Five important things you need to know about breast cancer

One in 14 ladies in Hong Kong is diagnosed with breast cancer, making it the most common cancer among females in Hong Kong. Fortunately, with modern screening tools and treatment options, the survival rate of breast cancer is high.

Breast surgeon, Dr. Mandy Wong, shares the five most important things we need to know about breast cancer.

1. Breast cancer symptoms

Symptoms may not show during early stages, it is usually when the cancer grows larger that symptoms start to appear. Adult women of all ages are encouraged to check their breasts for cancer by performing a breast self-examination monthly. Being familiar with the breast helps recognise changes early and can make a big difference in treatment options. If you notice any of the symptoms mentioned here, seek medical attention as soon as possible:

• A lump or thickening in or near the breast or under the armpit
• A change in the size or shape of the breast
• A change in the way the breast or nipple looks or feels
• Ridges or pitting of the breast- the skin resembles the surface of an orange
• Nipple discharge or tenderness; the nipple may also become inverted or pulled back into the breast.

2. Updated breast cancer screening guidelines

The recommendation by the Cancer Expert Working Group on Cancer Preventing and Screening (CEWG) in 2021, is that women aged over 44 should have a mammogram every two years if they have the below risk factors:

• A history of breast cancer among a first-degree relative.
• Prior diagnosis of benign breast disease.
• No previous pregnancy.
• Late age of first live birth.
• Early age of first menstrual period.
• High Body Mass Index (BMI).
• Physical inactivity.

Women with the BRACA 1 or BRACA 2 gene or a strong family history of breast and ovarian cancer should have an mammogram every year.
Mammogram vs ultrasound is a question that often comes up. An Ultrasound is used to screen for breast cancer but the CEWG suggested that it is not as effective as a screening tool. It may, however, help to assess an abnormality seen on mammography and to clarify features of a potential lesion. It may also be considered in women with a very dense breasts that affect the sensitivity of mammogram assessment.

3. Nine out of 10 women with an abnormal mammogram do NOT have breast cancer

If the result of the mammogram is abnormal, don’t panic. Depending on the doctor’s assessment, more diagnostic tests might be needed in order to investigate the abnormality.

An example, would be a breast biopsy where a small amount of tissue from the breast is taken out through a fine needle and sent to a laboratory to test for the presence of cancer cells.

If the doctor thinks that the abnormal result is unlikely to be cancer, they may suggest monitoring and repeat the mammogram in 6 months.

4. Breast cancer treatment

Surgery to remove the tumour is often the first line of treatment. The extent of the surgical treatment will depends on the situation and stage of breast cancer. The breast surgeon will discuss the most suitable surgical plan.

Surgery may followed by chemotherapy, radiotherapy, hormone or targeted therapies and will involve a team of health professionals to ensure the best treatment outcomes.

Early diagnosis is key to the success of treatment so a regular health check with breast screening is essential.

5. Can I prevent breast cancer?

For women with breast cancer genes BRCA1 and BRCA2, genetics have the strongest influence in their risk of breast cancer. For others, maintaining a healthy lifestyle and being aware of the following points can help you:

• Limit alcohol to 1 drink per day.
• Maintain a healthy BMI and body fat percentage.
• Be physically active and exercise at least 30 minutes a day, 3 days a week.
• Breastfeed your baby where possible.
• Discuss the risk with the doctor before starting hormonal therapy.

It is important to keep in mind, that by the time symptoms are noticeable it may be harder to treat. Regular health checks and breast screening play a crucial role in protection and prevention. So, don’t hesitate to speak to your doctor or healthcare professionals if you have any concerns, they will be able to offer care and guidance.