October is Breast Cancer Awareness Month

Reviewed By: Dr Joyce Lai

October is synonymous with Breast Cancer Awareness. It's a disease that affects 1 in 8 women, according to the American Cancer Society^[1]. In 2019, CHP reported that breast cancer was the commonest cancer among females in Hong Kong accounting for “27.4% of all new cancers in females diagnosed in Hong Kong”^[2].

Thanks to good screening practices and the advancement of medical treatments, there is now a strong chance of surviving breast cancer. However, it's still responsible for 12.2% of all cancer deaths in females making it incredibly important to recognise the signs and symptoms or attend regular screenings.

What is Breast Cancer?

Breast cancer is a type of cancer that develops in the mammary gland tissue in the breast. It is common in women, but men can also get breast cancer. Most often, breast cancer is discovered by a lump in the breast.

What are the risk factors for Breast Cancer?

According to the Centre of Health Protection, it is recommended for women to start screening for breast cancer regularly at age 35^[3]. There are also certain risk factors that can increase the possibility of breast cancer according to the University of Hong Kong^[4]:

• Women aged 44 – 69 years old
• Have a family history of breast cancer
• High body mass index
• Low physical activity

For people considered to be at moderate risk for breast cancer, your doctor might advise annual or biannual breast screenings.

How can you recognise the first sign of Breast Cancer

Many people know that an abnormal lump in your breast can indicate breast cancer. But other symptoms are less well known. It is essential that you know your breasts well (how they feel and look) so that you can notice a change in time with which you can detect an abnormality. If you are worried about any abnormality in your breast or nipple, then go to your doctor. It is also wise to get a breast examination or screening from your doctor every year to ensure you are not missing anything.

Symptoms of Breast Cancer

A breast lump is one of the most common symptoms of breast cancer. There are also other symptoms or changes that may indicate breast cancer. Common symptoms of breast cancer include:

• New lump or area of thickened tissue that was not there before
• Change in the size or shape of one or both breasts
• Discharge from nipples
• Lump or swelling in armpits
• Dimpling on the breast skin
• Rash on or around your nipple
• Change in the appearance of your nipples

Note: Breast pain is not usually a symptom of breast cancer.

You should see your doctor if you experience any of the symptoms above.

To spot any suspicious changes, it's important to check your breasts regularly so you will be able to recognise any abnormalities earlier.

What is included in a Breast Screening?

Breast screening will normally include a breast examination from a Family Doctor (GP) or Gynaecologist (OBGYN), a mammogram and sometimes an ultrasound. A mammogram is a non-invasive, specialised medical imaging that uses a low-dose x-ray system to see inside the breasts. During a mammogram, the breasts are gently flattened between two plates of the x-ray machine to spread the breast tissue apart gently. Breast images are then taken to check for abnormalities.

Combined with ultrasound, this is considered the most appropriate way to screen for early signs of breast cancer.

Having regular screenings means catching breast cancer early and lowering the risk of dying from it. Regular mammographic screening and catching breast cancer early is associated with an approximately 20% reduction in breast cancer mortality^[5].

Coronavirus and Breast Cancer

Because regular care was not as easily available during the early and mid-parts of the Covid-19 Pandemic outbreak, breast cancer may have remained undetected and unreported during this period. Some countries have reported as many as 5,000 fewer cancer diagnoses from 2020 - 2021 than in the previous ten years. It is therefore more important than ever to raise awareness about breast cancer and breast cancer screening.

Reference

1. Breast cancer facts and statistics. (n.d.). Retrieved September 22, 2022, from https://www.breastcancer.org/facts-statistics

2. Centre for Health Protection, Department of Health - Breast Cancer. Centre for Health Protection. (n.d.). Retrieved September 22, 2022, from https://www.chp.gov.hk/en/healthtopics/content/25/53.html

3. Centre for Health Protection, Department of Health - Breast Cancer. Centre for Health Protection. (n.d.). Retrieved September 22, 2022, from https://www.chp.gov.hk/en/healthtopics/content/25/53.html

4. Update on the Recommendations on Breast Cancer Screening by the Cancer Expert Working Group on Cancer Prevention and Screening. HKMJ. (2022, April 26). Retrieved September 22, 2022, from https://www.hkmj.org/abstracts/v28n2/161.htm

5. Marmot, M. G., Altman, D. G., Cameron, D. A., Dewar, J. A., Thompson, S. G., & Wilcox, M. (2013, June 6). The benefits and harms of breast cancer screening: an independent review. Nature News. Retrieved September 22, 2022, from https://www.nature.com/articles/bjc2013177