Don’t be blind to abnormal breast skin texture - 2 methods to check for breast cancer
HEALTH2019-10-24
4 Mins Read
Breast cancer is the most common cancer among Hong Kong’s females. Data at Hospital Authority shows there were 4,123 new cases in 2016, 1/4 of all new female cancer cases. The incidence rate even doubled over the past 10 years, indicating an upward trend. However, there is a 90%+ cure rate for early-stage breast cancer, and signs of the disease can be detected through self-examination and regular mammography, 2 proactive ways to increase the cure rate.
Self-examination, the simple way to find symptoms of abnormality
The most common symptom of breast cancer is a new lump; others include rashes, dryness, change of colour, sunken nipples and secretion from nipples. Most patients didn’t seek medical help until they discovered lumps by accident. So the first step to preventing breast cancer is self-examination.
Before examination, women should be familiar with the normal look, feel and cyclical changes (some may have swollen breasts during periods) of their breasts to tell if there are abnormalities.
2 steps to examine our breasts:
- Check the shape and skin texture of the breasts in front of the mirror to see if there is any abovementioned symptom. Then, raise both arms and check again for abnormal breast shape.
- Lie on the bed, relax and use both hands to massage the breasts in a circular motion, from top left to right, then bottom left to right, to check for lumps.
Mammography to counteract the trend of more younger patients
Regular self-examination is just the starting point and it may not be able to accurately detect tumors that are too small or too deep. This is where mammography comes in, an X-ray imaging of the breasts that provides a more precise diagnosis.
The Hong Kong Government is not active in promoting mammography, or breast cancer screening, but guidelines of the American Cancer Society suggest that women aged 45 to 54 should take mammography once a year and for those aged 55 or above, twice. High-risk individuals are advised to do it at a younger age¹.
In fact, there are traces that Hong Kong may have more younger patients. According to Hong Kong Breast Cancer Registry Report No. 11, 2/3 of interviewed patients were aged between 40 and 59 with one patient diagnosed at 19²! The Registry also has figures telling us that 30%³ patients are under 50, meaning breast cancer is not limited to the elderly and regular check-ups are essential to lowering the risk.
Overseas figures point out that 1 breast cancer patient would be discovered in every 2,000 people screened⁴. But errors do exist – some women who didn’t have breast cancer were shown positive after screening which led to unnecessary panic and further check-ups.
When it comes to surgery
Surgical removal of a tumor is a crucial part of a radical cure. In some cases, the doctor would suggest the patients taking medical treatment to shrink the tumor’s size before the surgery. In other cases, patients would be advised to receive adjuvant therapies, including chemotherapy, electrotherapy, targeted therapy and hormone therapy, reducing the risk of cancer recurrence.
The change of physical appearance after removing the breasts brings psychological stress to many patients. That’s why keeping the breasts has become the main direction of the surgery. But if the tumors are too large, too many in number or in too many places, removing the entire breast is necessary. In addition, any breast-conserving surgery has to be followed by electrotherapy and if the patients are reluctant or not suitable to receive electrotherapy, partial removal would not be an option.
Prevention starts from changing lifestyle
To minimise the risk of breast cancer, we should pay more attention to our lifestyle and make necessary changes to put the following risk factors under control:
- Lack of exercise
- Obesity/ Weight gain after menopause
- Intemperate eating and drinking/ alcoholism
- No breast-feeding
There should be no hesitation when it comes to breast cancer, especially those who have a family history or other risk factors. If you feel discomfort in the breasts, you need to seek professional medical advice and decide whether you should start having regular check-ups earlier.
Dr Conrad Lee,
Director of Oncology Services at International Medical Centre
Remarks:
¹ American Cancer Society Guidelines for the Early Detection of Cancer:
https://www.cancer.org/healthy/find-cancer-early/cancer-screening-guidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html
² Hong Kong Breast Cancer Registry report No. 11 – Executive Summary:
https://www.hkbcf.org/en/our_research/main/468/upload/category/468/self/5d939ba32861a.pdf
³ Female Breast Cancer in 2016:
http://www3.ha.org.hk/cancereg/pdf/factsheet/2016/breast_2016.pdf
⁴ Cancer Expert Working Group on Cancer Prevention and Screening for Breast Cancer:
https://www.chp.gov.hk/files/pdf/breast_ca_en.pdf
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