When Melbourne resident Xie Min was diagnosed with breast cancer in her forties, she was taken aback. The news came as a shock, as she believed she was too young to develop such a condition. “My heart sank,” she recalled. “How should I proceed with treatment? What would the outcome be? My mind was in turmoil.” Following an unsuccessful lumpectomy, Ms. Xie underwent a full mastectomy. “Because it [the cancer] was early stage, I didn’t need radiotherapy or chemotherapy, and I recovered very well after the operation,” she said.
Nearly two decades later, Ms. Xie is an advocate for breast screening, particularly urging younger women of Chinese descent to participate. Her call to action is supported by medical professionals who have observed a trend of earlier breast cancer diagnoses among ethnic Chinese women in Australia.
Doctors Recommend Earlier Screening
Australian oncologist Stephen Birrell has noted that ethnic Chinese women tend to develop breast cancer at a younger age compared to other Australians. “They get it at a young[er] age than in the West,” he explained. This observation is echoed by Melbourne-based breast and endocrine surgeon Suat Li Ng, who primarily treats patients of Chinese descent. “My patient demographics, where breast cancer is diagnosed, are usually in the 30s and 40s,” said Dr. Ng.
Research conducted in China and Australia supports these observations. A study examining breast cancer cases at Eastern Health in Victoria in 2020 found that Australian Chinese women were diagnosed with breast cancer on average about six years younger than their counterparts. The Royal Australasian College of Surgeons suggested that factors such as diet, lifestyle, and body mass index (BMI) might contribute to this discrepancy.
“Language barriers should also be addressed, as well as improving knowledge around breast cancer with these patients and how they view treatment,” the study’s summary stated.
Dr. Ng emphasized that Asian women often have denser breast tissue, which necessitates the use of 3D or contrast mammograms and ultrasounds for effective screening. “With the denser breast women, the standard 2D mammogram that we do with breast screening generally can’t see through the density,” she said. “Hence you might miss cancers.”
Addressing Barriers to Screening
Despite the increased risk of early breast cancer, Chinese Australian women face numerous barriers to screening. According to BreastScreen Victoria, participation rates among culturally and linguistically diverse (CALD) women are significantly lower than the state average. From July 2022 to June 2024, only 38.9% of CALD women participated in breast cancer screening, compared to the state average of 51.9%.
Dorothy Yiu, president of the Chinese Cancer and Chronic Illness Society of Victoria (CCCIS), highlighted several reasons for this reluctance, including language barriers, a lack of understanding of the benefits, and embarrassment. “It’s good to address these barriers and focus on the benefits of screening,” Ms. Yiu said. “Education is the best strategy to inform Chinese women about early detection of breast cancer.”
A 2022 study by the University of Sydney found that a common barrier to mammography among Chinese Australian women was the perception that doctors did not recommend it. “GPs [general practitioners] are essential for encouraging women to have a CBE [clinical breast exam], especially those who are not yet invited to mammography screening,” the study’s authors noted.
Growing Demand for Culturally Sensitive Services
In New South Wales, Eric Yeung, president of CanRevive, a support organization for Chinese-speaking cancer patients, observed similar reluctance towards breast cancer screening. “Younger women often think they’re too young for breast cancer and focus on work or family instead,” Mr. Yeung said. “Middle-aged and older women may hold fatalistic beliefs (‘if it’s my fate, it’s my fate’) or avoid screening out of fear.”
Mr. Yeung also pointed out cultural barriers, such as the reluctance to expose their bodies during mammograms and the taboo nature of discussing cancer. “Cancer remains a taboo topic; some patients hide their diagnosis or delay seeking help,” he said. “Due to mistrust and parallel care, some patients turn to overseas doctors or traditional Chinese medicine first, often without informing their oncologist.”
The number of breast cancer patients assisted by CanRevive has nearly doubled in the past two years, rising from 39 to 73 people, highlighting a growing demand for culturally appropriate cancer support services within Chinese-speaking communities.
The Importance of Language and Support
Breast cancer remains the second most commonly diagnosed cancer in Australia, with nine people dying from it every day. According to a 2024 report by the Australian Institute of Health and Welfare, one in seven women in Australia risk being diagnosed with breast cancer during their lifetime.
For non-native English speakers, seeking diagnosis and treatment can be particularly daunting. Dr. Ng, who is fluent in Mandarin, Cantonese, Malay, and English, noted that communicating with patients in their language provides comfort and clarity. Earlier this month, she hosted a workshop for breast cancer patients, emphasizing the importance of holistic care during recovery.
“It’s really just to empower the women with more knowledge about living their life, and also to help them connect with other women who have been through cancer as well,” Dr. Ng said. She acknowledged that it takes time for women to readapt to normal life after treatment. “A lot of women will live with fear of their cancer recurring again,” she said. “You’ve got to move on … you get better at managing the fear with time.”
Since her battle with breast cancer, Xie Min has embraced activities such as calligraphy, yoga, and hiking, and has been actively involved in raising awareness for breast cancer. Reflecting on her experience, she credited her recovery to the support of family and friends and encouraged women to prioritize their health and that of their peers.
