DOES THIS DESCRIPTION fit you? Over 50 years old, Caucasian (and have lived in the west for most of your life), have had relatives suffer from breast cancer, had first menstrual period earlier than 11, had a late menopause, childless, or have children but did not breastfeed, have had biopsies for benign conditions in the breast, have taken or are taking hormonal replacements after menopause, are obese especially after menopause, drink alcohol. Women who fit this description are at higher risk of getting breast cancer, according to William Foo, director at the radiotherapy and oncology centre of the Hong Kong Baptist Hospital, though he concedes that 'knowledge of the risk factors for breast cancer is still sparse'. One early way of detecting breast cancer is by mammogram. In Europe and America, mammograms are used to screen for breast cancer, but in Hong Kong it is not advocated because the incidence of breast cancer here is not sufficiently high. 'Since mammograms have a false-positive rate of 5 to 15 per cent, subjecting healthy women to such procedures could yield more problems, especially when the incidence rate is not high enough,' Dr Foo said. Other diagnostic methods include clinical examination, ultrasonography and sometimes magnetic resonance imaging. 'Different situations have different needs for these examinations,' Dr Foo said. 'More importantly, obtaining tissue diagnosis is crucial if breast cancer is suspected. This is done through a core biopsy by inserting a needle under imaging guidance.' A less intrusive way, and one women can do themselves and is advocated by the Hong Kong Cancer Fund (HKCF), is to observe one's own breasts according to the 'look, feel and compare' guidelines (see insert). Dr Foo, who is also an adviser for the HKCF, said the whole point of 'look, feel and compare' is to raise women's awareness of changes in their breasts. 'This is a more practical, down-to-earth way than teaching breast self-examination. Self- examination is no more than a set of procedures that women can perform at regular intervals using their hands. By itself, it is a rather dry theme,' he said. He said women should be familiar with their breasts in order to be able to observe any changes. 'One should look [in a mirror], feel often and look for changes. One should seek medical help whenever one suspects things are happening in one's breasts,' Dr Foo said. Self-diagnosing has been effective in detecting breast cancer early. 'Nowadays we are seeing more and more early-stage, smaller breast cancers. Most were found by the patients themselves. Only a small proportion were discovered by doctors,' he said. To lower the risk of breast cancer, Dr Foo suggests maintaining a diet high in vegetables and fruits, and low in meat and fat, having children and breastfeeding them. He also suggests lowering alcohol intake, and minimising the use of hormonal replacements after menopause.
