Mammography for breast cancer detection in Hong Kong.

Breast cancer poses a significant health burden worldwide. It is the most common cancer in women with nearly 1.7 million new cases diagnosed globally in 2012.1 Early detection reduces mortality and mammogram screening has been shown to achieve a mortality reduction of 25% to 28%.2,3 Many countries have a breast screening programme, including the UK, Australia, Norway, Sweden, the US, Singapore, Japan, and Korea. Population screening for breast cancer remains controversial, however, especially the decision on whom, when, and how to screen due to different epidemiological characteristics of breast cancer in different populations. In Hong Kong, the incidence and mortality of Asian female breast cancer is lower compared with the Caucasian population. In the Surveillance and Health Services Research in 2013, the American Cancer Society published a lifetime risk of 1 in 8 for developing invasive female breast cancer,4 similar to the findings of Cancer Research UK in 2010.5 The median age at diagnosis of cancer was 61 years in 2006 to 2010 in these studies. In Hong Kong, breast cancer is the number-one female cancer with 3524 cases of invasive cancer diagnosed in 2013. The lifetime risk of female breast cancer before the age of 75 years was 1 in 17. Breast cancer in Hong Kong occurs at a younger age compared with the western population. The median age at diagnosis of breast cancer was 54 years.6 Due to different tumour characteristics and the overall smaller size and denser fibroglandular tissue of Asian women’s breasts, local epidemiology and clinical studies are important to facilitate our understanding of this common disease in Hong Kong. In this issue of the Hong Kong Medical Journal, studies conducted by Lau et al7 and Chan et al8 in Hong Kong provide valuable local data on this important topic. Lau et al7 compared the surgical outcome and pathology of breast cancer in self-detected and screen-detected women (physical breast examination, mammogram, or ultrasound) in their institute in Hong Kong. Several interesting aspects are raised. First, the screen-detected group had a smaller tumour of an earlier stage and lower grade with less lymph node involvement. This could imply that early detection may result in better prognosis. Hong Kong Med J 2016;22:200–1 DOI: 10.12809/hkmj164916 Kathy CK Wong *1, FHKCR, FHKAM (Radiology), CY Lui 2, FHKCR, FHKAM (Radiology) 1 Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Yaumatei, Hong Kong; 2 Hong Kong Women’s Imaging