposite is true - one in two women do not check their breasts regularly, according to a new survey, commissioned by the Hong Kong Cancer Fund, of more than 500 local women aged over 18.

The incidence of breast cancer in Hong Kong has doubled in the past 20 years
Dr raymond liang

What's more startling is that among those who do not do examine themselves, the most common reason - 36 per cent gave - is that they "do not see the need for doing it" or "breast cancer will never happen to me".

Well, it can. According to the Hong Kong Cancer Registry, there were 3,014 new cases of breast cancer in 2010, compared to 1,918 in 2000. Early detection and treatment greatly increases the chances of being cured, yet only a third of breast cancer cases in the city are found at stage one.

"The incidence of breast cancer in Hong Kong has doubled in the past 20 years, with one in every 19 women suffering from some form of breast cancer," says Dr Raymond Liang Hin-suen, assistant medical superintendent and director of the Comprehensive Oncology Centre at the Hong Kong Sanatorium & Hospital.

"All women should be vigilant and know breast cancer symptoms, as well as check their breasts regularly."

A change in the skin texture of the breasts or rashes found on or near the nipple are warning signs, says Liang. Other symptoms include: change of shape or location of breasts; persistent pain on or near the breast or underarm; abnormal nipple discharge; and lumpiness or dimpling found in breasts.

Dr Hung Wai-ka, honorary medical adviser at the Hong Kong Breast Cancer Foundation's Breast Health Centre, recommends women 40 and older get a mammogram every two years, a doctor's examination every two years, and do breast self-examination once a month.

For women under 40 with normal risk, a doctor's examination every three years and monthly breast self-examination is sufficient. Liang says women at high risk should discuss the best screening schedule with their doctor.

Age (above 50 years) and a family history of the disease are risk factors, as well as not having children, having the first child at an older age, no breastfeeding experience, drinking large amounts of alcohol, excess body weight and genetic factors. According to the Cancer Fund survey, a majority of respondents also demonstrated a poor understanding of the symptoms. Only one in 10 of women polled knew that breast self-examinations should start at age 20, and less than a fifth knew that mammograms should start at age 40.

Guidelines for the starting age for mammography screening to prevent breast cancer deaths can be conflicting.

In 2009, the US Preventive Services Task Force proposed screening for women aged 50 to 74 years once every two years.

This is because some studies show that routine screening leads to over-diagnosis and unnecessary treatment, including biopsies, lumpectomies and mastectomies, and weeks of radiation and potentially toxic drugs. False positives result in avoidable procedures and psychological trauma.

Some other researchers have produced a contrary view. A study published last month in the American Cancer Society journal Cancer found that most deaths from breast cancer occur in younger women who do not have regular mammograms.

The research team, led by Dr Blake Cady of Harvard Medical School, looked backwards from more than 600 confirmed breast cancer deaths to discover correlations at diagnosis.

Nearly 30 per cent occurred among those who had been screened and about 70 per cent were among unscreened women. Only 13 per cent of deaths occurred in women aged 70 or older, but half occurred in women under 50.

Dr Lui Chun-ying, honorary consultant at Tung Wah Group of Hospital's Well Women Clinics, says the pattern of breast cancer in Asia is different from that in the West.

"In the West, there's a higher incidence of breast cancer in women of increasing age, but in Asian countries, such as Hong Kong, Taiwan and Singapore, the age of the cancer is more in the range of 45 to 50. We recommend screening at the age of 40," Lui says.

The Cancer Fund, in collaboration with the Hong Kong Sanatorium, is offering 500 Hong Kong residents aged 40 or above a discounted mammogram screening for HK$600. The normal price is HK$1,600. Women who have not received any clinical breast cancer screening in the past two years can apply for the discount through the Cancer Fund, tel: 3656 0800. The offer runs until October 31 and is on a first-come, first-served basis.