One in eight women in Hong Kong will be diagnosed with breast cancer at some point during their lifetime. When identified early, the prognosis can be very positive, but with an average of 10 women in the city are diagnosed every day, it’s important to know what to look out for and when to seek medical help.
The good news is that the vast majority of lumps found in the breast turn out to be benign, with many due simply to hormonal fluctuations during the menstrual cycle. Each month, breast tissue temporarily develops and then regresses. However, sometimes the tissue doesn’t regress fully, which leaves residual lumps in the breast. Other possible causes of benign breast lumps are cysts and fibroadenomas, which are both very common.
Despite this, it’s worth bearing in mind that according to 2015 statistics, breast cancer is the most common form of cancer in women in Hong Kong, accounting for 26.1% of all cancer cases, with the incidence on the rise. On the other hand, survival rates over the past 20 years have improved significantly such that the five-year survival rate is now 85-99%. Why? Early detection is the key!
To determine whether a lump is benign or whether it needs further investigation, therefore we recommend that women with concerns, consult a breast specialist as early as possible.
Every woman, regardless of her age, family history or lifestyle habits should be familiar with how her breasts usually look and feel. It’s important to conduct breast self-examinations every month to look for any possible changes in the contour of the breast, any nipple discharge or the palpation of a lump.
Examinations should be carried out mid-cycle, so make a point of marking in your diary when you anticipate that to be and set yourself a reminder. If you notice a lump, a change in the size or shape of the breast, or any other abnormalities, schedule an appointment to see your doctor as soon as possible.
Remember – finding a nodule in your breast does not automatically mean you have cancer. However, early diagnosis is extremely important, so if you do notice a lump, make an appointment to see your family practitioner or a breast care specialist straight away in order to determine the most appropriate course of action.
Attend Regular Clinical Examinations
While monthly breast self-examinations are important, it is not always easy to detect issues yourself, therefore we recommend that you also attend regular clinical examinations. Annual mammograms and breast ultrasounds should be carried out from the age of 40. However, for patients with a family history of breast cancer, we suggest having the first screening at 35, followed by clinical examinations once a year until you reach 40, after which annual imaging and clinical examinations should take place. This is because breast cancer risk doubles with each decade of life until menopause when the rate of increase slows. The majority of instances of breast cancer take place after the menopause.
Mammograms are an x-ray examination of the breast. They are effective at detecting microcalcifications or suspicious lesions at an early stage.
Breast ultrasound is not used to screen for breast cancer by itself. However, it is an important imaging tool that provides extra information to assist in the interpretation of mammograms. Ultrasounds are effective at differentiating whether a lump or nodule is solid or cystic. Cystic lesions are of much less concern than solid ones.
Risk Factors Explained
Certain life events represent key risk factors for breast cancer, as they increase lifetime exposure to oestrogen and progesterone. These include:
Early onset of periods (before the age of 12)
Late menopause (after the age of 55)
Not bearing children
Having your first pregnancy after the age of 30
Other risk factors come from a woman’s lifestyle, such as:
Lack of exercise (less than three hours per week)
A diet rich in meat and dairy products
Working night shifts
Lack of vitamin D
Drugs (OCP and HRT may be implicated)
A family history of breast cancer
Ionizing radiation exposure from medical treatments such as x-rays, particularly during puberty, even at lose doses
In order to assess your own personal risk level, it is recommended to enter a breast cancer screening programme. The initial consultation will comprise a clinical examination as well as a detailed assessment looking at your medical history, lifestyle and habits.
This article was written and shared with courtesy of Hong Kong Surgical Specialists.
To assess your personal risk or learn more, call HKSS 2715 – 4577
Charities and Support:
Hong Kong Breast Cancer Foundation
Hong Kong Hereditary Breast Cancer Family Registry