Breast cancer is the most common cancer in women. According to a report from GLOBOCAN (Global Cancer Registry), there was 21,555 new cases of breast cancer in Vietnam, accounting for 25.8% of all cancer cases in women in 2020. In which, the mortality rate was 7.6 % (9,345 cases), just ranking below liver cancer, lung cancer and stomach cancer.

What is Breast Cancer?

Breast cancer is the common type of cancer in women, which is the uncontrolled growth of breast cells, thereby creating malignant tumors, capable of spreading to distant areas.

Normally, mammary gland cells are formed and die under a certain way. This mechanism ensures the number of breast cells is always at an adequate level, balancing between new cells and dead cells.

However, the appearance of gene mutations together with special conditions can go through the body’s immune control, mammary gland cells will be produced continuously, the production rate of cells becomes several times higher than their death rate, leading to loss of control. As a result, tumors are formed. These tumors can be benign or malignant – breast cancer.

Breast cancer gene test is one of the new methods to help detect the genetic risk of breast cancer, thereby taking early measures of prevention.

How dangerous is breast cancer?

Many people often overlook this disease, in fact, it is as dangerous as other cancers. Every year, there are about 2 million new cases of breast cancer, the number of deaths from this disease is up to 600,000 people around the world.

Specifically, according to statistics from GLOBOCAN, in 2018, our country had nearly 165,000 new cancer cases, including 15,000 breast cancer cases, accounting for 9.2%. The number of deaths from breast cancer was about 6,000 cases in 2018.

The danger of breast cancer is reflected not only in the high mortality rate, high number of cases, but also in the rapid increase year by year.

According to statistics from GLOBOCAN, in 2020, Vietnam has nearly 182,563 new cancer cases, of which breast cancer is 21,555, accounting for 11.8%. Also in 2020, our country recorded 9,345 deaths from this disease.

About 1 in 10 breast cancers are hereditary, and one of the early detection methods is breast cancer genetic test.

The gene mutations that make the mammary gland cells produce uncontrollably lead to breast cancer. There are many reasons why the body appears gene mutations forming breast cancer, specifically as follows:

• Hereditary breast cancer. The hereditary rate of this disease accounts for 5 – 7%. If you have a family member with breast cancer, you should get tested for breast cancer because there is a high rate of inheritance among family members.
• The “toxic” agents from the surrounding environment such as fine dust, chemicals, ultraviolet rays, X-rays, microorganisms, etc. increase the risk of breast cancer. During gene replication, these “toxic” agents can make genes prone to breakage, creating conditions for genetic mutations.
• An unhealthy lifestyle can promote the development of breast cancer. In particular, if you drink a lot of alcohol, smoke regularly, overweight, be sedentary, …causing an increase of estrogen, thus growing the risk of breast cancer. Because mammary gland cells rely on the hormone estrogen, so an increase of estrogen will lead to the risk of breast cancer.
• Early menarche, late menopause, or a history of breast-related diseases can cause breast cancer.
• Weak immune system also lead to breast cancer. In order to appear a gene mutation, it must pass the body’s immune system. Therefore, if the immune system is weak, the risk of breast cancer will be higher than the ones with a strong immune system.

Blood test for cancer genes is a new method. However, at present, tumor gene identification is being used more for cancer treatment than cancer screening and diagnosis.

According to experts, blood test for breast cancer contribute to look for cancer markers – special proteins produced by cancer cells or hormones, which cannot fully detect the nature of breast cancer. The index can give false positive results because there are substances similar to the tumor in the blood.

If the breast cancer blood test is to determine whether cancer is present, the test should be repeated after a period of 3 to 6 months to compare whether the index has increased over time.

Breast cancer testing helps to detect the disease as early as possible for the best treatment measures. The demand for breast cancer testing is increasing, so there are many testing units. To ensure the accuracy of test results, time saving, and reasonable service fees, we should go to large hospitals that specialize in oncology, you can refer to:

K Central Hospital

Currently, K hospital has 3 facilities, but facilities 1 and 3 have regular examination schedules and the most sufficient equipment system.

Address of branch 1 (K1): No. 9A – 9B Phan Chu Trinh, Hoan Kiem, Hanoi.

Address of branch 3 (K3): No. 30 Cau Buu Street, Tan Trieu, Thanh Tri, Hanoi

Time: Monday – Saturday: 7:30 am – 5:00 pm (Saturday only on request).

Hospital K is the leading central-level hospital for oncology. The breast cancer test package here costs about 2.5 million VND.

Hanoi Oncology Hospital

Address: 42A Thanh Nhan, Hai Ba Trung, Hanoi

Time: Monday – Friday: Morning: 6:30 – 12:00; afternoon: 13h00 – 17h00

Saturday: 7:30 a.m. – 12:00 p.m. (on-demand examination)

Hanoi Oncology Hospital is Hanoi’s specialized oncology hospital. This is one of the leading reputable breast cancer testing sites, preferred by many people.

The price of the breast cancer screening package is about 1.7 million VND, including: clinical examination by a specialist; urine test; blood test, x-ray – ultrasound of the breast.

HCM City Oncology Hospital

Address 1: No. 3 No Trang Long, Ward 7, Binh Thanh District, HCM City.

Address 2: No. 12, Street 400, Quarter 3, Tam Phu Ward, Thu Duc City, HCM City.

Working time: Monday – Friday, from 7:30 to 16:30.

This is the leading hospital for cancer examination and treatment in the southern provinces. Therefore, Oncology Ho Chi Minh City is a hospital of screening breast cancer , which is chosen by many women.

