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Monday, March 13, 2006

Breast Cancer

Symptoms
Women, young and old, should practise breast awareness. This involves getting to know what is normal for your breasts in terms of look and texture, so you can spot any changes and get them checked out as soon as possible.

In particular, you should look for:

* lumps or thickening of the tissue
* pain
* discharge from the nipple
* unusual appearance or sensation
* ‘tethering’ of the skin, as if being pulled from the inside

Remember, most lumps are harmless, especially if you’re young. But you should still get them checked by a doctor as soon as possible.

For a more in-depth look at what it means to be breast aware, take a look at our Breast awareness feature.

Causes
The exact causes of breast cancer aren’t yet know, but certain risk factors have been identified. They are:

* Getting older – 80 per cent of breast cancer cases are in post-menopausal women.
* Having no children or children late in life.
* Starting your periods early or the menopause late.
* Taking HRT.
* A significant family history of breast cancer.

There have also been suggestions that taking the oral contraceptive pill slightly increases your risk of breast cancer.

A genetic link
Fewer than one in 20 cases of breast cancer are inherited. About one person in 1,000 carries the genes responsible. If a relative has breast cancer it may just be chance. However, you should be more wary if:

* Your relative was diagnosed under the age of 40.
* You have a first-degree relative with cancer in both breasts.
* You have a male relative with breast cancer.
* You have two first- or second-degree relatives on the same side of the family diagnosed with breast cancer under 60, or with ovarian cancer.
* You have three first- or second-degree relatives diagnosed with breast or ovarian cancer at any age.

It may be worth completing a family health history chart to help you work out patterns of disease that run in your family.

If you’re worried, talk to your GP. You may want to think about genetic screening.

For more information about the genetic link, see Dr Trisha Macnair’s article on the inherited risks of breast cancer.

To find out more about breast cancers caused by specific genetic mutations, take a look at Gene stories.

Diagnosis
In order to make an accurate diagnosis of breast cancer, doctors must do a thorough examination. This might include a chest x-ray and blood tests. They’ll also need to take a careful look at the lump itself, possibly using an ultrasound, mammogram, needle aspiration and/or needle biopsy. In some cases, more complex tests such as liver or bone scans may be necessary.

Some hospitals run ‘one-stop shops’ for breast lumps. These are clinics where all examinations can be done on the spot, with the results coming through the same day. You can usually leave with a diagnosis.

Treatment
There is no quick cure for breast cancer – if anyone tries to tell you otherwise, be extremely sceptical. From the growth of the first abnormal cell to the end of treatment, breast cancer is a long hard road. Roll your mouse over the pictures to see how long each stage takes.

Once a lump is found, rapid diagnosis and treatment is imperative. Three-quarters of breast cancers are detected by women or their partners, but 20 to 30 per cent of these women wait three months or longer before seeing a doctor. This delay can be critical: studies have found that those who wait more than three months before seeking treatment are less likely to be alive five years later than those who seek help immediately (survival rates among the group who delay are as much as 12 per cent lower).

Until recently, the gap between referral by a GP and a hospital visit was often more than three months, which was clearly not good enough. In April 1999, the Government ordered that all patients suspected of having breast cancer must be seen by a hospital specialist within two weeks of an urgent referral by their GP.

Once diagnosis is confirmed, the exact treatment used, how soon it’s given and how long it takes all depends on several factors including:

* the stage of the tumour (how much it has spread)
* the type of breast cancer
* whether the patient has passed the menopause
* whether there are any secondary cancers
* the woman’s own wishes

Doctors treating breast cancer have a number of options to offer to their patients. Surgery to remove either the lump or the breast (mastectomy) is almost always recommended, followed by an ‘adjuvant’ therapy (this could be a combination of radiotherapy, chemotherapy or tamoxifen) to kill off any stray cancer cells. Patients should also be offered supportive therapies, such as counselling.

It’s difficult to pronounce breast cancer cured because secondary breast cancer can appear ten or 20 years later after tiny cells lying dormant in the liver, bones or elsewhere become active. However, if breast cancer is going to come back it usually does so within the first two years, and after five years without disease the chances of a recurrence are very small.

All content within WomensHealthOnly.com 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. WomensHealthOnly.com is not responsible or liable for any diagnosis made by a user based on the content of WomensHealthOnly.com website.

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