Breast Cancer

What is breast cancer?

The organs and tissues of the body are made up of over 100 million tiny building blocks called cells. Cancer happens when something goes wrong inside just one of these cells. Although cells in different parts of the body may look and work differently, most repair and reproduce themselves in the same way. Normally, this division of cells takes place in a controlled manner. If for some reason, the process gets out of control, the cells will continue to divide, developing into a lump, which is called a tumour. Tumours can either be benign or malignant.

If this process starts in the cells that make up the glandular tissue of the breast, the tumour is known as breast cancer.

Breast cancer is a complex disease, with many different forms and treatments. Everyday we are finding out more about cancer – how to detect it early, what treatments are available and most importantly, how to cure it. As in all cases, the earlier a cancer is found the more chance there is of a complete recovery.

How do I know if I have breast cancer?

It is important that every woman should become aware and remain aware of her breasts throughout her lifetime. Breast size and shape vary considerably from woman to woman and so do nipple size and shape. Breast self-awareness is important, by examining your breasts regularly you will become familiar with what is normal for your body and will be able to recognize changes promptly. Remember, there are many factors which may make them feel different at certain times of the month e.g. your menstrual cycle, just before a period breasts are known to get a little tender and feel lumpy.

When and how should I do my breast check?

You should check your breasts monthly from the age of 18. Many women’s’ breasts change before their period. They may feel lumpy or tender and then feel soft immediately afterwards, so this is a good time to check your breasts. After the menopause breasts tend to feel soft and less lumpy.

Once familiar with your breasts you will soon spot any changes.

IN THE SHOWER/ BATH

Fingers slide easier over wet skin. Raise your left arm and with the flat side of your hand move gently over each breast in a circular motion. Check for any lump, hard knot or thickening. Do not squeeze or prod your breasts. It is also important that you feel around your collarbone and armpit for any swellings or lumps.

IN FRONT OF A MIRROR

Put your hands on your hips and then press inwards until the chest muscles tighten. This will make any changes more prominent. Now, put your hands on your head and look for dimples or bulges, particularly underneath your breast. Dimples that are symmetrical in each breast are usually harmless. Put your arm over your head and look again for any changes. Look carefully at your breasts from every angle from the side, underneath and leaning forward.

LYING DOWN

Place a pillow under your left shoulder and put your left arm above your head. Examine your breast in a circular motion. Look for any change in nipple direction, puckering, swelling of the dark skin surrounding the nipple or orange peel skin. Repeat on right side. Also squeeze each nipple gently to check for any discharge.

There are a few other signs you should be aware of and look out for when doing your self-awareness – check routine:

• A change in the shape or size of the breast – it may be that one breast has become noticeably larger or lower.
• The nipple turns in – it becomes inverted.
• The nipple changes position or shape.
• A swelling or lump in your armpit.
• A blood-stained discharge – this a very rare symptom.
• A rash on a nipple or surrounding area (very rare).
• Veins which stand out more than usual.
• Any pain in your breast that you have not experienced before.

Remember, that if there is any change in your breast from what is normal for you, you should make an appointment to discuss your concerns with your doctor.

What else may cause lumps or pain in the breast?

The good news is that 9 out of 10 breast lumps are not caused by cancer and will prove to be benign. Although breast problems can sometimes be painful, they can usually be treated easily and rapidly.

There are two types of lumps common in women:-

• Cysts – these are fluid filled lumps, which may vary in size. They can be removed if they are painful, but they usually shrink without the need of treatment.
• Fibro-adenomas – these are firm painless lumps, made up of fibrous and glandular tissue. These lumps are easy to remove surgically if they are causing discomfort.

Breast pain, also known as mastalgia, is a common problem that most women experience at some point in their life. This usually happens before their period and can be helped by a prescription, available from your doctor. As with all breast problems you should always report any lumps or pain to your doctor.

Am I at risk of developing breast cancer?

Women may be at increased risk if two or more close relatives have had breast cancer. The level of risk is increased if their mother or sister had the disease before the age of 50.

It is estimated that 1 in 8 women in the UK will develop breast cancer during her lifetime. Breast cancer can occur at any age, but approximately 90% of women with breast cancer are over 45 and is very rare in women under the age of 40. Breast cancer is a possibility for all of us, including men. Every year, approximately 400 men are diagnosed with breast cancer, so men too should report any breast changes to their doctor.

Women may be at increased risk if two or more close relatives have had breast cancer. The level of risk is increased if their mother or sister had the disease before the age of 50.

Studies suggest that the contraceptive pill and H.R.T. may cause a small increase in women developing breast cancer, this risk is reduced when the use of these hormones stop.

Women who start their periods early or those who have a late menopause also tend to have an increased risk of breast cancer.

Is there anything I can do to reduce my risk of breast cancer?

A general recommendation for a healthier lifestyle is regular exercise and sticking to a healthy, well balanced diet. Cut down on your alcohol intake, if you do like to have a drink – try to keep within the recommended levels. For both men and women this is two units daily. This amount of alcohol shouldn’t put your health at risk (click here for more information on alcohol).

The main way of reducing your risk of all cancers and diseases is to stop smoking. No matter what your age, using the recommended self-awareness routine (above) is a process you can use regularly.

How is breast cancer diagnosed?

Breast Screening can detect cancers at an early stage in their development and often before they can be felt by the woman. When breast cancer is found early, there is a better chance of successful treatment. Breast Screening, also known as a mammography, involves taking X-rays of both breasts. The X-rays are then examined for any signs of cancer or other abnormalities. A routine X-ray is available for women over the age of 50. You may be offered screening at an earlier age, if there is a family history of breast cancer.

If you have a lump in your breast and are under the age of 50, your doctor may recommend that you have a mammography or an ultrasound scan. These tests can usually diagnose if the lump is cancerous or just a cyst. You may also have to have part or all of the lump removed, this is known as a biopsy. Once removed, the doctor will examine the lump under a microscope to see if any of the cells are malignant.

How is breast cancer treated?

Reassuringly, figures over the last few years have made breast cancer, a common, but NOT a deadly disease. It has been estimated that 84% of women whose breast cancer is found early (before it has spread), will have a very good chance of recovery.

If breast cancer is diagnosed, there will be a number of treatments available. The treatments available to you will depend on your age, general health, the type of cancer and how far it has spread.

If the tumour is small you may just need surgery to remove the lump or part of the breast. This surgery is often followed by radiotherapy, to make sure that all cancer cells are destroyed. For most women this small operation is usually all that is needed. However, if the tumour is too big or has spread, a mastectomy is more suitable. A mastectomy is the removal of the breast. Chemotherapy may also be recommended. Your doctor will discuss all options with you.