Breast cancer is the most common cancer in women and a major cause of death in Hong Kong. Not only is this true in Hong Kong but also many parts of Asia. The rate of increase is noticeably high in the premenopausal age group and in particular, in Hong Kong, there is a peak rate in the 40s which is not seen in Caucasian population. In addition the increasing incidence in post-menopausal breast cancer seen in the Caucasian population is not present. Although this may be partially due to the change in environment and adaptation of a Western life-style, it does not fully explain this rapid increase in numbers in young women in

both Hong Kong and the Asian countries. It has been suggested that genetic predisposition to the disease and its interaction with the environment may be more important in Asian women including Chinese than in the Caucasian women. About one quarter of women with breast cancer has a family history of breast cancer (familial cause) and 5-10% is known to have a hereditary cause where a mutated gene can be passed on from generations to generations. A percentage of these women especially those who are young or have a family history, will have a hereditary cause. Mutation of the BRCA 1 and BRCA 2 genes account for over 80% of the familial breast cancers and increases a life time risk of breast cancer greatly to 85% which is 10 times more than the population risk. In addition it also increases the lifetime risk of ovarian cancer to 50 times the population risk and therefore this has much significance in the management of this high risk group of women. Breast cancer does only exclusively affect women as men can also suffer from breast cancer.and inherit this hereditary syndrome where breast cancer risk will increase by 6 fold compared to the normal male population.

Genetic testing can allow the identification of high risk individuals so that early diagnosis and preventative measures can be taken leading to better outcomes. Unfortunately this standard of care, although very well established in Western countries, is not readily available in Asia including Hong Kong. More over the different patterns of presentation of breast cancer in Chinese and Asian women suggest that there may be differences in the spectrum and prevalence of hereditary breast and ovarian syndrome.

The Hong Kong Hereditary and High Risk Breast Cancer Programme has been established in Hong Kong since March 2007 and is the first community-wide programme of its kind to offer both clinical service and data collection to improve the understanding of the spectrum of this disease in Asians, and in particular the Chinese population in both Hong Kong and other parts of Asia.