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Preventing & Screening for Breast Cancer — What’s Special for Chinese Women?

"Breast cancer is a major killer of female tumors worldwide, both in terms of the number of cases and the number of deaths. In the United States, over the age of 60 is the peak incidence of breast cancer, and the age of Chinese women who have breast cancer is at least 10 years earlier than that in western countries! Ma Jing Shared three aspects of breast cancer which are diagnosis, detection and prevention.

MA Jing, Director, China Center, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute

"Preventing & Screening for Breast Cancer — What’s Special for Chinese Women?"

Prevention: High Mortality from Breast Cancer due to Late Detection

From the perspective of clinical diagnosis and staging of breast cancer, compared with the United Kingdom and the United States, stage 1 breast cancer is relatively less diagnosed in China and most of the diagnoses are in stage 2. In general, in comparison with the western developed countries where screening is common, the clinical staging of breast cancer in China has quite a small number of women who are already in the middle and late stage at the time of detection.

Statistically, breast cancer is a problem for women globally and a major problem for women in Asian countries. The incidence and mortality of breast cancer among women in China and other Asian countries has been on the rise, possibly due to late detection and the lack of effective and organized screening methods.

Detection: Chinese Breast Cancer Screening Still Needs an Innovative Path

Early diagnosis and treatment of breast cancer can not only avoid unnecessary treatment and medical expenses, but also better improve the survival rate.

At present, there are many diagnostic methods for breast cancer, such as clinical manual examination, ultrasound, examination, X-ray molybdenum target, as well as NMR and so on. Recently, western countries have said that it is not recommended to use clinical manual examination. In fact, studies in underdeveloped regions and countries have shown that clinical examination and self-examination is still a worthwhile and cost-effective method, especially in the vast rural areas where resources are lacking.

From the perspective of the diagnosis methods of breast cancer, ultrasound examination is widely promoted in China, but it is greatly affected by the technical level of operators. Although X-ray molybdenum target is advocated as a standardized screening method in developed countries, it is not very ideal for the examination of dense breasts which is common among Asian women. Nuclear magnetic resonance (NMR) is a clear and sensitive method, but the high cost of the method may affect its wide application, and innovative ways to use it are still needed.

Prevention: Menstruation, Fertility, Feeding, etc. All Have an Impact

In the United States, the American Cancer Foundation recommends screening for breast cancer from the age of 45 and do it once a year. Canada and Japan recommend regular examinations for people over the age of 50, which should be checked once every two years, while the UK recommends checking every three years.

In addition, menstruation is also a factor affecting breast cancer, as well as fertility history, the number of children one has, at what age to give birth, or does not give birth at all. There is also breastfeeding, and the more you breastfeed, the lower the risk in having breast cancer. Therefore, everyone is encouraged to breastfeed.

Finally, we should pay attention to the screening of both cancers, not only at the national level, but also at the family level to understand that early diagnosis and early treatment are beneficial to the family and the society.

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