In 1999, breast cancer accounted for 19.4 per cent of all new cancer cases, with 1,787 new cases recorded. In 2002, 2,059 new cases of breast cancer were recorded, accounting for 21 per cent of all cancers diagnosed in women. In 2003, 431 women died from breast cancer in Hong Kong. Current statistics indicate that one in every 23 Hong Kong women will develop breast cancer.

However, the statistics do not indicate a parallel increase in mortality. The age-standardised mortality rate of female breast cancer has shown a slight but steady decline over the 1983 to 2002 period. The five-year trend of age standardised death rates per 100,000 women, between 1981 and 2000, was 8.6 in 1981-85, 8.8 in 1986-90, nine in 1991-95, 8.4 in 1995-2000 and eight in 2001-02.

The decline is attributed to earlier diagnosis and improved adjuvant therapy. 'There is increasing application of mammographic (MMG) screening, and adjuvant therapy which includes radiation therapy, chemotherapy and hormonal therapy, to reduce incidence of relapses. The advances in adjuvant therapy have shown to be very effective in preventing relapses,' said Dr Foo, who is also medical consultant with the Hong Kong Cancer Fund.

'It is also important to be aware that mastectomy, the removal of the breast tissue, is not the only option for containing breast cancer. If the cancer is discovered in its early stages, when it is below 3cm in diameter, mastectomy becomes unnecessary.'

Breast cancer became prevalent with the industrialisation of Hong Kong after the second world war. 'Ever since Hong Kong stepped into the industrialised age and adopted a more westernised lifestyle, the incidences of breast cancer have been increasing. There's no particular cause. It's a lifestyle thing - factors such as eating a more protein-rich diet with less rice and fresh vegetables and having fewer children have contributed to the rise.'

Shifting demographic patterns in the future may increase the incidence of breast cancer over the next two decades. It is estimated that by 2015, women aged 50 to 54, when women are most vulnerable, will comprise the widest segment of Hong Kong's female population pyramid. If age-specific incidence rates for breast cancer remain at the current level, the incidence of female breast cancer will escalate significantly.

The International Breast Awareness month is associated with the colour pink. Dr Foo was wearing the HKCF's pink ribbon badge on his coat lapel during this interview. A leading oncologist, his main clinical interests are breast cancer, prostate cancer and psychosocial care. He is an active supporter of the HKCF, providing assistance on issues related to all types of cancer.

World Health Organisation figures released in 2003 revealed breast cancer was the second most prevalent cancer in the world, with more than 1 million new cases reported worldwide annually. The highest incidences of breast cancer occur in the United States, Canada, Britain and Australia at between 53 and 101 cases per 100,000 women. Hong Kong and Singapore follow with between 35 and 52 cases per 100,000 women. Japan and the Middle East follow with between 26 and 34 cases.

Incidence is lowest in China, India and many African countries with 19 per 100,000 cases. However, the mainland's Ministry of Health recently reported that breast cancer kills nearly 40 per cent more women than it did a decade ago. Early detection methods such as self-examination or regular MMG screenings are not practised as a habit in Hong Kong.

The statistics are a wake-up call and an unequivocal message for all women that early detection is necessary and recovery is attainable.