“She told me that medical treatment for breast cancer had improved in the 30 years since my mother was diagnosed, and encouraged me to get treatment immediately,” says the 63-year-old Hong Kong resident.

A month after her diagnosis, Leung underwent a mastectomy and had reconstructive surgery on her left breast. She was in hospital for nine days and later had chemotherapy and radiation therapy.

Since completing chemotherapy in November 2022 and radiation therapy in April this year, Leung has been on the road to recovery. Over the past several weeks she has been receiving therapy in the form of hormone-targeting drugs which work to block the growth of breast cancer cells.

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Leung is thankful that she got her mammogram when she did. She reminds others that early cancer detection gave her more treatment options and a better chance of survival.

Early detection does indeed save lives, according to new research from the Hong Kong Breast Cancer Registry (HKBCR), run by the Hong Kong Breast Cancer Foundation.

At the end of September 2023, the HKBCR published a report based on a study that compared the effectiveness of mammograms with self-detection of breast cancer. Perhaps not surprisingly, it found that mammograms were able to detect the disease at a much earlier stage.

More than 80 per cent of breast cancer cases detected by mammogram were diagnosed at the early stages of 0 and I (1), whereas only 37 per cent of self-detected breast cancer cases were diagnosed at these two early stages.

In addition the 10-year survival rate was higher for patients whose cancer had been found by mammograms, an estimated 96 per cent compared to 88 per cent for self-detected breast cancer patients.

Finding cancer at an early stage generally makes the cost of treating it lower.

According to HKBCR data, the average cost of treatment for each breast cancer case detected by mammogram was HK$361,000 (US$46,000), compared to HK$504,000 for each self-detected case of breast cancer.

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Early detection of breast cancer also allows for prompt and simpler treatment, with fewer patients requiring a total mastectomy and chemotherapy.

Breast cancer is the leading cancer affecting women in Hong Kong and, of all forms of the disease – including lung, colon, cervical and endometrial cancer – the one increasing the fastest in women, says Dr Polly Cheung, the founder of HKBCR.

“As a woman’s risk of breast cancer starts to increase from the age of 40, women should undergo a mammogram every one or two years from this age until the age of 70 to 74, depending on their personal risk,” Cheung says.

Cancer risk can be categorised as high, moderate or average.

“Ninety-five per cent of breast cancer cases are not from a hereditary gene mutation and 85 per cent of patients do not have a family history of breast cancer,” Cheung says.

She advises women of average risk to adopt a healthy lifestyle and undergo regular breast screening so that any cancer is detected early. Women at average risk of suffering breast cancer include those who:

• are above the age of 40

• are obese

• don’t exercise

• eat a diet rich in meat and dairy products

• have never breast-fed

• have never given birth or gave birth after 35

• had their first menstruation before they were 12

• started menopause after 55

• underwent prolonged hormone-replacement therapy after menopause.

How a screening mammogram works

A mammogram is a soft-tissue X-ray of the breast that uses a different radiation source from an ordinary chest or abdominal X-ray. The radiation dose is safe enough for healthy women to get annual screenings, Cheung says.

During a mammogram, the breast is compressed between a paddle and a platform, one breast at a time; this might feel slightly uncomfortable at first.

Cheung says that if cancer is present, it may be detected as a distorted shape or breast-tissue pattern, or as small deposits of calcium, called microcalcifications, that show up as bright white specks on the soft tissue background of the breasts.

Breast cancer can also be detected by ultrasound.

“This method uses sound wave reflection to detect images that are classified as benign or malignant,” Cheung says. “Images with an irregular edge or a tall shadow are suspicious.”

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However, she adds: “As the cancer has to form a mass before it can be detected, an ultrasound cannot replace a mammogram for early detection.

“It is more of an adjunct to mammogram screening in women with dense breasts, as dense breasts tend to reduce the accuracy of mammogram screening.”

The HKBCR study found that mammograms’ accuracy in detecting local breast cancer is 85 per cent. Supplementary ultrasound picks up an additional 9 per cent, to give a combined detection rate of 94 per cent.

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The ability of a mammogram to detect microcalcifications is not hindered by breast size or density, Cheung says.

Women who have breast implants can also have mammograms. In such cases, the implant is pushed back from the X-ray paddle so that only the soft tissue is compressed.

Leung encourages all women over the age of 40 to get regular mammograms for the sake of their health and peace of mind.

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“It’s important to take care of yourself, because when you’re healthy you can live a fuller, happier life and be around longer for your family,” she says.

“Getting regular breast screenings should form part of that self-care. Early detection means early treatment and fewer worries about your health.”