Breast cancer is the most common cancer among women in Hong Kong, with incidence continuing to rise and a trend toward younger age at diagnosis. It develops in breast tissue, and although it mainly affects women, a very small number of men are also affected. Breast cancer is a prime example of a cancer with a high cure rate when detected early—long-term survival for stage I breast cancer is very high, making screening and self-awareness critically important.
Modern breast cancer treatment has entered a precision era of "treating by subtype": different molecular subtypes of breast cancer require completely different drug strategies, and treatment outcomes have improved dramatically compared with the past.
Causes and Risk Factors
Breast cancer risk factors are related to the duration of exposure to female hormones: early menarche, late menopause, never having given birth or giving birth later in life, and never having breastfed all slightly increase risk. Other factors include: increasing age, obesity (especially after menopause), lack of exercise, alcohol consumption, and long-term use of hormone replacement therapy.
Genetic factors account for a portion of cases: having a first-degree relative (mother, sister) with breast cancer increases risk; those with BRCA1/BRCA2 gene mutations have a significantly higher lifetime risk, and such individuals may consider genetic testing and enhanced surveillance. However, it is important to note that most breast cancer patients actually have no family history—having no family history does not mean zero risk.
Common Symptoms and Warning Signs
The most common presentation of breast cancer is a painless lump in the breast. Other warning signs include: dimpling or orange-peel appearance of the breast skin, nipple retraction or abnormal discharge (especially bloody), change in breast shape, swollen lymph nodes in the armpit, and persistent redness or ulceration of the breast skin.
Women are advised to perform a self-examination once a month to become familiar with the normal state of their breasts, so that changes can be detected early. Finding a lump is not necessarily cause for panic—most breast lumps are benign fibroadenomas or cysts—but you should seek medical attention promptly to clarify with ultrasound or imaging.
Diagnostic Methods and Staging Concepts
Mammography is an internationally recognized breast cancer screening tool that can detect small tumors that cannot be felt; Asian women tend to have denser breast tissue, so ultrasound is often needed in combination. After a suspicious lesion is found, a fine-needle or core-needle biopsy is performed to confirm the diagnosis, and biomarkers such as hormone receptors (ER/PR), HER2, and Ki-67 are tested at the same time.
Staging ranges from stage 0 (carcinoma in situ) to stage IV (distant metastasis). "Molecular subtyping" is just as important as staging: hormone receptor-positive, HER2-positive, and triple-negative breast cancer have completely different treatment pathways and prognoses—this is the foundation of personalized breast cancer treatment.
Overview of Treatment Options
Surgery is the cornerstone of treatment for early breast cancer, including breast-conserving surgery (with postoperative radiotherapy) or total mastectomy, with immediate reconstruction possible depending on the situation. Preoperative chemotherapy (neoadjuvant therapy) can shrink the tumor and increase the chance of breast conservation, with particular benefit for triple-negative and HER2-positive patients.
Drug treatment depends on the subtype: hormone receptor-positive types are primarily treated with hormone therapy (such as tamoxifen, aromatase inhibitors), which may be combined with CDK4/6 inhibitors; HER2-positive types have anti-HER2 targeted drugs (such as trastuzumab) and ADC drugs; triple-negative breast cancer is mainly treated with chemotherapy, and in recent years immunotherapy and ADC drugs have brought new breakthroughs. Genetic testing (such as BRCA) may also open up options such as PARP inhibitors.
Clinical Trials: One More Treatment Option
Breast cancer is one of the cancer types with the largest number of clinical trials worldwide, with new ADC drugs, oral targeted therapies, and immunotherapy combination regimens constantly emerging. Participating in a clinical trial is not a last resort—it is an opportunity to access tomorrow's standard treatments early.
The CancerLink platform can screen for breast cancer clinical studies recruiting in Hong Kong based on cancer type, stage, and genetic mutations. Once successfully matched and enrolled, study-related treatment costs are fully covered. Whether you have just been diagnosed or have hit a treatment plateau, it is worth checking whether there is a suitable trial for you.
To every woman: regular screening and knowing your own body are the two most powerful things you can do against breast cancer. If you are unfortunately diagnosed, remember that breast cancer is one of the cancers with the richest arsenal of treatments—subtyping, staging, and genetic testing will piece together a clear treatment map for you.