The Importance of Regular Breast Cancer Screening and Early Detection
Breast cancer has been the most common cancer among women in Hong Kong since 1994. From 1993 to 2018, the number of confirmed cases increased fourfold, with invasive breast cancer reaching 4618 cases in 2018. According to the statistics released by the Hong Kong Cancer Information and Statistics Center in 2020, there is a growing trend of women being diagnosed with breast cancer at a younger age, with a majority of the patients aged between 40 and 59. On average, one in every 14 women will develop breast cancer in their lifetime. Therefore, younger women should stay alert for breast cancer by conducting regular self-examinations and breast screenings. Women are also advised to have medical professionals to assess the risks, detect symptoms early, and receive treatment as soon as possible if needed.
Research shows that 80% percent of patients only seek medical help when they discover they have symptoms of breast cancer. What we should know is that symptoms of early stages of breast cancer are not easily noticeable. Often when symptoms appear, cancer has already advanced to a later stage. Therefore, it is important for women to receive regular breast check-ups on top of breast self-examinations for better breast health.
The earlier breast cancer is detected, the better the chance of recovery. Women are suggested to do a monthly breast self-examination 3 to 5 days after their menstrual period. As for women who are in their menopause, they should perform regular self-checks every month. Aside from self-examinations, women who are above 20 should see a specialist for regular breast palpation by medical professionals.
Steps
Stand in front of a mirror
Observe your breasts with your arms by your side and also with them raised. Look to see if the skin of your breasts appears sunken, wrinkled, or red. Check the condition of the nipples and see if there is any fluid seeping out (not during breastfeeding).
Lie down on a bed
Put two fingers together and check each breast with the opposite hand i.e., touch your left breast with your right hand and vice versa. Check the whole breast area with the pads of your fingers and move them in a circular motion (start from the outside and slowly move to the centre of the breasts, then proceed vertically from the collar bone to the lower part of the breasts).
Standing
When you are in the shower, lightly soap your breasts and move your fingers across the entire breast area to check if there is any lump.
Early stages of breast cancer might not be easily detected by self-examinations. The following changes to the breasts could be signs of breast cancer. Patients must seek medical help if they have any of the following symptoms.
- A lump in the breasts
- A change in the size or shape of the breasts
- A change in the appearance of the breast or the skin around the nipples, for example, redness, scaling, thickening, or the skin resembles the surface of an orange
- Rash around the nipples
- Nipples are inverted
- Nipple discharge
- Continuous discomfort in the breasts or under the armpit
Studies have shown that the risk of breast cancer is inextricably linked to aging. Therefore, women of different ages require check-ups of different frequencies. It is recommended to follow the below guideline to receive regular examinations.
Age |
Self-examinations |
Mammgraphy* |
20-39 |
Monthly |
- |
40 or above |
Monthly |
Once every 1-2 years |
*As Asians, especially women of younger age, have a higher breast density, they will be advised by doctors to undergo ultrasound examinations if necessary.
Like other cancers, breast cancer has some risk factors that we must pay close attention to. If you have one of the following risk factors, do not hesitate to seek medical help from specialists. They can suggest check-up plans that are suitable for you.
- Lack of exercise;
- Obesity (with a BMI over 25);
- High stress level;
- High intake of food with saturated fats, such as red meats and whole milk products;
- Lack of vegetables and fruits in the diet;
- You have never given birth, had the first pregnancy relatively late (after age 30), or have never breastfed before;
- Early menstrual periods (before age 12) or late menopause (after age 55);
- History of breast, ovarian or endometrial cancer;
- History of benign breast diseases (such as atypical hyperplasia) or lobular carcinoma in situ (LCIS);
- Currently taking hormone replacement therapy;
- Currently taking combined oral contraceptive pills;
- Previous treatment using radiation therapy to the chest or breasts before age 30;
- Genetic mutations confirmed from genetic testing (such as BRCA1 and BRCA2 genes)
- Family history of genetic mutations (such as BRCA1 and BRCA2 genes)
- Immediate family history of breast cancer before age 50
Patients may require further examinations if doctors have doubts about the check-up results.
Mammography
Low-radiation x-ray images will be taken to check for malignant tumors. Women aged 40 or above who do not have any breast cancer symptoms should get mammography screenings regularly.
Breast Ultrasound
High-frequency sound waves are used to produce images of the internal structures of the breast, which can show whether the lump is a solid mass or a liquid cyst, or a combination of the two. A breast ultrasound examination can help check the size and location of the lump as well as its surrounding tissue.
Breast Magnetic Resonance Imaging (MRI)
During the examination, magnetic and radio waves that have no radiation are emitted from the machine, which is connected to a computer, through the breast tissues to produce detailed images of the internal structure of the breast, which helps to determine if the lump in the breast is benign or malignant.
Breast Biopsy
A sample of suspicious breast tissue is removed and sent to a laboratory for testing to evaluate if the lump is cancerous. This diagnostic method is the only definitive way to make a diagnosis of breast cancer.
Tumor Biomarker Test
Once a patient is diagnosed with breast cancer, further tests can be performed on the tumor tissue to learn about its biometrics, which refers to the presence or absence of ER, PR, and HER2 receptors. Based on the test results, doctors can suggest more targeted and effective treatment methods for the patient.