Breast cancer

Breast cancer is the most common female cancer worldwide. In Hong Kong , breast cancer has been the number one female cancer for the past two decades and the number of new cases and related deaths are rising. In 2008, there were 2616 new cases of breast cancer and 508 women died of the disease. Although breast cancer is a fearful disease, early detection and early treatment can significantly improve the chance of cure.

Signs of breast cancer

A lump found in the breast is often how women with breast cancer first come to discover their disease. Other possible signs include discharge or bleeding from the nipple or the appearance of a retracted nipple. Cancer cells may invade the surrounding skin and lymph nodes, and lead to swelling of the armpit. However, breast lumps are not all cancerous. If any of the above occurs, it is most important to consult your doctor promptly.

Who has a higher chance of developing breast cancer?

1.  The risk of breast cancer increases with age

2.   Early first period or late menopause

3.  First pregnancy after the age of 35 or women who have never been pregnant

4.  A family history of breast cancer

5.  High fat diet, frequent consumption of alcohol and physical inactivity

How to reduce the chance of developing breast cancer?

1.  Maintain a healthy body weight

2.  Exercise regularly

3.  Limit alcohol consumption

4.  Healthy diet

5.  Breastfeeding

6.  Be breast-alert

Breast screening

The aim of breast screening is to look for the disease before warning signs appear.

1. Self breast examination

The first line of defense is to perform the monthly breast self-examination. Women over the age of twenty should examine their breasts after period every month. Women aged forty years or above may consider regular mammogram examination once every 2 years.

2. Mammogram examination

A mammogram is an X-ray of the breast. This is a standard screening test for women with an increased risk of breast cancer to allow for early diagnosis and early treatment if needed. The test has its inherent limitations and chance of error. Our clinic nurse will discuss the examination details with women before it is performed.

Preparation: on the day of the mammogram examination:

•  Clothing: the upper body will be unclothed during the examination. Hence, wearing a T-shirt or blouse will be most convenient. Full-length dress is to be avoided.

•  Refrain from using anti-perspirant or talcum powder on the breast and underarm. These substances may affect the quality of the films.

•  Bring along the films and reports of any previous mammography or breast ultrasound.

•  Abstain from coffee or schedule the exam to after your period ends may decrease the breast discomfort during examination.

•  If you think you may be pregnant, please inform our staff before the examination.

Before the procedure:

•  Our clinic nurse will take a relevant history from you and explain the procedure and workflow of reporting.

•  Our clinic nurse will perform a clinical breast examination on you, and show you how to do a breast self-exam correctly.

The Procedure:

Taking a mammogram is like taking an X-ray. To keep the dose of radiation to a minimum and to get a good quality image, it is necessary to firmly compress the breast at different angles between a plastic paddle and an X-ray film holder. This may cause pain or discomfort at the breast. If the discomfort becomes intolerable, you may let us know and the procedure will be terminated.

After the procedure:

•  There may be mild soreness at the breast. Mild bruising of the breast is very rare.

•  The mammogram will be sent to a radiologist for reporting.

Workflow of reporting:

•  If the result is normal, the report will be mailed to you in about 4 weeks after the examination.

•  If the result is suspicious or abnormal, our clinic staff will telephone you to arrange for a follow-up appointment. If necessary, the radiologist may recommend you to have a breast ultrasound. This procedure will incur a charge.

•  The mammogram and full report will be kept by the clinic to facilitate future follow up. If you want a duplicate copy of the film or report, extra charge will apply. There is no charge for films or a copy of the report on loan for medical purpose.

Lady Helen Woo's Women Diagnostic and Treatment Centre at Tsan Yuk Hospital is managed by the Department of Obstetrics and Gynaecology, The University of Hong Kong. Our centre provides a comprehensive breast health service including mammogram examination, breast ultrasound and breast biopsy. If an abnormality is found, women may be referred to Queen Mary Hospital for follow-up.