[Ask Dr Chiu] Understanding breast cancer: Symptoms, causes, treatment, and prevention
Health2024-09-13
6 Mins Read
Breast cancer is one of the deadliest cancers for women in Hong Kong, second only to lung and colorectal cancer. According to the Hong Kong Cancer Registry, 1 in every 14 women in Hong Kong is at risk of developing breast cancer. It is completely understandable to feel worried and anxious if you discover a lump in your breast during a self-examination, as a breast lump is the most noticeable symptom of breast cancer.
While the exact causes of breast cancer are still unknown, it is generally believed to be related to hormonal imbalances or immune system dysfunction caused by emotional stress. What other factors might increase the risk of developing breast cancer? Today, Dr. Chiu will share some important knowledge about breast cancer, helping you better understand its symptoms, causes, treatments, and prevention methods, so you can face this situation with greater confidence.
What is breast cancer?
Breast cancer is a type of cancer that originates in the tissues of the breast, and it is primarily divided into two types: ductal carcinoma and lobular carcinoma. Ductal carcinoma occurs in the ducts that carry secretion or milk to the nipple, while lobular carcinoma begins in the glands that produce them. Breast cancer can spread (metastasise) to other parts of the body, including lymph nodes, bones, liver, and lungs.
Symptoms of breast cancer
In its early stages, breast cancer may not present with any noticeable symptoms. However, as the disease progresses, the following symptoms may appear:
- Breast lumps: The most commonly observed symptom is a painless, irregular lump in the breast or underarm, which typically grows larger over time.
- Changes in the shape or size of the breast, nipple, or areola.
- Skin changes: The skin of the breast may become red, pitted like an orange peel, dimpled, scaly, or thickened.
- Nipple abnormalities: The nipple may become inverted or produce discharges, such as blood stained fluid
- Pain and discomfort: Although most early-stage breast cancers do not cause pain, some people may experience discomfort or pain in the breast or nipple.
Causes of breast cancer
The exact causes of breast cancer remain unclear, but several key risk factors include:
- Genetic factors: About 5% to 10% of breast cancer cases are linked to inherited genetic mutations, with the most common genes being BRCA1 and BRCA2. Women who have a first-degree relative, such as mother or sister, diagnosed with breast cancer before the age of 50, or who carry certain gene mutations, have a higher risk of developing breast cancer.
- Environmental factors: Regular exposure to certain chemicals or radiation may increase the risk of breast cancer.
- Hormonal factors: Extended exposure to estrogen and progesterone, such as early menstruation, late menopause, not having children, or having children later in life, can increase breast cancer risk.
- Age and gender: Breast cancer mainly affects women, and the risk increases with age. Men can also develop breast cancer, but the percentage is much lower. In Hong Kong, more than half of breast cancer cases are diagnosed after the age of 50.
- Lifestyle factors: Women who frequently consume high-fat, high-sodium, high-sugar foods, or who smoke and drink excessively in their daily lives, are at a higher risk of developing breast cancer.
- Medications and treatments: Women who are on hormone replacement therapy, take combined oral contraceptives, or use postmenopausal hormone supplements have elevated levels of estrogen, which can increase the risk of breast cancer. Additionally, women who received chest radiation therapy before the age of 30 are at increased risk due to moderate to high levels of radiation exposure.
Methods for breast cancer screening
Self breast examination steps and techniques
Self breast examination is a simple and effective method for helping women detect early breast cancer. It is recommended to perform a self-exam once a month, preferably within a week after your period ends. Here are the steps and methods for self-examination:
Observe the appearance of the breasts:
- Stand in front of a mirror with arms relaxed and observe the shape, size, and colour of your breasts.
- Raise your arms and check for any changes in shape, dimpling, or orange peel-like texture on the skin.
- Place your hands on your hips and press firmly to check for any asymmetry or deformation of the breasts.
Palpate the breasts and nipples:
1. Breast examination
- Lying down: Lie flat on your back with one hand under your head and use the fingers of your other hand to feel the breast. Use your fingertips to press the breast in a circular motion from the outer edges toward the centre, covering the entire breast, including the underarm area.
- Standing: This can be done in the shower. With hands wet, use the same circular motion to check your breasts. The slippery texture makes it easier to detect abnormalities.
2. Nipple examination
- Gently squeeze the nipple to check for any unusual discharge.
Seek professional medical examination
If you detect any lumps or discharge during self-examination, it is crucial to seek medical advice promptly. The doctor may perform various investigations, including:
- Mammography: A mammogram is the primary tool for breast cancer screening, especially for women over 40. It can detect early, asymptomatic breast cancer. During the examination, a technician places the breast between two plates on the X-ray machine to obtain a clear image. The procedure may cause slight discomfort, but it is quick and crucial.
