Feelings of doubt
BRENDA HAS A ROUTINE: once a month, the 41-year-old examines her breasts for lumps, a habit she picked up in her early 30s. It may have saved her life. In 1999, she found a pea-sized lump in one breast; four months later, when it was removed, the tumour was the size of a ping-pong ball.
Yet recent research suggests women should no longer perform self-examinations; instead, they should be 'breast aware'. What's the difference? That's one of the issues the Hong Kong Cancer Fund will highlight through its Pink Revolution fund-raising parade in Lan Kwai Fong tomorrow.
The controversy surrounding breast self-examinations (BSEs) stems from a study published in September in the Journal Of The National Cancer Institute in the United States. It was based on research involving more than 266,000 women in Shanghai, the results of which suggest that women who check their breasts every month do not significantly reduce their chances of dying from breast cancer, but raise their chances of unnecessary biopsies - and all the anxiety they entail. Based on this study, British doctors have been advised by their government not to recommend routine self-examination.
Now Hong Kong's Department of Health has stopped telling women to perform BSEs but to 'be breast aware'. 'Breast awareness is different from BSE,' says a Department of Health spokesperson. 'Instead of performing regular, ritualistic exercises ? women are encouraged to take convenient opportunities to observe and feel their breasts, such as while bathing or dressing, so as to become familiar with the texture of their normal breast tissue and how it changes at different times of the month and with age.'
But cancer specialist Dr William Foo, from Queen Elizabeth Hospital, says BSE is part of breast awareness and shouldn't be discouraged. 'I don't agree that BSE increases the chance of benign biopsies,' he says, adding that all the breast lumps found by his patients have turned out to be cancerous.
Foo also takes issue with the Shanghai study. 'The standard and quality of treatment in China, even Shanghai, may not be so established,' he says. 'The mortality is therefore unaffected, whether you discover the cancer sooner or later. In Hong Kong, because of more advanced treatments, if the cancer is discovered early, then the patient's chance of survival is enhanced significantly.'
It's a view echoed by Miranda Chan, senior medical officer of the Breast Centre at Kwong Wah Hospital. 'Breast cancer is one of the most treatable cancers,' she says. 'If found early, women have a much greater chance of successful treatment.'
And an increasing number of local women are needing that treatment. According to the Hong Kong Cancer Registry, one in 24 Hong Kong women will develop breast cancer, compared with one in 28 a decade ago, although the chance of a Hong Kong woman getting breast cancer is still only about one-third of her Western counterpart's.
Rekindling awareness is one of the main objectives of Friday's Pink Revolution. The charity also hopes to raise much-needed funds for its breast-cancer services. A 'pink parade' will be held at 9pm in Lan Kwai Fong, where the Lan Kwai Fong Festival will be in full flow. Volunteers will be seeking donations and giving prizes to the best-dressed supporters. How do you win one? Wear lots of pink.
