Introduction to Breast Cancer

Breast cancer is a malignant tumor that occurs in breast tissue. Both women and men can develop breast cancer, but it is rare in men.

Risk factors for women include:

• High-risk factors: Confirmed personal (or family history) of certain gene mutations (e.g., BRCA1 or BRCA2), family history of breast or ovarian cancer (e.g., a first-degree relative diagnosed before age 50), chest radiation therapy before age 30.
• Other risk factors: Lack of physical activity, alcohol consumption, post-menopausal obesity, increasing age, never giving birth or first birth after age 30, never breastfeeding, early menarche (before age 12) or late menopause (after age 55), previous breast or ovarian cancer, benign breast disease or lobular carcinoma in situ, ongoing hormone replacement therapy, use of combined oral contraceptives.

Common Symptoms of Breast Cancer

Early breast cancer symptoms are not easily noticeable. Common symptoms include:

• A lump in the breast
• Changes in breast size or shape
• Changes in breast or nipple skin (e.g., redness, scaling, thickening, or orange-peel appearance)
• Rash, inversion, or discharge around the nipple
• New persistent discomfort or pain in the breast or armpit
• New lump or thickening in the armpit

If you experience any of these symptoms, seek medical advice promptly.

How to Reduce the Risk of Breast Cancer

To lower the risk of breast cancer:

• Engage in regular physical activity
• Avoid alcohol
• Maintain a balanced diet
• Keep a healthy weight and waistline
• Give birth at a younger age and extend breastfeeding duration

Paying Attention to Breast Health

Women should always be aware of their breast health and familiarize themselves with the normal appearance and feel of their breasts. Pay attention to any unusual changes and seek medical consultation promptly if noticed.

Breast cancer screening aims to detect breast cancer in women before symptoms appear, allowing for timely treatment. Mammography is a common screening method using X-rays to image the breasts.

Should You Undergo Breast Cancer Screening?

Based on current international and local scientific evidence, the Cancer Expert Working Group on Cancer Prevention and Screening recommends:

• High-risk women (e.g., confirmed BRCA1/2 mutation carriers, strong family history of breast or ovarian cancer, chest radiation before age 30): Consult a doctor for annual mammography and discuss starting age.
• Moderate-risk women (one first-degree female relative diagnosed at or before age 50, or two after age 50): Biennial mammography.
• General women: Aged 44-69 with certain personalized risk factors (e.g., age at menarche, first birth, family history, benign breast disease, BMI, physical activity), consider biennial mammography. Use tools like the one developed by the University of Hong Kong for risk assessment.

Note that all screening tests have limitations and may produce false positives or negatives. Discuss benefits and potential risks with a doctor before proceeding.

Mammography

1. Introduction

Mammography uses X-rays to examine breast tumors and abnormalities, and can be used for breast cancer prevention screening.

2. Preparation Before the Procedure

• If you suspect or are pregnant, inform the radiology staff beforehand.
• Avoid caffeine before the exam or schedule it after your menstrual period to reduce discomfort.

3. Procedure Process

• Each breast is imaged from front and oblique views: Relax your body, turn your head sideways, suck in your abdomen, stand tall, lean forward, place armpit muscles and breast on the machine, pull the breast out as much as possible, and compress with a plastic plate.
• Compression with the plastic plate is necessary for clearer images, accurate diagnosis, and reduced radiation dose, but it may cause discomfort or pain (especially before menstruation).
• If the pain is unbearable, request to stop immediately.
• The entire procedure takes about 1-2 hours or longer.

4. After the Procedure

After imaging, the breast may have temporary pain, with minor bruising being rare. Results will be sent to your doctor. If further diagnosis is needed, the doctor may examine your breast or use ultrasound/fine-needle aspiration.

5. Notes

For any inquiries, contact your attending doctor. (Information provided by the Cancer Online Resource Centre)

Related Resources

• Cancer Online Resource Centre: www.cancer.gov.hk
• Change for Health Website: www.change4health.gov.hk
• Department of Health Health Education Hotline: 2833 0111
• Family Health Service: www.fhs.gov.hk / 24-hour Information Hotline: 2112 9900