Breast Cancer Prevention and Screening

(Published 01/2022)

Breast cancer is a malignant tumour formed in the breast tissues. It occurs in both women and men, although breast cancer in men is rare.

Am I at risk of breast cancer?

Women with the following risk factors are at increased risk of breast cancer:

  • Confirmed carrier (or family history) of certain gene (e.g. BRCA1 or BRCA2 ) mutations
  • Family history of breast cancer or ovarian cancer, such as first-degree relatives (mother, sister or daughter) diagnosed with breast cancer before age of 50
  • History of receiving radiation therapy to the chest before age of 30

Other risk factors include:

  • Lack of physical activity
  • Alcohol consumption
  • Obesity after menopause
  • Advancing age
  • No childbirth, late first live birth (after age of 30) or no breastfeeding
  • Early menarche (before age of 12) or late menopause (after age of 55)
  • History of breast cancer or ovarian cancer
  • History of benign breast conditions or lobular carcinoma in situ
  • Receiving hormonal replacement therapy
  • Using combined oral contraceptives

What are the common symptoms of breast cancer?

The symptoms of breast cancer may not be easily noticed at an early stage.

Common symptoms include:

  • Breast lump
  • A change in the size or shape of the breast
  • A change in skin texture of the breast or nipple (e.g. red, scaly, thickened or "orange-skin" appearance)
  • Rash around, in-drawing of, or discharge from the nipple
  • New and persistent discomfort or pain in the breast or armpit
  • A new lump or thickening in the armpit

You should consult a doctor as soon as possible if you develop any of the above symptoms.

How to reduce the chance of getting breast cancer?

  • Have regular physical activity
  • Avoid alcohol consumption
  • Have a balanced diet
  • Maintain a healthy body weight and waist circumference
  • Have childbirth at an earlier age and breastfeed each child for a longer duration

Why should I be breast aware?

Every woman should be breast aware and familiar with the normal look and feel of their breasts at all time. Be aware of any unusual changes of their breast. If women notice unusual changes in the breast, they should see a doctor as soon as possible.

What is breast cancer screening?

The purpose of breast cancer screening is to detect breast cancer before it gives rise to symptoms, so that early treatment can be initiated. Mammography is a widely used screening tool which is an X-ray examination of the breasts.

Should I get screened?

Based on available international and local scientific evidence, the Government's Cancer Expert Working Group on Cancer Prevention and Screening (CEWG) makes the recommendations on breast cancer screening for women at different risk profiles as follows:

  • Women at high risk (e.g. carriers of confirmed BRCA1/2 gene mutations, with strong family history of breast cancer or ovarian cancer, history of receiving radiation therapy to the chest before age of 30, etc.) should seek doctor's advice for annual mammography screening and starting age for screening.
  • Women at moderate risk (i.e. with family history of ONLY one first-degree female relative with breast cancer diagnosed at age ≤50 OR two diagnosed at age >50) should have mammography screening every 2 years.
  • Other women at general population in which women aged 44-69 years with certain combinations of personalised risk factors putting them at increased risk of breast cancer are recommended to consider mammography screening every 2 years. A risk assessment tool for local women (e.g. one developed by The University of Hong Kong (HKU)) is recommended to be used for estimating the risk of developing breast cancer with regard to the personalised risk factors including age of menarche, age of first live birth, presence of history of breast cancer among first-degree relative (mother, sister or daughter), prior diagnosis of benign breast disease, body mass index (BMI) and level of physical activity.

Of note, all screening tests have their limitations and they are not 100% accurate. There are false-positive and false-negative results. All women who consider breast cancer screening should discuss with doctors on the potential benefits and harms before undergoing screening.

Related information

More information can be found from:

(Source of information provided by the Non-communicable Disease Branch of Centre for Health Protection, Department of Health - January 2021 version)

Mammogram

1. Introduction

Mammography is an x-ray imaging procedure to screen for cancer and suspected pathology in the breast.

2. Preparation before the procedure

  • Please inform medical staff before the examination if you think you are or may be pregnant.
  • Abstaining from coffee or postponing the procedure to post-menstrual period may decrease the discomfort.

3. The procedure

  • Two views are performed for each breast:
    • Body relaxed with head rotates to one side.
    • Back straight with tummy in and lean forward.
    • Breast rests on bucky.
    • Whole breast pulled out with force.
    • Breast flattened by plastic paddle.
  • It involves compression of the breast by a flat plastic paddle. Patient may feel pain or discomfort during compression of the breasts, especially when performed in pre-menstrual period. This process is absolutely important because it can improve image quality, increase the diagnostic accuracy and reduce radiation dose.
  • Patient may feel discomfort or pain during compression of the breasts. If the pain is intolerable, patient can ask to stop the procedure immediately.
  • The examination takes approximately 1 to 2 hours, though occasionally the time required may be longer.

4. After the procedure

After the examination, patient may have pain for a short period of time. In rare situation, bruise may occur in some patients. The examination report will be sent to the referring doctor. If further investigations are needed, the doctor will conduct further examination or arrange ultrasound scanning with or without needle biopsy.

5. Remarks

For further information please contact your doctor.

(Source of information provided by Cancer Online Resource Hub - Revised on August 2021)