Breast cancer: Your questions answered
We answer questions about breast cancer awareness and early detection, with advice from two members of our multidisciplinary cancer care team
If left untreated, breast cancer can be fatal. However, in its early stages breast cancer is generally not life-threatening. As we learn more and develop new treatments, more and more people are surviving breast cancer, especially when it’s caught early.
Because early detection is so important to survival rates, it’s crucial to spread awareness of the signs, symptoms and screening procedures for breast cancer. We’ve answered your most frequently asked questions on breast cancer below, with input from two of our cancer care experts: Consultant Breast Surgeon Mr Douglas Macmillan, and Macmillan Breast Care Nurse Claire Hayward.
What are the most common breast cancer symptoms?
Mr Douglas Macmillan: “The most common symptom of breast cancer is a breast lump. Other less common symptoms are distortion of the breast or changes in the appearance of the nipple. Any distortion, puckering, change of shape, skin change or nipple change should be investigated.
“Certain types of discharge from the nipple, or sometimes a rash, can represent underlying breast cancer and particularly pre-cancerous change of the breast. Breast cancer can also present as an inflammation of the breast or as lumps under the arm or, very rarely, as breast pain.”
Breasts are fully developed by the age of 17 so I advise women to start checking regularly from that age... Regular self-examination enables women to recognise what is a normal for them.
At what age and how often should women start checking their breasts?
Claire Hayward: “Breasts are fully developed by the age of 17 so I advise women to start checking regularly from that age.
“The breasts are best examined with the flat of the hand, compressing the breast in a gentle massage-type motion and feeling for any lumps between the flat of the hand and the underlying chest wall. Regular self-examination enables women to recognise what is a normal for them.”
If a lump is found, what's the next step?
Mr Douglas Macmillan: “If a woman finds a lump in her breast or an area of lumpiness that is definitely different and new then it should be investigated by a breast specialist. It is very difficult for GPs to distinguish between significant and non-significant breast lumps, hence seeing a breast specialist is the best option.
“If the breast specialist isn't particularly concerned by the symptoms, an ultrasound of the breast and/or a mammogram is likely to be performed to rule out anything sinister. If a definite lump is found by the specialist and/or a lump is seen on imaging, a biopsy is taken from the lump using a needle and local anaesthetic.”
What kind of women are most at risk of breast cancer?
Mr Douglas Macmillan: “Breast cancer incidence increases with age and over a lifetime the average woman has approximately a one in nine chance of developing it. Breast cancer is uncommon before the age of 50, with only one in 50 women developing breast cancer before this age. Other risk factors include having a family history of breast cancer and having certain types of benign breast changes.”
Claire Hayward: “The most common at risks factors are gender, getting older and a significant family history of the disease. Others could be a previous breast cancer, period starting before the age of 12, being overweight especially after menopause and drinking more alcohol than the recommended amount.”
Is there any way to reduce my risk of breast cancer?
Whilst some risk factors such as ageing are unavoidable, there are things you can do that may help reduce your risk of developing breast cancer. It’s important to remember, though, that around half of breast cancer cases happen in women with no risk factors outside of age and sex.
1. Get more exercise
Studies have shown that regular exercise can lower the risk of developing breast cancer. The more active you are, the better. Exercise doesn’t have to mean recreational sports or going to the gym, it’s anything that gets you breathing harder and feeling warmer. Walking, cycling, swimming, gardening, doing housework or having a physically active job all count.
2. Reduce your alcohol intake
The less alcohol you drink, the lower your risk of breast cancer. The latest UK government guidelines recommend that men and women should drink no more than 14 units a week.
3. Maintain a healthy weight
Try and keep your weight within the healthy range through a combination of regular physical activity and by eating a healthy, balanced diet. Being a healthy weight not only reduces your risk of developing breast cancer, it lowers your risk of 11 other common cancers too. It also reduces your risk of developing chronic diseases such as type 2 diabetes and heart disease.
4. Breastfeeding
Studies have shown that breast feeding may reduce the risk of breast cancer. It’s not clear why, but it could be due to breast cells becoming more resistant to cancerous changes, or to fewer menstrual cycles during breast feeding.
If a woman thinks she has a significant family history, then she should seek advice. Women who are judged to have a significant family history are offered additional screening before the national screening age.
If there is a history of breast cancer in the family, should extra precaution be taken?
Mr Douglas Macmillan: “Having a family history of breast cancer is the most common way of identifying women who are at increased risk of breast cancer. A significant family history is one in which there are either multiple relatives, relatives affected at a very young age, relatives who have had cancer in both breasts, relatives with breast and ovarian cancer or male breast cancer in the family, or a combination of these.
“If a woman thinks she has a significant family history, then she should seek advice. Women who are judged to have a significant family history are offered additional screening before the national screening age.”
What happens during a breast screening?
The process for breast cancer screening in the UK is that women are invited by the NHS every three years between the ages of 50 to 70 (47-73 in England) for a mammogram. Approximately 5% are recalled for further assessment and of these only a small percentage will have a breast cancer.
If you wish to have more regular screening than offered by the NHS, or screening from a lower age than you are offered, our private breast clinics offer screening for women of any age.
“Screening is by bilateral mammography, which involves taking two X-rays of each breast, and for this the breasts are compressed gently,” explains Mr Macmillan. A mammogram can detect breast cancer before any signs and symptoms present.
“In some clinics the results can be given the same day,” he continues. “A very small percentage of women are asked to return for another appointment to have another X-ray taken which will be to look from a different view at a particular area of the breast or to do a breast ultrasound, or to take a biopsy from something that has been seen on the mammogram.”
Rapid access breast screening clinics
Whether you are concerned about your breasts, have a family history of breast cancer, are not eligible for a screening on the NHS, or would simply like a more regular screening, we can offer you fast access to an expert diagnosis, at a time to suit you.
Many Circle Health Group hospitals have dedicated breast clinics, which offer a prompt appointment with a specialist Breast Surgeon, screening, and an accurate assessment – all usually within 48 hours. Give us a call to find your nearest clinic.
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How do I book an appointment?
If you're concerned about symptoms you're experiencing or require further information on this subject, talk to a GP or see an expert consultant at your local Circle Hospital.