The importance of breast cancer screening

Breast cancer is one of the most common cancers in women worldwide, and in Hong Kong, it is the number one cancer killer for women. According to the latest data from the Hong Kong Cancer Registry, there are more than 5,000 new cases of breast cancer diagnosed every year, and an average of about 15 women are diagnosed with breast cancer every day. In the face of such grim numbers, take the initiative to do it regularlyhas changed from "optional items" to "necessary actions to protect life and health". The core value of screening lies in "early detection". When breast cancer is detected in stage zero or stage I, the tumor is small and has not spread, and the treatment options are more diverse, with a cure rate of more than 90%. On the other hand, if you wait until obvious symptoms appear (such as painless lumps, sunken skin, abnormal nipple discharge), the cancer cells may have spread, and treatment will become complicated and the prognosis will be poor.

So, who are the high-risk groups that need to be especially vigilant and screened regularly? First of all, if a mother, sister or daughter has a family history of breast or ovarian cancer, the risk is 2 to 3 times that of the general population. This is followed by those with specific gene mutations (such as BRCA1 or BRCA2). In addition, personal factors also play a key role: early menarche (before the age of 12), late menopause (after the age of 55), not having given birth or having a first child after the age of 30, not breastfeeding, and taking hormone supplements for a long time, all of which will slightly increase the risk. In terms of lifestyle, alcohol consumption, obesity, and lack of exercise are also known risk factors. However, it is important to emphasize that about 75% of breast cancer patients do not have a clear family history, which means that every woman should face up to the importance of breast cancer screening and not take it lightly because no one in her family has the disease. RegularGynecological breast examination, is the first step to taking responsibility for your own health.

Common breast cancer screening methods

Modern medicine offers a variety of breast cancer screening tools, each with its own principles, applicable scenarios, and limitations. Understanding these tools can help us participate more wisely in our own health management.

Breast self-examination

Breast self-examination is the most basic and convenient screening method, and it is recommended to do it one day a month (for example, one week after menstruation, when the breasts are less swollen). The steps include "looking" and "touching": observe the shape of the breasts in front of the mirror, whether there are depressions or orange peel-like changes in the skin, whether there are inverted nipples or abnormal discharge; Then lie flat and use your fingertips (not fingertips) to press on the entire breast and armpits in small circles to feel for any lumps or thickening. The purpose is not to "self-diagnose", but to familiarize yourself with the normal state of your breasts, and seek professional advice immediately if you notice any "new" or "persistent" abnormalitiesinstead of panicking or waiting. It is not a subscenium for any medical imaging test, but it is an important health awareness habit.

Clinical breast examination

This is a professional palpation performed by a doctor such as a family medicine department, surgery, or gynecologist. Doctors will systematically examine the breast and armpit lymph nodes to assess the texture, size, mobility and relationship of any lumps to surrounding tissues. All at onceGynecological breast examinationIt usually includes a consultation to understand personal and family medical history and provide relevant health education. Although its ability to detect tiny tumors is limited, it is an important part of the screening program for experienced physicians to detect changes that may be overlooked by certain imaging tests.

Mammography (mammography)

Mammography is currently internationally recognized as the most effective breast cancer screening tool, especially sensitive to detect microcalcifications (which may be a sign of "carcinoma in situ" in early-stage stage zero breast cancer). During the examination, the technician squashes the breast on the camera board, which causes temporary discomfort or pain, but this compression allows for clearer images and reduces the radiation dose. The possible side effects are minimal, mainly very low dose radiation exposure (about the equivalent of the average person's exposure to background radiation from the natural environment for three months) and discomfort caused by compression. The Hong Kong Department of Health's "Breast Cancer Screening Pilot Programme" provides mammography every two years for women aged 44 to 69 at specific risk. However, their sensitivity to dense breasts (more common in young women) decreases and may require other tests.

Breast ultrasound

Breast ultrasound uses high-frequency sound wave imaging, which is radiation-free and painless, and can clearly distinguish whether the lump is solid or cystular (blister). It is particularly suitable for:

• Women with dense breasts as an auxiliary tool for X-ray photography.
• Evaluate suspicious areas that are touched or found by X-rays.
• The test is the preferred test for young women (such as those under 30 years old) because of their dense breast tissue and relative sensitivity to radiation.

Its advantage is that it can be observed dynamically in real time, but the disadvantage is that it is difficult to detect microcalcifications, and the test results are more dependent on the operator's experience and interpretation.

Magnetic resonance imaging (MRI) of the breast

Breast MRI uses strong magnetic fields and radio waves to produce highly detailed 3D images with high sensitivity. Because of its high cost and long examination time (requiring contrast injection), it is usually not used for routine screening, but for "high-risk groups", such as:

• Those with BRCA1/2 gene mutations.
• Those with a strong family history but not genetic testing.
• Those who have received thoracic radiation therapy for Hodgkin's lymphoma.

