Women's Health
Educate and empower yourself by accessing exclusive content and advice on health issues affecting women today, such as breast cancer, heart disease, fertility and other conditions and treatments. Find out what the common symptoms are and what treatments are available.
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Breast Cancer
Breast Cancer
Introduction
In the UK, breast cancer currently causes more than 12,500 deaths a year, with more than 44,600 new cases of breast cancer diagnosed every 12 months. It is the commonest female cancer in the UK and is responsible for almost one in three cancers in women.
Eight out of 10 breast cancers are found in women aged 50 or over.
Younger women are less at risk of breast cancer, with approximately 8,600 women under 50 (or pre-menopausal) diagnosed each year, around 1,500 of whom are aged between 35 and 39. In men, the risk is even smaller, with 300 or so male breast cancers diagnosed annually.
While breast cancer is the commonest cancer in the UK, survival rates are improving thanks to the national screening programme, which is helping to detect potential problems earlier, as well as improvements in drugs and other treatments.
Since 1990, breast cancer deaths have fallen by 18 per cent. It is, however, still the third biggest cause of death from cancer, after lung cancer and bowel cancer.
Increased awareness of the disease is also thought to be responsible for the recent improvements in breast cancer mortality rates. So whatever your age or sex, here's what you need to know.
- Am I at risk?
- What are the different types of breast cancer?
- What should I look for?
- Breast Awareness
- What happens if I find a lump?
- Should I be screened for breast cancer?
- What treatments are there?
- Will I get better?
- What can I do to protect myself?
Am I at risk?
Several things are thought to increase your risk of developing breast cancer, one of which is your age – as with many other diseases, the older you are, the greater your risk becomes.
If you have already had breast cancer, your risk of developing another cancer is also higher, although drug treatments, such as tamoxifen, are helping to lower recurrence.
Around ten per cent of breast cancer cases are thought to be genetic, which means your risk may be higher than the general population's if one or more close relatives from the same side of your family have been diagnosed with breast cancer.
For example, if your mother or sister had breast cancer under the age of 40, or if two close relatives (one of which was your mother, sister or daughter) had breast cancer, or three other close family members were diagnosed at any age, you may have an increased risk too.
If you have breast cancer in your family and you want to find out more about how you may be affected and whether or not you should be tested for breast cancer genes, you can download information from the National Institute for Health and Clinical Excellence (NICE).
Other risk factors for breast cancer:
- Starting your periods early (11 years old or under) and finishing having periods late (54 and over)
- Not having children
- Having your first child late in life
- Having had non-cancerous (benign) breast disease in the past
- Being a moderate or heavy drinker of alcohol
- Being overweight after having the menopause
- Exposure to high amounts of radiation, including radiotherapy treatment to your chest for Hodgkin's lymphoma
- Taking the contraceptive pill and hormone replacement therapy (HRT) may also increase your risk, but only very slightly
What are the different types of breast cancer?
- Ductal carcinoma in situ (DCIS) is a very early form of breast cancer where cancer cells are found in the ducts of the breast (ducts connect the lobes – areas of gland tissue within the breast – to the nipple). In DCIS there's only a small chance that the breast cancer has spread to the lymph nodes (glands in the armpits) or to other parts of the body
- Invasive ductal breast cancer (ductal carcinoma) is the commonest form of breast cancer, accounting for up to 85 per cent of cases. Not to be confused with DCIS, ductal carcinoma is where cancer cells are found in the lining of the milk ducts in the breast
- Lobular carcinoma in situ (LCIS) is regarded as a benign (non-cancerous) condition where cell changes are found inside the lobes of the breast. If you are diagnosed with LCIS, it means you could have a higher risk of developing breast cancer
- Invasive lobular breast cancer is less common than invasive ductal breast cancer, and is found in around 15 per cent of cases. In this form, cancer cells are found in the lining of the breast lobes
- There are also several rarer types, including inflammatory breast cancer, where the breast becomes red, swollen and sometimes painful to touch, and Paget's disease, which typically starts out looking like an eczema-type rash on and around the nipple
What should I look for?
Most women realise that a breast lump could be a sign of cancer, but there are other signs to watch out for too:
- Changes in the breast, such as puckering or dimpling of the skin
- Rash on or around the nipple
- Blood-stained discharge from the nipple
- Changes in the shape of the nipple (including an inverted nipple)
- Changes in the size or shape of the breast
- Lumps or swellings in the armpits
Breast Awareness
Examining your breasts yourself is important, so you get used to the size, shape and texture of your breast tissue. Becoming familiar with your breasts is important, as you will be more aware of any changes and pay more attention to anything unusual. Many women, for instance, notice some lumpiness around the time of their period, but for them this can be completely normal.
