Hong-Kong Breast cancer Foundation: Analysis of the latest data collected by the Hong Kong Breast Cancer Registry (HKBCR) shows that low-skilled workers, widowed patients, or those who have a history of benign breast conditions, such as fibroadenoma, are vulnerable because they tend to delay seeking medical attention even with the onset of symptoms. More about breast cancer.
One-third of patients delayed seeking medical consultation
To assess the magnitude of delay in seeking medical care from the onset of symptom(s), as well as the factors associated with such delay, HKBCR analysed the data of 2,242 symptomatic patients who had already completed treatment for breast cancer.
In this analysis, consistent with similar studies overseas, “total delay” encompasses (1) “self delay”, i.e. patients’ delay in seeking first medical consultation after the onset of symptoms and (2) “care delay”, i.e. medical systems’ delay in diagnosis or/and treatment.
HKBCR’s finding shows that there was no significant “care delay” but, in contrast, “self delay” was more common: Approximately one-third of patients took more than three months to consult a doctor after the onset of symptoms.
Dr Yau Tsz-kok, member of the HKBCR Steering Committee, expressed concern over the alarming findings on “self delay”, “Delay in seeking first medical attention has significant negative impact on the disease – those who delayed for three or more months are 50% more likely to have larger tumours at diagnosis which are 30% more likely to be node-positive, thus the tumours are 70% more likely to be diagnosed as stage III to IV cancer. The clinical and financial implications point to a bigger, unresolved public health problem in Hong Kong,” says Dr Yau.
Three factors, namely occupation, marital status, and having a history of benign breast conditions, were found to be strongly associated with delays in seeking medical attention. Non-clerical (low-skilled) or labourers were found to be about 60% more likely to delay seeking medical attention than those who were unemployed; patients who were widowed were nearly 240% more likely to delay than those who were unmarried; and patients with previous benign breast conditions had an almost 50% higher tendency to delay.
The most comprehensive report on 12,345 local breast cancer cases
The findings on delay in seeking medical care are released in the Hong Kong Breast
Cancer Foundation (HKBCF)’s sixth “Hong Kong Breast Cancer Registry Report” (HKBCR
Report No. 6) today. The report presents the statistics of 12,345 breast cancer patients in
Hong Kong, and the subsequent analysis derived from there. This figure constitutes about
40% of breast cancer cases recorded1.
Dr Polly Cheung, Chairman of the HKBCR Steering Committee, pointed out key figures
of the HKBCR Report No. 6:
1) the majority of patients (70%) were diagnosed at the age
40-59, with a median of 50 and
2) the following factors continued to be the top three risk
factors for breast cancer: ‘lack of physical exercise’, ‘no breastfeeding experience’ and ‘high
level of stress’.
“According to HKBCR Report No. 6, around 85% of the patients accidentally detected their
breast cancer, mostly prompted by feeling a painless mass in the breast.
The statistics also
highlighted the prevalence of stage II breast cancer at diagnosis (40%), a figure which
differs from the stage distribution at diagnosis in western countries such as Canada (where
population-based breast screening programmes are implemented).
In countries such as
Canada, stage 0 to I breast cancer prevail. It is noteworthy that the larger the tumour size,
the higher the chance of positive nodes, and, consequently, the higher the need for more
complicated and intrusive treatment, including mastectomy,” said Dr. Cheung.
Speaking at the press conference today, Dr Cheung said, “The latest HKBCR statistics
indicate that regular breast screening helps detect breast cancer at an earlier stage. Early
detection saves lives. On the other hand, we note the position of Department of Health and
the Cancer Expert Working Group that currently there is insufficient local evidence to recommend for or against population-based mammography screening for women in Hong Kong. Women should be aware of breast changes and visit doctors promptly if symptoms appear.”
The real cost of delay
Cancer death is now the most common cause of death in our population, more than heart attack or stroke. Breast cancer is the number one cancer affecting women in Hong Kong where the number of cases has tripled since 1993. Breast cancer also accounts for 26% of all cancers in women. Nine new cases are diagnosed each day. In 2011, 552 women died of breast cancer in Hong Kong, making it the third cause of cancer deaths among women that year.
Mrs Eliza Fok, Chairman of the HKBCF said, “Each year, the HKBCF will lend support to about 800 patients and their family members through our Breast Cancer Support Centre and serve around 6,000 persons through our Breast Health Centre. The groups which are significantly associated with delay in seeking medical help are observed to have lower breast health awareness and are ignorant of breast cancer symptoms.”
“Breast cancer is curable if detected early. So be diligent and mindful about breast health. Take notice of any change in our breasts and seek medical advice as soon as possible should you detect any symptoms that persist. Do not easily dismiss symptoms as infections or allergies. They could be signs of breast cancer,” Mrs Fok said.
Take action, prevent delay
While breast cancer may not be preventable, delay is. The HKBCF renews its call for more resources to be devoted to community-wide breast health education, which should emphasize breast cancer symptoms and the need to seek medical advice if unusual changes in the breast persist for a month or more.