Many people wonder about the breast cancer testing proces. According to the latest recommendations of the NCCN Guidelines (National comprehensive cancer Network), here are some steps:

Clinical examination

The doctor will ask about specific information such as your age, health status, menstrual cycle, current symptoms or personal and family medical history, etc. to assess the risk of disease. After that, a clinical examination will be performed to detect signs and symptoms of the disease.

Mammography

Mammography (or mammography) is a medical technique that uses X-rays to screen for breast cancer and other problems. The image after the procedure is called a mammogram (an x-ray image of a tumor in the breast).

Breast cancer testing with ultrasound

Ultrasound breast cancer test uses high-frequency ultrasound waves to detect abnormalities in the breast or the area around the breast. Ultrasound technology creates the images exposing deep lesions located in the breast tissue that cannot be detected by conventional clinical examination.

Breast cancer testing by CT scan, MRI scan

CT (computed tomography) and MRI (magnetic resonance imaging) are cancer screening techniques through high- precision imaging. The doctor relies on the images on the computer to make conclusions.

This method gives high resolution, clear quality images that help doctors evaluate the lesions in detail for an accurate diagnosis, suitable for women with dense breast tissue or are at high risk of breast cancer.

Breast cancer biopsy

This method uses a small tissue sample from the breast to be examined under a microscope to detect breast cancer. This method is usually only used after X-ray, ultrasound but does not give results.

Breast cancer gene test

The test is used to detect hereditary breast cancer gene mutations such as BRCA1 and BRCA2. Gene test plays a very important role in early screening and risk assessment of breast cancer.

Breast cancer test for women over the age of 40 should be done about every 6 months. Test results are usually returned in 2 to 3 weeks.

After about 2-3 weeks, the returned results can have the following 3 outcomes:

Positive result

This means that one of the two mutant genes was found, BRCA1, BRCA2, or both.

The average lifetime risk of breast cancer for a woman is about 12%. Women with a BRCA1 or BRCA2 mutation have a 72 percent risk of developing breast cancer over their lifetime – six times that of women without the mutation.

The lifetime risk of ovarian cancer also increases significantly: from 17% to 44%, compared with less than 2% in the general population. Men with a BRCA gene mutation have a higher lifetime risk of developing breast cancer, especially when the BRCA2 gene is mutated.

One study found that men with a BRCA2 mutation had about a 7% lifetime risk of developing breast cancer, and they also had an increased risk of prostate cancer.

Negative result

If you have a family history of breast cancer gene mutations but you test negative, you have a 12%-13% lifetime risk of developing breast cancer, which is the average rate of breast cancer in the general population.

A negative cancer gene mutation test means that you cannot pass the cancer-causing gene abnormality in your family to the next generation.

The result is VUS (Variant Uncertain Significant)

Sometimes, genetic results can’t definitively answer whether you are at increased risk for breast cancer or other types of cancer. Your results could be:

• Not enough information to conclude: If you have a clear family history of breast or ovarian cancer, but you have a negative gene test, your chance of inheriting another genetic mutation has not been studied. If you test negative for a gene mutation, but no one in your family has had breast cancer, it could mean that you inherit an unidentified mutation.
• Inconclusive or variant uncertain mutation: Sometimes genetic test can find an abnormality or mutation in a gene that researchers have not yet concluded is linked to an increased risk of breast cancer or not. This mutation can be identified whether it ralates to risk of cancer if more of your family members also conduct genetic cancer test. You can stay in touch with your genetic counselor to stay updated for more information about your uncertain mutation.

Note: The result of the BRCA gene test is indicative of risk. If the result is positive, it does not mean that the cancer spreads immediately. If it is negative, it does not mean that you do not get cancer. The factors such as a person’s physical condition and family history will affect an individual’s risk of developing the disease.

Regardless of whether you have had breast cancer or not, having a BRCA mutation after testing for a breast cancer gene increases your risk of developing breast or ovarian cancer in the future. There are some ways to reduce your risk of cancer:

Breast cancer prevention surgery – removal of both breasts – can reduce the risk of breast cancer by about 90%. When a person with an hereditary cancer mutation is first diagnosed with breast cancer, the risk of new breast cancer increases by about 3% per year or 15% after 5 years. While a person without a BRCA1 or BRCA2 mutation is diagnosed with breast cancer for the first time, the risk of developing the cancer is only about 1% per year.

Surgical removal of the ovaries – removal of both ovaries and fallopian tubes – can reduce the risk of breast cancer by 50% if performed before menopause because it gets the body’s main source of the hormone estrogen. This surgery can greatly decrease the risk of ovarian cancer. The time of this surgery also depends on whether the person carries the BRCA1 or BRCA2 gene mutation. For people with a BRCA1 gene mutation, the recommended age for oophorectomy is 35 to 40 years old. For people with a BRCA2 mutation, the age is considered to be 40 to 45 years old.

Hormone therapy: consisting of two selective estrogen receptor modulators (SERMs) and two aromatase inhibitors, which may help reduce the risk of developing hormone receptor-positive breast cancer.

• Tamoxifen
• Evista
• Aromasin
• Arimidex

However, hormone therapy does not reduce the risk of hormone receptor-negative breast cancer.

The use of the drug goes hand in hand with unwanted side effects. Therefore, when having indications for treatment of these drugs, patients should consult their doctor for instructions on the appropriate use of the drug.

More frequent cancer screening – individuals who do not want to undergo the preventive surgery may consider this option.

There is currently no specific price for breast cancer test. Prices will vary from clinic to clinic. In general, the price of breast cancer screening will range from 1,200,000 to 15,000,000 VND depending on the category of examination.