Breast cancer starts in your breast tissue. It is the most common cancer in the UK. 1 in 7 women in the UK will develop breast cancer in their lifetime1 and 1 woman is diagnosed every 10 minutes2.
By finding breast cancer early, you have the best chance of being successfully treated. So, it’s important to be breast-aware and get to know your breasts and what is normal for you. If you have been diagnosed with breast cancer, there’s a lot to take in.
This mini guide gives you an easy-to-understand overview of what you need to know about breast cancer. Read about the symptoms and how to check your breasts, what causes breast cancer and is it hereditary? You can also learn about how breast cancer is diagnosed and treated.
Breast cancer symptoms
Typically, the first symptom of breast cancer that women notice is a lump or area of thickened breast tissue. Most breast lumps are not cancerous. However, you should always get them checked by a doctor.
Other symptoms you should see your GP about include:
· a change in the size, shape or feel of one or both breasts
· fluid leaking from either of your nipples
· a lump or swelling in your armpit
· breast skin changes such as dimpling, puckering, a rash or redness
· a change in your nipple appearance, such as turning in or sinking into your breast
Be aware that breast pain is not usually a symptom of breast cancer.
How to check your breasts at home
Being breast-aware and checking your breasts regularly is important. This allows you to notice any changes as soon as possible.
You need to get to know how your breasts and chest normally feel. Your breasts may change at different times of your life and around the time of your period compared to when it is over. Get to know if your breasts are lumpier around the time of a period. Often breasts feel softer and less lumpy after you stop having periods.
To check your breasts, look and feel each breast and armpit, up to your collarbone. It’s useful to look at your breasts in the mirror both with your arms by your side and also with them raised. Some women do a feel check of their breasts in the shower or bath as they find it easier to run a soapy hand over each breast and under each armpit.
During your breast check, you are looking for changes in the size, shape or feel of your breasts and armpits and any of the symptoms listed under symptoms.
If you notice any breast changes that aren’t normal for you, then book an appointment to see your GP without delay.
Causes of breast cancer
The cause of female breast cancer is not fully understood. However, there are risk factors known to increase your likelihood of developing breast cancer. It’s worth being aware of these as you can do something about some of them, but some you can’t.
Breast cancer risk factors include:
· getting older - the risk of developing breast cancer increases as you age. It is most common in women over 50 who have been through the menopause.
· family history – you may be at higher risk of breast cancer if a close relative has had breast cancer or ovarian cancer.
· dense breast tissue – means you have more cells that could become cancerous so you may have a higher risk of developing breast cancer.
· oestrogen exposure - your risk of developing breast cancer may rise slightly if you started having periods earlier or went through menopause later than average.
· taking a contraceptive pill and hormone replacement therapy (HRT) for over a year – the risk falls after you stop taking these.
· being overweight or obese after menopause
· drinking alcohol – the more you drink the greater your risk of breast cancer.
· X-rays and radiotherapy - increase your risk of many types of cancer, although doctors keep medical radiation exposure as low as possible.
Diagnosing breast cancer
If you notice any breast cancer symptoms you should see your GP as soon as possible. They will examine you and refer you to a specialist breast cancer clinic if they think you need further assessment.
Mammography
Mammography takes X-rays of your breasts.
You'll probably be invited to have a mammogram if you are referred by your GP to a breast clinic.
Routine mammography breast screening may also diagnose breast cancer. The NHS Breast Screening Programme invites all women registered with a GP from the age of 50 up to 70 for screening every 3 years. Women often come to Ramsay for mammography screening in between their NHS breast screening or if they would like this before they become eligible for the NHS programme.
Other diagnostic tests
You may have a breast ultrasound scan or a biopsy test to take a sample of cells from the suspected area to do further diagnostic testing after your mammogram. There are different types of biopsies called needle core biopsy, fine needle aspiration and vacuum-assisted biopsy.
Further tests for breast cancer
If you are diagnosed with breast cancer, you will need more tests to determine the stage and grade of your cancer. This will help direct the best method of treatment for you.
Stage and grading tests can include a CT scan, chest X-ray, liver ultrasound scan, an MRI scan and bone scan.
You may be invited to have a hormone receptor test or human epidermal growth factor receptor 2 (HER2) to find out if your cancer will respond to specific types of treatment.
Your treatment options
A group of specialists called a multidisciplinary team (MDT), will together provide the best breast cancer treatment and care for you.
The main treatments for breast cancer are:
· Surgery – is usually the first treatment for breast cancer. There are two main types of surgery: breast-conserving surgery which removes your cancerous lump (tumour) and mastectomy which removes your whole breast. Mastectomy may be followed by reconstructive surgery to recreate your breast.
· Chemotherapy – is usually given after surgery to destroy any cancer cells that remain. Sometimes it is used before surgery to shrink a large tumour. It uses anti-cancer medicines to kill cancer cells. Chemotherapy is typically given every 2 to 4 weeks followed by a break, called a cycle. You may have up to 8 cycles. Tiredness, feeling and being sick and hair loss are common side effects.
· Radiotherapy – is usually given after surgery and chemotherapy. It uses controlled doses of radiation to kill any remaining cancer cells. Radiotherapy treatment is typically given for 3 to 5 weeks, with sessions lasting a few minutes over 3 to 5 days a week. Fatigue and skin changes are common side effects of radiation.
· Hormone therapy – is usually given after surgery and chemotherapy. Sometimes it is given before surgery to shrink a tumour so that it is easier to remove. It may be used as a sole breast cancer treatment if your health prevents other treatments. Hormone therapy is used if you have a hormone receptor-positive cancer which means that your cancer is stimulated to grow by hormones. It lowers the levels of oestrogen or progesterone hormones in your body or stops their effects.
· Targeted and immunotherapy – may be used before surgery to try to shrink the tumour so you can have a smaller operation, after surgery to lower your risk of cancer coming back, or instead of surgery if this is not possible. It may also be used for secondary breast cancer where the cancer has spread to other parts of your body such as your lungs and bones. Targeted therapies target the differences in cancer cells that help them to grow and survive. Immunotherapy uses your immune system to help it to recognise and attack cancer cells. Not all types of breast cancer can be treated with these therapies. There are many different types of targeted and immunotherapy drugs and there is a lot of research into these drugs and using different combinations.
References
1 https://breastcancernow.org/about-breast-cancer/awareness/what-is-breast-cancer/
2 https://breastcancernow.org/about-us/why-we-do-it/breast-cancer-facts-and-statistics/