The number of ribbons distributed since 1992 would create a bridge of pink between New York and China, if stretched end to end.

The Pink Ribbon Campaign debuted in China in 2003.

In the last two years, Shanghai Nanpu Bridge has been lighted in pink, and so has China Century Monument in Beijing.

The American Cancer Society estimates that this year, 182,460 new cases of invasive breast cancer will be diagnosed among women in the United States and about 40,480 will die.

But the five-year relative survival rate for localized breast cancer has increased from 80 percent in the 1950s to 98 percent today.

Globally, breast cancer incidence rates are highest in North America and northern Europe, lowest in Asia and Africa. However, rates in Japan and urban China are rising.

Professor Damon T.K. Choy from Ruijin AmMed Cancer Center said that about half the cases are linked to risk factors, such as age at menarche, first live birth, menopause and proliferative breast disease. Another 10 percent are associated with a positive family history.

"Studies have shown that having a close relative with breast or ovarian cancer may increase one's personal risk," he said.

For those with family or personal histories of these cancers, genetic testing may help.

Knowledge of the disease and risk factors can clear up misunderstandings. Some factors cannot be controlled, but we can control our weight, cut down on fats, eat healthy foods, including fruits and vegetables with antioxidants that protect cells.

"Breast care is very important," said Choy. "We recommend breast self-exam once a month on the second and third day after our period ends or at the same time each month if you are post-menopausal."

Mammograms, ultrasounds for older women, and professional checkups are essential.

Breast self-exam

Step 1: Before the mirror

Check for changes in shape, size and appearance, such as dimpling, rash, nipple discharge, etc.

Inspect your breasts in four steps with your arms at your sides, over your head, your hands on your hips, tightening chest muscles, bend forward with hands on hips.

Step 2: Lying down

Lie on your back with a pillow under your right shoulder. Feel for any hard lumps or changes.

Use three middle fingers on your left hand to examine your right breast.

Press using light, medium and firm pressure in a circular motion.

Follow an up-and-down pattern over entire breast, above and below the collarbone and armpit.

Repeat on your left breast with right hand.

Step 3: In the shower

Raise your right arm and check your right breast with soapy left hand using same motions in step 2.

(Shanghai Daily October 14, 2008)