Breast Cancer Symptoms and Screening Options in Hong Kong

This October we are very proud to be supporting Breast Cancer Awareness Month. In Hong Kong, breast cancer is the number one cancer affecting women and the number three most frequent cancer affecting both men and women, alongside colon (one), lung (two), prostate (four), and liver cancer (five). Furthermore, in comparison to a decade ago breast cancer has shown a substantial rise due to the aging and growing population in Hong Kong.
 
Breast cancer prevention is very important and includes monitoring or changing your lifestyle choices on a daily basis including diet, alcohol consumption, exercise, and maintaining a healthy weight. Other measures include genetic testing and becoming accustomed to self-examination of your breasts which can also help prevent and detect breast cancer. In addition, seek information on breast cancer screening and start discussing when to begin breast exams and mammograms with your doctor early on.
 
 

Breast cancer statistics in Hong Kong

Breast cancer has become the most common cancer affecting women since 1993, it has tripled in incidence rate, and is considered the third leading cause of death for women in Hong Kong after lung and colon cancer.
 
Alarmingly, it is estimated that 10 women are diagnosed with breast cancer every day and has accounted for 26.1% of all new cancers in females diagnosed in Hong Kong in 2015.
 
The age-standardized incidence rate of female breast cancer had an upward trend between 1983 and 2015. The older in age a woman is the higher the risk of breast cancer she has. The median age of breast cancer patients is 56 in Hong Kong, parallel to this, 55% of the women diagnosed were 40-59 in age (compared with age 62 in the US and age 60 in Australia).
 
 

What are the signs and symptoms of Breast cancer?

The most common signs and symptoms of breast cancer according to obstetrician gynecologist Dr. Selina Pang 彭敏華醫生 may include:
  • A breast lump or irregularity that is different from the surrounding tissues around the breast.
  • A change in size, shape, or appearance of the breast.
  • Change in skin texture of the breast or around the nipple, for example, red, scaling, peeling, flaking, dimpling, or pigmented discoloration.
  • A rash around the nipple or discharge from one or both nipples.
  • A newly inverted nipple.
  • An “orange-skin” appearance.
  • New lump or thickening in the armpit.
 
If you notice a change in your breasts such as lumps or other unusual signs, talk to your doctor promptly.
 
 

How often should I self-exam my breasts and be screened?

Several countries recommend visiting your physician on an annual basis. In Hong Kong, unlike a lot of comparable countries, the public health system does not have a set of recommendations for when various populations should undergo screening tests specifically among local women who are asymptomatic or at average risk. This is due to lack of research and data currently available.
 
Below are the recommendations from the Hong Kong Breast Cancer Foundation on screening tests: 
  • Self-examination for women age 20-40+ must be done every month.
  • Clinical examination should be done every 3 years for ages 20-39 and every 2 years for 40 and over.
  • Women aged 40 and over should go for mammography screening once every 2 years (while other organizations recommend this to be every year).
 
 

Where and how to be screened in Hong Kong?

If you reside in Hong Kong you must access body checks in private clinic settings. Note that the private sector is not standardized in Hong Kong and that packages, costs, and user experience vary greatly depending on the provider. You can also visit non-private options such as the Hospital Authority, HKBCF, and Family Health Service.
 
As explained by obstetrician gynecologist Dr. Selina Pang 彭敏華醫生, the methods of breast screening include self-examination, gynecologic annual check-ups, mammograms, MRI and ultrasound scanning, as well as, genetic testing:
  • Self-examination can promote breast awareness which can help bring an understanding to the normal changes the breasts undergo and may help to identify any unusual signs or symptoms that can happen gradually.
  • Mammography has been the standard screening modality for women at increased risk of breast cancer, and women aged 40 and over.
  • MRIs are common for younger women and those with a genetic predisposition to breast cancer.
  • Ultrasound is used as an adjunct to mammography in women with radiologically dense breasts and has the potential of depicting breast cancers not seen on mammography. Ultrasound is relatively inexpensive, well tolerated, more widely available than MRI.
 
 

How much does breast cancer treatment cost in Hong Kong?

Public fees and non-profit organization fees
The Breast Health Center is a non-profit organization which is run by HKBCF the center offers screening services including mammograms and ultrasounds, you can find price details here.
 
The Family Health Service, Department of Health offer Women’s Health Services including screenings, examinations, education, and counseling. For an eligible person, there is an annual fee of HK$310 and each mammography screening costs HK$225, for a non-eligible person there is an annual fee of HK$850 and each screening fee costs HK$510. Find more information here
 
The Hospital Authority offers services at the Well Women Clinic at Tung Wah Eastern Hospital; 2D mammography is listed at HK$800, 3D mammography is HK$1,800, and breast ultrasound is HK$800, find more information here.
 
Private fees
According to WeCareBill Foundation, a Hong Kong-based charity that promotes patient price transparency, baseline major surgery costs (main part of breast removed with lymph node) are between HK$80,000 and HK$120,000 with most expensive private hospitals and medical doctors charging as high as HK$250,000-300,000 for semi private room.
 
WeCareBill strongly advises to prepare for implant surgery (even though the surgery may not look like needing implants) as the stand-by preparation fees are less expensive than having to pay for a second operation. Baseline implant costs are between HK$30,000 and HK$50,000. The necessity of breast implants can be decided by the doctor during the operation.
 
As for chemotherapy treatment, it can reach HK$700,000 in Hong Kong’s most expensive private hospitals. Some day cancer treatment centers charge HK$30,000-35,000 per cycle. 
 
It is very important to keep in mind that in Hong Kong, private medical fees are not subject to regulation or standardization. 
 
 

Does insurance cover breast cancer screening and treatment?

According to our health insurance partner and healthcare expert AD MediLink, many insurers in Hong Kong cover cancer diagnosis and treatment. Oncological benefits vary greatly between insurers and finding a plan that covers you 100% with no financial limits or time limits is of the outmost importance when being treated in private sector in Hong Kong.
 
Also note that if you have if you were diagnosed with cancer in the past, some insurers may consider this a pre-existing condition and refuse to pay for its care.
 
 
Sources cited:
 
 
Clinical information reviewed on 22 October 2018 by Doctor Selina Pang 彭敏華醫生, a Specialist in Obstetrics and Gynecology practicing at Hong Kong Health Practice in Central. Dr. Pang completed her obstetrics and gynecology training at the Prince of Wales Hospital, Hong Kong. She received her specialization qualification from the Royal College of Obstetricians and Gynaecologists in the U.K. She is currently Consultant Obstetrician and Gynecologist at the Hong Kong Adventist Hospital.
This article was independently written by Healthy Matters and not sponsored. It is informative only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.