For women at high risk, international guidelines often recommend alternating mammography and MRI examinations every year to achieve complementary effects.

Choose the screening method that suits you

No screening method is a one-size-fits-all approach, and the most effective strategy is to "tailor" it to the individual. Age is the primary consideration. The recommendations of Hong Kong and many international organisations are as follows:乳癌檢查

In addition to age, family medical history and personal medical history are even more important. If an immediate family member developed breast or bilateral breast cancer before menopause, or if there are multiple relatives in your family who have breast or ovarian cancer, your risk level may be classified as "high" and you will need a more aggressive and earlier screening program. Individuals with a history of breast dysplasia, breast cancer on one side, or chest exposure to large amounts of radiation are also high-risk groups. Most importantly, proactively discuss with your doctor (family doctor, obstetrician and gynecologist, or breast surgeon) to provide complete personal and family health information and jointly develop a screening schedule and method combination that is unique to you. This personalized plan is the most solid shield against breast cancer.

Interpretation of breast cancer screening results

After completing the screening, it is crucial to properly understand the reported results. A "normal" or "negative" report means that no suspicious signs of malignancy were found during this examination, which is undoubtedly reassuring. But it is not a lifelong "death avoidance gold medal", but a snapshot of breast health representing "at this moment". You will still need to follow up regularly in the future as recommended, as breast cancer can develop between exams (called "interval cancer").

If the report shows "abnormal" or "needs further evaluation," it's important to remain calm. Abnormalities are not equal to cancer. In most cases, abnormal findings may be false positives due to benign cysts, fibroadenomas, breast tissue hyperplasia, or overlapping images. The follow-up steps are usually very clear:

1. Check further: Your doctor may order a "diagnostic mammography" (taking images of a specific area at more angles), a breast ultrasound, or both to get clearer image information.
2. Tissue sampling (sectioning): If imaging tests are still unconclusive, a biopsy is required to obtain a small amount of tissue for examination under a microscope, which is the gold standard for diagnosing breast cancer. The biopsy method includes fine needle aspiration, coarse needle aspiration or surgical section, with increasing trauma in order.
3. Diagnosis and treatment planning: If the pathology report confirms cancer, the medical team will discuss the most suitable treatment plan with you based on the type, stage, hormone receptor status, etc., including surgery, chemotherapy, radiation therapy, targeted therapy, or hormone therapy.

Although the whole process is full of uncertainty and pressure, following medical guidelines step by step is the only way to overcome the disease. All at onceGynecological breast examinationThe process already includes the complete path from screening to diagnosis when necessary.

Myths and truths about breast cancer screening

There are many plausible beliefs about breast cancer screening that may prevent women from taking action. Here are some common myths to clarify:

Myth 1: "I have no family medical history, so it's safe and doesn't need to be tested."
Truth: As mentioned earlier, most people with breast cancer do not have a family history. Aging itself is the most important risk factor. Therefore, all women should be recommended to be screened according to their age.

Myth 2: "Mammography has strong radiation and can cause cancer."
Truth: Modern mammography has a very low radiation dose, and the benefits (early detection of cancer, saving lives) far outweigh its minimal potential risks. The International Agency for Research on Cancer assessment also supports this view.

Myth 3: "Breast ultrasound is better and more advanced than X-ray photography, I just need to do ultrasound."
Truth: The two are complementary tools, not substitutes. Ultrasound is good at looking at "structures" (masses), and X-ray photography is good at looking at "calcified points". For routine screening, especially in women over 40, X-rays remain the cornerstone of detecting early-stage breast cancer. Your doctor will decide whether you need an ultrasound based on your breast tissue type.

Myth 4: "If you do a normal examination, you won't have to do it again for several years."
Truth: Breast cancer can develop at any time. The effectiveness of screening is based on "regular" and "continuous". A single inspection can only reflect the current state, and continuous tracking at recommended intervals (such as once every two years) can form an effective protective net.

Myth 5: "Self-examination is useless because I can't figure it out."
Truth: The purpose of self-examination is not to replace professionalismBreast cancer screening, but to cultivate familiarity with one's own body. When you are familiar with your "normal" state, it is easier to detect any "unusual" changes and seek medical attention in time. it's a healthy habit of empowering yourself.

In the face of breast cancer, knowledge is strength, and action is protection. By understanding the importance of screening, familiarizing yourself with various tools, and collaborating with healthcare professionals to develop a personal plan, every woman can build the most proactive and effective line of defense for their breast health. From today, it will be regularGynecological breast examinationPut it on your life schedule.

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