On average, 5.5 women are diagnosed with the disease each day in Hong Kong, and about half of those are under 50.

Jane, 38, was breastfeeding when she found a lump in her breast. 'I always thought breast cancer happened to people in their 50s,' she says. 'I'd never heard of anyone my age having it. I was in the low-risk category: I wasn't overweight, I had no history of the disease in my family, I've always eaten well, I was fit, and I'd breastfed three children. Everything was against me getting this disease.'

Many sufferers over 50, such as Virginia Kwan, can relate to Jane's shock.

'I'd always prided myself on being healthy,' Kwan says. 'I had no history of breast cancer in my family, so I'd been tardy in going for a medical check-up. I didn't think there was anything wrong with me, so I didn't think it was urgent.'

Both admit they weren't breast aware. 'I was lax,' says Jane. 'Without having a routine for checking your breasts every month, how are you going to detect any changes?

'It mightn't be a lump,' she says. 'It could be a swelling, a discharge, a thickening. But how are you going to know, if you're not paying attention?'

Most western nations such as France, the US, Britain, Canada, Australia and Germany provide mammograms free of charge or subsidise them for women over 50. In addition, women in some countries are advised to perform regular breast self-examinations (BSE) and get a clinical breast examination during routine medical checks.

However, in Hong Kong, the government doesn't promote routine mammograms or self-examinations. Recommendations from a Department of Health report on breast cancer and mass screening are the subject of heated debate in medical, academic and government circles.

The debate centres on issues such as: the effectiveness of mammograms for Asian women; the cost effectiveness of allocating limited funds to screening instead of putting more money into treatment; and the risk of false positives - finding a lump and having invasive and expensive treatment, only to find it's benign. Most significantly, the report highlights a lack of data on the effectiveness of mammograms for Hong Kong women and stresses instead the importance of primary prevention.

'If you want to prevent breast cancer, the best way is primary prevention,' says University of Hong Kong associate professor Gabriel Leung, one of the report's authors. 'Everyone should live a healthy lifestyle to prevent breast cancer.

'Don't rely on secondary prevention, such as BSE or screening, where you're not trying to stop the disease or prevent it. What you're doing is merely finding the cancer earlier.'

Surgeon and founder of the Hong Kong Breast Cancer Foundation Polly Cheung Suk-yee says it's difficult to adopt primary prevention measures - which include having children earlier, breastfeeding and eating less fat - especially in an increasingly westernised society. She says there's no substitute for breast screening. 'Using today's technology, mammography is the only proven useful tool to detect breast cancer before you feel a lump.'

Cheung set up the city's first breast clinic in 1990 at the Kwong Wah Hospital, and has been conducting a pilot study for the past 15 years. She says she's seen a huge change in the pattern of the disease since the introduction of screening.

'The government needs to look into screening rather than simply saying it's no good for the general population,' Cheung says. 'Like other countries, it should launch a study in a local hospital, and examine the Kwong Wah data.

'Even within my smaller study, I can see radical changes. In the early days, 50 per cent of our patients were in the late stages of cancer. Today, these patients make up less than 10 per cent.

'I'm confident that our breast-screening programme has an effect on early diagnosis of breast cancer. It's simple logic. The sooner you find the disease, the greater the chance of survival.'

Leung says experience in Britain and the US shows that better treatment with drugs, chemotherapy and radiotherapy is responsible for a 90 per cent increase in survival among patients. 'On the face of it, the issues seem simple - early detection saves lives. Whereas, the logic doesn't stand up to scientific scrutiny, and this leaves many women confused,' he says.

Leung and Cheung agree that there's a need for more breast awareness. 'Being breast aware doesn't just mean self-examination,' says Leung. 'But it also means you don't ignore symptoms if you feel there's something wrong.'

By contrast, Cheung and the Hong Kong Breast Cancer Foundation say self-examination and screening are the only ways to become breast aware.

'Early detection will also mean the treatment is simpler,' Cheung says. 'You may not need to undergo chemotherapy. I'm not pushing the government to launch population-based screening because I don't think there's enough money.

'But to say you shouldn't do mammograms or breast self-examination is against the world trend of medical advancement.'

Kwan has these words of advice for Hong Kong women: 'Breast cancer is on the rise. Women should be aware of this and go for examinations when they reach a certain age. Don't think that, because you're healthy, you don't need to go for check-ups. I say to my friends, if this can happen to me, it can happen to anyone.'

October is Breast Cancer Awareness Month. Many Hong Kong stores - including Estee Lauder, Aramis, Bobbi Brown, Clinique, Origins, Shanghai Tang and Ellemis - are offering promotional items or pink ribbons to raise funds for research