Breast Cancer

Breast cancer is an extremely common cancer. In the UK about 50,000 women are diagnosed with breast cancer each year and eight out of ten of these women are aged over 50. However, younger women, as well as men, can also get breast cancer.

Breast cancer is the name given to a malignant tumour that has developed from cells which are housed within the breast. Over time, if the tumour is not detected early, cancer cells can invade nearby healthy breast tissue and make their way into the underarm lymph nodes. These are small organs that filter out foreign substances in the body.

If cancer cells get into the lymph nodes, then they have a pathway into other parts of the body. If breast cancer is diagnosed, then the ‘stage’ that it is at refers to how far the cancer cells have spread beyond the original tumour.

Who is at risk?

Both men and women can get breast cancer. However, it is most common in women over 50

Breast cancer risk factors include

  • Age – the risk of developing breast cancer increases as you get older
  • Family history – if you have relatives who have had breast cancer you may have a higher risk of developing breast cancer
  • Previous diagnosis – if you have previously had breast cancer or early non-invasive cancer cell changes then you have a higher risk of developing it again
  • Previous benign breast lump – a benign lump does not mean you have cancer. However, certain types of lump may increase the risk of developing it
  • Being overweight or obese means more at risk of developing breast cancer
  • Alcohol – your risk of developing breast cancer increases with the amount of alcohol you drink
  • Radiation – certain medical procedures that use radiation such as x-rays and CT scans may slightly increase your risk
  • Hormone Replacement Therapy (HRT) – is associated with a slightly increased risk of developing breast cancer
  • Women who use oral contraception have a slightly increased risk of developing breast cancer

Breast cancer risk does not stop after 70 years. There is evidence to suggest that older women delay presentation and may even experience delays because of a lower awareness of risk amongst staff. It is important to maintain breast awareness in elderly women.Breast cancer symptoms

The most common symptom of breast cancer is a painless lump in the breast. However, other common symptoms can occur such as:

  • Change in the size or shape of a breast
  • Dimpling of the skin of the breast
  • Thickening in the breast tissue
  • Nipple becoming inverted (turned in)
  • Lump or thickening behind the nipple
  • Rash (like eczema) affecting the nipple
  • Bloodstained discharge from the nipple (this is very rare)
  • Swelling or lump in the armpit

Prevention

Possible ways to prevent breast cancer are:

  • Replace animal fats with polyunsaturated fats (found in many vegetable oils and margarines) and monounsaturated fats (such as olive oil)
  • Eat more isoflavones (found in soy, peas and beans) and lignans (found in vegetables, fruits, grains, tea and coffee)

Some research shows that the following dietary changes may also help to prevent breast cancer:

  • Eat more fibre, which can be commonly found in wheat bran, cereals, beans, fruit and vegetables
  • Make sure you have enough calcium in your diet – from milk, cheese and other dairy foods, green leafy vegetables (such as broccoli, cabbage and okra, but not spinach unless it is boiled. Raw spinach may interfere with calcium absorption), soya beans, tofu, nuts, bread, and fish where you eat the bones, such as sardines and pilchards
  • Eat foods high in carotenoids (chemicals that the body changes to vitamin A) such as carrots, sweet potatoes, spinach, kale, and tomatoes

It is also important to exercise regularly and maintain a healthy weight.

NHS breast cancer screening programme

All women aged between 50 and 70 who are registered with a GP are automatically invited for breast cancer screening every three years. Around one-and-a-half million women are screened in the UK each year. Women over 73 can request a mammogram every 3 years by contacting their local breast screening unit.

Breast screening is a method of detecting breast cancer at a very early stage by x-raying each breast – this is known as a mammogram.

The x-ray is taken while carefully compressing the breast. The mammogram can detect small changes in breast tissue which may indicate cancers. These changes are too small to be felt either by self or staff examination. This is why, while self-examination is crucial it should always be complemented by a mammogram when it is offered.

Some women find the mammogram a bit uncomfortable and a few find it painful.

The NHS breast screening programme is phasing in an extension of the age range of women eligible for breast screening to those aged 47 to 73.  That means that some women aged 47-50 are being called for the first time and women aged 70-73 are continuing to be screened. Full rollout is not expected until after 2016. For more information visit the breast cancer screening page at: http://www.nhs.uk.

Key Messages

Early detection results in simpler, more effective treatment and saves lives.

Screening can find very small cancers before a lump can be found on the breast.

Still encourage women to be ‘breast aware’ and examine their breasts regularly. Evidence suggests when staff are comfortable talking about this, it helps patients and clients.

Older women are less likely to check their breasts or take up their breast screening invitations