Proposal for universal breast cancer screening to find patients at early stages

Thursday, September 24, 2020

A three-phase implementation of the population-wide breast screening programme is proposed by the Hong Kong Breast Cancer Foundation, given that breast cancer is the most common type of cancer found in Hong Kong women. 

With screening, the mortality rate of breast cancer would decrease by 40 percent in overseas examples, the Foundation said today. 

The first stage of the proposal is to provide subsidies to high-risk women, aged 40 or above, for regular breast checking. Women residing in districts with lower household income such as Wong Tai Sin, Kwun Tong and Sham Shui Po should be the second target group for breast screening. 

“Our data showed that by the time the underprivileged go to a doctor, the majority of them are already at stage two or more advanced stage breast cancer,” Eliza Fok Ho Yi-wah, chairman of the HKBCF, said.

The Foundation proposed that the government should, in the end, offer universal breast screening, suggesting that the authorities could cooperate with private clinics to alleviate the medical burden.

Currently, women can detect breast cancer through 2D and 3D mammography, breast ultrasound, and Magnetic Resonance Imaging. 

Professor Winnie Chu Chiu-wing, Professor of Department of Imaging and Interventional Radiology of the Chinese University of Hong Kong, said that the MRI is reserved for high-risk groups while ultrasound and mammography suit women at average risk.

Hong Kong Breast Cancer Registry comprised the data of over 17,000 local breast cancer patients since 2006, finding that using 2D mammography alone had an accuracy of 85.2 percent, and when performed with breast ultrasound, the detection accuracy rose to 94.3 percent.

Chairman of the HKBCF Breast Health Centre Advisory Committee, Dr.Hung Wai-ka, said the two tests complement each other as mammography can detect earlier stages of breast cancer, while ultrasound can detect the cancer when tumors are fully developed. 

Hung also noted that 2D mammography would have a higher accuracy in older patients, given that their breasts are more fatty and less dense when compared to their younger counterparts.

Chu said that patients can opt for 3D mammography as it has a higher detection rate than 2D mammography, with an increase of 2.7 cancer cases detected per 1,000 patients. “3D mammography can take multiple images of breast tissues from different angles and thus, produce a more accurate screening result.”

HKBCF suggested that women aged 40 or above should have their breasts checked every two years, as breast cancer cases increase at that age.