Hong Kong Breast Cancer Registry Report No. 15 Press Conference: Mammogram Screening Saves Lives, Saves Treatment Cost

HONG KONG,Sept. 27,2023 --The Hong Kong Breast Cancer Registry (HKBCR),run by the Hong Kong Breast Cancer Foundation Limited (HKBCF),published its 15th annual research report at a press conference today. The Report aims to bring a better understanding of the clinical and economic impacts of breast cancer cases using two different detection methods: self-detection and screening mammography (MMG),which is crucial for healthcare resource allocation and policy-making in Hong Kong.

The study,which utilised local real-life data obtained from the HKBCR,revealed that the average cost of breast cancer treatment per patient was lower by 28.4% with screening MMG-detected method compared with self-detection. This was mainly driven by downstaging of breast cancer and less intensive cancer treatment at the time of diagnosis. Implementation of using screening MMG as a breast cancer detection method in a 100,000-person cohort starting breast screening from the age of 40 saved HK$774.6 million on total cost of treatment in the long run.

In 2020,4,956 women and 32 men were diagnosed with breast cancer and on average about 14 women dies from breast cancer every week. Screening of breast cancer with mammography should be encouraged to remedy the alarming situation.

Dr. Polly CHEUNG,Founder of the HKBCF and Co-chairman of HKBCR Steering Committee,HKBCF,said,"Breast cancer is the most common cancer affecting women in Hong Kong and has the third highest mortality rate among all female cancer deaths. The BCR Report No. 15 findings reflect unsatisfactory breast screening habits in Hong Kong. Among the 19,719 patients who were diagnosed of breast cancer between 2006 and 2018 and recruited in the HKBCR,two-thirds were aged between 40 and 59,with the median age at 52.2. Of the patients aged 40 or above,66.7% had never undergone mammography,while less than a quarter had regular mammography."

During the same period from 2006 to 2018 under analysis,breast cancer detection was 82.3% by self-detection and only 11.1% was detected through MMG screening. Highlighting the low detection rate via screening which is lagging behind with the world trend of breast screening.

To understand the clinical implications and economic impact of self-detection and screening MMG detection method,the Report included a retrospective cohort study into 15,144 eligible participants from the HKBCR diagnosed between 2006 and 2018,who were either self-detected or screening MMG-detected cases,and with no missing data on cancer stage and biological subtype.

Lower stage at diagnosis for screening MMG-detected breast cancer

Among the participants,13,502 were self-detected breast cancer cases and 1,642 were screening MMG-detected. Dr. Lawrence LI,Member of Management Committee and HKBCR Steering Committee,highlighted that the stage at diagnosis of screening MMG-detected breast cancer was lower than that of those self-detected. Nearly 81.5% of screening MMG-detected breast cancer cases were diagnosed at early stages of 0 and I,whereas only about 37% of self-detected breast cancer cases were diagnosed at these two early stages.

A subgroup analysis looked into 6,359 breast cancer patients,with 5,817 self-detected breast cancer cases and 542 screeningMMG-detected. Dr. Li supplemented that the overall 10-year survival was higher in using screening MMG-detected breast cancer patients,with an estimated rate of 95.7%,compared with 88.4% for self-detected breast cancer patients.

Lower average treatment cost for screening MMG-detected cases

Prof. Kelvin TSOI,Member of HKBCR Steering Committee,further explained that the downstaging of breast cancer detected by mammography at the time of diagnosis contributed to a significant lower average treatment cost (28.4%) per patient as compared with self-detected breast cancer. Based on the HKBCR data,the average cost of treatment of each screening MMG-detected breast cancer (HK$361,069) was lower than that of self-detected breast cancer (HK$504,200).

The Report included an additional simulation model study. Comparing the two breast cancer detection methods in a cohort of 100,000 average-risk women aged 40 in the Report,there was an estimation of 5,314 breast cancer cases. The estimated overall cost of treatment in the simulated cohort was HK$2,402.1 million with self-detection method and HK$1,627.5 million with screening MMG detection method. In another words,implementation of screening MMG as detection method saved HK$774.6 million in the cohort in the long run.

Early detection by mammogram screening saves lives,saves treatment cost

Referring to the result of the simulation model study,Dr. Eliza Fok,Chairman of the HKBCF,added that the estimated 10-year mortality from the model was 14.5% with self-detection and 8.9% with screening MMG-detected. Using screening MMG as a breast cancer detection method from the age of 40 saved 27,932 life-years,whilst the benefit decreased to saving 17,723 life-years when deferring the implementation to the age of 50. Apart from saving treatment costs,Dr. Fok stressed that screening MMG also saves lives and improve the quality of life of breast cancer patients. Accordingly,more work should be done to enhance women's awareness of regular check-ups and the effective screening of breast cancer with mammography should be encouraged. She called for the Hong Kong SAR Government to step up the risk-based Breast Cancer Screening Pilot Programme and expressed wishes that a population-wide breast cancer screening be implemented to safeguard women's health; thus building a better and healthier community.

"Early detection saves lives," Dr. Fok reiterated,while urging women aged 40 and above to establish a habit for regular breast screening and take mammogram screening every two years.

Please go to this link for the event press release,slides,bulletins and photos:

https://bit.ly/3ESR35m

About Hong Kong Breast Cancer Foundation

The Hong Kong Breast Cancer Foundation was set up on 8 March 2005,as a non-profit charitable organisation dedicated to mitigating the threat of breast cancer to the local community through education,patient support and research and advocacy. Its mission is to promote breast health awareness,support breast cancer patients on their road to recovery,and advocate breast health education and cancer care in Hong Kong.