Breast Cancer Risk Assessment Tool

Preamble

Breast cancer is the most common cancer among women in Hong Kong. The average lifetime risk for a woman in Hong Kong to develop invasive breast cancer is about 6.8%, meaning that roughly 1 out of 14 women will be diagnosed with invasive breast cancer. However, this figure does not mean that your personal risk is 6.8%. Personalised breast cancer risk assessment tool can provide information on your personal risk which can help you to work with your doctor in making an informed decision for screening and prevention.

The Government of the Hong Kong Special Administrative Region commissioned the School of Public Health of The University of Hong Kong (HKU) to conduct the Hong Kong Breast Cancer Study (HKBCS) and analysed local data that form the basis for developing the Breast Cancer Risk Assessment Tool. The tool aims to estimate the risk of a local Chinese woman in developing breast cancer and has been validated for Hong Kong Chinese female population.

In light of the findings of the HKBCS and available evidence, the Cancer Expert Working Group on Cancer Prevention and Screening (CEWG) under the Cancer Coordinating Committee revised its recommendations on breast cancer screening for other women at general population (please refer to ensuing paragraphs for details). Women aged 44-69 years with certain combinations of personalised risk factors putting them at increased risk of breast cancer are recommended to consider mammography screening every two years. A risk assessment tool for local women (e.g. one developed by HKU) is recommended to be used for estimating the risk of developing breast cancer with regard to the personalised risk factors including age of menarche, age of first live birth, presence of history of breast cancer among first-degree relative (mother, sister or daughter), prior diagnosis of benign breast disease, body mass index (BMI) and level of physical activity.

It is important to note that this assessment tool cannot accurately estimate breast cancer risk for women classified by CEWG at high or moderate risk for breast cancer. The CEWG’s breast cancer screening recommendations are as follows:

*Women at high risk (i.e. with any one of the following risk factors) are recommended to seek advice from doctors and have mammography screening every year -

• carriers of germline mutation which linked to breast cancer e.g. BRCA1/2 deleterious mutations;
• certain strong family history of breast or ovarian cancer (e.g. any first-degree female relative is a confirmed carrier of BRCA1/2 deleterious mutations, any first- or second-degree female relative with both breast and ovarian cancer, etc.);
• history of radiation therapy to chest for treatment between the age of 10 and 30 (e.g. Hodgkin’s disease); or
• previous history of invasive or in situ breast cancer; invasive lobular carcinoma; atypical ductal hyperplasia or atypical lobular hyperplasia.

*Women at moderate risk (i.e. with any one of the following risk factors) are recommended to have mammography screening every two years and should discuss with their doctors the potential benefits and harms of breast cancer screening -

• family history of only one first-degree female relative with breast cancer diagnosed at or before the age of 50; or
• two first-degree female relatives diagnosed with breast cancer after the age of 50.

For details of the local definition of high risk and moderate risk, please click here.

Besides, it should be highlighted that this assessment tool is not used for diagnosis of breast cancer. If you have signs or symptoms of breast cancer such as breast lump, change in the size or shape of the breast, change in skin texture of the breast or nipple, rash around, in-drawing or discharge from the nipple, new and persistent discomfort or pain in the breast or armpit, etc., please consult your doctor immediately.

While the assessment tool is designed for estimating individual risk of developing breast cancer, it cannot differentiate exactly which women who underwent assessment will develop breast cancer. In a word, even if the assessment tool identifies that a woman has a higher risk than the average population, the result does not necessarily mean that she will develop breast cancer eventually. By the same token, if a woman is assessed to have a lower risk than the average population, she should still be breast aware and adopt a healthy lifestyle. For any enquiries on the assessment result, please consult your family doctor.

Disclaimer

This Breast Cancer Risk Assessment Tool is intended to provide women aged 44-69 with information for better understanding of their risk of developing breast cancer with regard to the personalised risk factors described above. It cannot be considered as medical diagnosis or medical consultation. For any enquiries on the assessment result, please consult your family doctor.

Please note that your options and name, if filled, will not be recorded/stored in any form in the assessment tool.

The Department of Health makes no representation or warranty as to the accuracy, completeness or reliability of the information contained in this Breast Cancer Risk Assessment Tool or the appropriateness of such information for any particular purpose.