- Ultrasound: Ultrasound is often used to supplement mammography, particularly for younger women with denser breast tissue. This test helps distinguish between solid tumours and fluid-filled cysts. During the procedure, a doctor applies conductive gel to the breast and uses a probe to scan, generating images of the internal structure.
- Biopsy: If imaging tests reveal anything suspicious, a biopsy may be recommended. This minimally invasive procedure involves removing a sample of breast tissue for pathological examination to determine if it is cancerous. Biopsies can be performed as fine-needle aspiration, core needle biopsy, or surgical biopsy, depending on the situation and the doctor's recommendation.
Methods of preventing breast cancer
Prevention is better than cure. Maintaining a healthy lifestyle and undergoing regular breast examinations are essential. Here are some tips for preventing breast cancer:
- Regular exercise: Engaging in moderate-intensity exercise, such as brisk walking, jogging, or swimming, can help reduce the risk of breast cancer. It is recommended to participate in at least 150 to 300 minutes of moderate-intensity aerobic activity per week, such as stair climbing or fast walking, or at least 75 to 150 minutes of vigorous-intensity aerobic activity, such as skipping rope or jogging, while avoiding prolonged sitting.
- Weight management: Maintaining a healthy body weight is vital in breast cancer prevention. Obesity is associated with increased hormone levels and inflammatory responses, which may aggravate breast cancer development.
- Balanced diet: A study involving over 160,000 American women showed that those who followed a healthy lifestyle have a 30% lower risk of breast cancer than women who live the least healthy lifestyle. People should follow the 'Healthy Eating Food Pyramid' in adopting a diet rich in fruits, vegetables, whole grains, nuts, lean proteins, and healthy fats, while avoiding processed foods and red meat, can help reduce the risk of chronic diseases, including breast cancer.
- Avoid bad habits: Excessive alcohol intake has been linked to an increased risk of breast cancer, and it is recommended that women should drink no more than one drink a day. Besides, tobacco contains carcinogens, so smoking is related to various cancers, including breast cancer. Women who smoke have a higher risk of developing breast cancer. Quitting smoking or avoiding exposure to second-hand smoke can reduce the risk of breast cancer.
- Self-breast examination: Self-breast examination allows women to detect any abnormalities early. It is recommended to be conducted a few days after your period.
- Regular medical check-ups: Women aged 40 and above should undergo regular breast cancer screenings, such as mammograms or ultrasounds, and follow their doctor's advice to help detect the disease early.
Focus on breast health and early treatment
Facing the challenge of breast cancer, early detection and prevention are crucial. Understanding the symptoms, risk factors, and screening methods for breast cancer, along with regular professional breast examinations, are key steps in early detection. This approach not only increases the chances of successful treatment but also reduces the burden and anxiety associated within the treatment process.
In addition to adopting a healthy lifestyle and regular check-ups, it is also important to add protection to your life. There are insurance plans available that cover not only serious and non-serious illnesses but also early-stage conditions, such as early breast abnormalities. These plans can provide financial support when a disease is detected early, allowing access to the most effective treatments as soon as possible, thereby improving recovery chances. Let's work together to focus on our health and practice a healthy lifestyle in our daily lives to reduce the risk of serious illnesses.
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8. National Cancer Institute. (2022). Breast cancer treatment (PDQ) - health professional version. Bethesda, MD: National Cancer Institute.
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10. World Health Organization. (2021). Breast cancer: prevention and control. Geneva: World Health Organization.
The above content is reviewed by Dr Alexander Chiu - Chief Medical Officer of AXA Hong Kong and Macau.
Information and materials provided is general in nature and does not constitute medical or health advice from AXA Hong Kong and is on an “as is” and “as-available” basis without representation and/or warranty of any kind, either express or implied. While AXA Hong Kong has taken reasonable care in providing such information and materials, they are not specific to your investment objective, financial situation, health or medical conditions or particular needs. No warranty or responsibility is assumed by AXA Hong Kong and our related or holding companies regarding non-infringement, security, accuracy, completeness, adequacy, reasonableness, fitness for a purpose or free from computer viruses in connection with the information and materials provided. AXA Hong Kong and our related companies and holding companies do not accept any liability for any loss, damage, cost or other expense, whether wholly or partially, directly or indirectly, arising from any error, inaccuracy or omission of the information and materials to the extent that such liability is not excluded by law.
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