[Breast Cancer] Found a lump in the breast? Understanding 5 types of tumours and why breast screening matters.

Breast cancer is the critical illness women are most likely to face, and many people keep a very close watch on whether there are any lumps in their breasts. In fact, 80% to 90% of women worldwide have experienced breast lumps, pain or enlargement; pain may be caused by hormones, caffeine and other factors, and among younger patients, most lumps are benign. Nevertheless, to prevent problems before they arise, breast screening is very important.

Research has found that among women aged 20 to 50, about 70% of breast lumps are benign; after the age of 50, lumps are more likely to be malignant. In 2019, the median age at diagnosis for breast cancer patients was 58.

Benign breast conditions can be divided into three major categories: non-proliferative, proliferative and atypical proliferative. The first two are the most common, while fewer than 10% of patients have the latter, which falls into the category that increases the risk of cancer.

The most common benign breast tumours in women include fibroadenoma, cyst, fibrocystic change, atypical hyperplasia and intraduct papilloma.

Both atypical hyperplasia and intraduct papilloma may develop into malignant tumours. Around 20% to 30% of patients may develop carcinoma in situ after a few years; if left untreated, it may gradually progress to invasive breast cancer.

In fact, breast cancer undoubtedly shows a trend towards affecting younger people and increasing in incidence. The youngest patient I have encountered was only 23 years old. However, regular screening can enable early detection of atypical hyperplasia. After surgical removal, this can prevent it from developing into breast cancer and avoid a long treatment course, while also reducing the mortality rate.

Common breast cancer screening methods include mammography, breast ultrasound and breast self-examination. Mammography can examine the structure of breast tissue, such as calcifications and lumps, as well as detect abnormalities deep within the breast tissue.

Studies have found that mammography is the only screening method proven to reduce breast cancer mortality. Other screening methods, such as breast self-examination or breast ultrasound, cannot reduce breast cancer mortality. If the mammography results are abnormal, further biopsy is required to extract cells and determine whether the findings are benign or malignant.

As for the age at which screening should begin and the interval between screenings, appropriate recommendations should be made based on a woman’s risk level, as well as the benefits and side effects of screening. If there is no first-degree relative with a history of breast cancer or ovarian cancer, women at average risk of breast cancer should generally undergo a mammogram every two years starting in their forties.

If diagnosed with breast cancer, patients should not be overly worried. With appropriate treatment, the 5-year survival rate for patients in stages 1 to 2 can reach 90%, and cure rates are also improving. Even some stage 4 patients have survived for more than 10 years.

Specialist in Surgery
Dr Kong Wai-chung 

References:
 

1. Hartmann, Lynn C., et al. "Benign breast disease and the risk of breast cancer." New England Journal of Medicine 353.3 (2005): 229-237.
2. US Preventive Services Task Force. Screening for Breast Cancer: US Preventive Services Task Force recommendation statement. Ann Intern Med 2016; 164:279.

This English version of this article has been generated by machine translation powered by AI. It is provided solely for reference purposes. In the event of any discrepancy or inconsistency between this translation and the original Chinese version, the Chinese version shall prevail.