What happens if I find a lump?
The first thing to do is not to panic. Nine out of 10 breast lumps are non-cancerous (benign). If you do spot a lump or another type of change in your breast that you haven't noticed before, discuss it with your doctor as soon as you can.
After examining you, your doctor may send you to your local breast assessment clinic where you will be seen by a specialist and, if necessary, have further tests.
According to current UK guidelines, if you are considered an urgent case, you will get an appointment with the specialist within two weeks of seeing your GP.
One of the tests you may have to see if you have breast cancer is called a mammogram – an X-ray of the breasts. In a mammogram, the breast is compressed between two plates, which can be slightly uncomfortable, but rarely painful.
If you are younger, you may have an ultrasound test instead, as this may give clearer results than mammography.
Other types of breast cancer test include a biopsy – where some cell or tissue samples are removed from your breast and examined under a microscope – and fine needle aspiration, where cells from a lump are extracted for assessment.
Should I be screened for breast cancer?
Currently, all women in this country aged between 50 and 70 are eligible for breast cancer screening in the form of three-yearly mammograms (those over 70 can still have them every three years on request).
By 2012, however, the NHS aims to screen even more women by extending the age range to 47 to 73.
If you are in a high-risk group, you can ask your doctor about the possibility of being screened earlier than 50. Since breast tissue is denser in younger women, however, a mammogram is a less reliable means of detecting cancer.
For more information on the national breast cancer screening programme, visit Cancer Screening.
What treatments are there?
Any breast cancer treatment depends on the size and stage of the cancer, and whether or not it has spread to other parts of the body.
The main treatments include the following:
- Surgery – the most common procedures include removing the lump (lumpectomy) or, less often these days, the whole breast (mastectomy)
- Radiotherapy – killing cancer cells with radiation – is mostly used following surgery to reduce the risk of the cancer returning in the treated breast and/or lymph nodes
- Chemotherapy – this can be used before or after surgery to either reduce the size of the cancer before your operation or to reduce the likelihood of it coming back
- Hormone therapy – the marketed drugs Tamoxifen ® or Arimidex ® can also be used for the same purpose
- Biological therapy – newer drugs, such as Herceptin ®, are called biological therapy, and are used in cases of early breast cancer, where there are high levels of a protein called HER2
Will I get better?
Your prognosis (the likely outcome of your breast cancer and its treatment) very much depends on how early your cancer was spotted.
The estimated relative five-year survival rate for women diagnosed in England and Wales in 2001-2003 was 80 per cent, compared with only 52 per cent for women diagnosed in 1971-1975. The estimated relative twenty year survival rate for women with breast cancer has gone from 44 per cent in the early 1990s to 64 per cent for 2003.
Breast cancer can be treated more easily when found at an early stage. Women
diagnosed with breast cancer at the earliest stages have a nine in 10 chance of beating the disease. If the cancer is
advanced when the doctor diagnoses it, less than two in 10 women will survive.
What can I do to protect myself?
There are several ways that you can help yourself and reduce your risk of developing breast cancer:
- Examine your own breasts regularly. Get used to how they look and feel. If you notice a hard lump that you can’t get under or move about, go to your doctor
- Changing your diet may help – research suggests that more than a quarter of cancers could be prevented if people ate more fruit, vegetables and fibre-rich foods, avoiding sugars or processed foods and too much saturated fat
- A healthy diet and taking more exercise could also prevent you from becoming overweight or obese, which is also associated with a higher risk of breast cancer in post-menopausal women
- Statistics show that breastfeeding may reduce your risk too – and the longer you breastfeed, the lower your risk of breast cancer
- Alcohol intake has also been linked to breast cancer, so drink sensibly and don't exceed current recommendations (two units of alcohol a day for women and three for men, where a unit is a small glass of wine, half a pint of beer or lager or a single measure of spirits)
Clickthrough information and support links:
Action Against Breast
Cancer
Breakthrough
Breast Cancer
Breast Cancer
Care
Cancer Help (Cancer
Research UK)
Cancer
Backup
Macmillan Cancer
Support
Marie Curie Cancer
Care
References:This article has been written for PruHealth by Dr Foster Research. All Dr Foster Research (DFR) health content is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional.
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