When Melbourne resident Xie Min was diagnosed with breast cancer in her forties, she was taken aback. She had always considered herself too young for such a diagnosis. “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. Fortunately, because her cancer was detected at an early stage, she did not require radiotherapy or chemotherapy and recovered well after surgery.
Nearly two decades later, Ms. Xie is advocating for younger women, particularly those from Chinese backgrounds, to participate in breast screening. 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 Early Screening for Chinese Australians
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 stated. This observation is echoed by Melbourne-based breast and endocrine surgeon Suat Li Ng, who primarily treats patients of Chinese descent. Dr. Ng pointed out that while breast cancer is generally diagnosed in women in their 50s, her patients are often in their 30s and 40s.
Research conducted in China and Australia supports these observations. A 2020 study of breast cancer patients treated at Eastern Health in Victoria found that Australian Chinese women diagnosed with breast cancer were, on average, about six years younger than their counterparts. The Royal Australasian College of Surgeons summarized that factors such as diet, lifestyle, and body mass index (BMI) might contribute to these differences. The study recommended that Chinese patients be offered screening programs earlier to improve outcomes.
“Language barriers should also be addressed, as well as improving knowledge around breast cancer with these patients and how they view treatment,” the summary noted.
Dr. Ng added that Asian women tend to have denser breast tissue, making 3D or contrast mammograms and ultrasounds more effective than standard 2D mammograms. “With the denser breast women, the standard 2D mammogram that we do with breast screening generally can’t see through the density,” she explained. “Hence you might miss cancers.”
Addressing Barriers to Breast Cancer Screening
Despite the increased risk of developing breast cancer at a younger age, women from Chinese backgrounds face several barriers to getting screened. According to BreastScreen Victoria, culturally and linguistically diverse (CALD) women are generally less likely to participate in breast cancer screening. From July 2022 to June 2024, only 38.9 percent of Victorians from CALD backgrounds participated in breast cancer screening, compared to the state average of 51.9 percent.
Dorothy Yiu, president of the Chinese Cancer and Chronic Illness Society of Victoria (CCCIS), identified language barriers, lack of understanding of the benefits, and embarrassment as reasons for reluctance. “It’s good to address these barriers and focus on the benefits of screening,” Ms. Yiu emphasized. “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 the most 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 suggested.
Growing Demand for Culturally Appropriate Cancer Support
In New South Wales, Eric Yeung, president of CanRevive, a support organization for Chinese-speaking cancer patients and their families, also noted a reluctance towards breast cancer screening among Chinese women. “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 highlighted other barriers, including cultural beliefs, taboos, and a reluctance to expose their bodies during mammograms. “Cancer remains a taboo topic; some patients hide their diagnosis or delay seeking help,” he explained. “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 over the past two years, rising from 39 to 73 people.
This increase underscores the growing demand for culturally appropriate cancer support services within Chinese-speaking communities. Language remains a crucial factor in patient care, as Dr. Ng noted. “If you are being diagnosed with breast cancer, there’s a lot of anxiety that goes with the diagnosis, plus all the medical jargon, the medical terminology that scares people,” she said.
Dr. Ng, who speaks Mandarin, Cantonese, Malay, and English, emphasized the importance of communicating with patients in their language. Earlier this month, she hosted a workshop for breast cancer patients, highlighting 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,” she said.
Reflecting on her own experience, Xie Min has found solace and purpose in activities like calligraphy, yoga, and hiking, and has become an advocate for breast cancer awareness. She encourages women to prioritize their health and that of their friends, underscoring the critical need for early detection and culturally sensitive healthcare solutions.
