This article discusses frequently asked questions surrounding breast cancer including symptoms and risk factors. We believe that this article will be of great help to anyone who would like to know more about the symptoms of breast cancer or has been recently diagnosed with the disease.
A cancer can be considered as the uncontrolled growth of the cells of the body. It can occur in any organ and there are over 100 different types. In addition to uncontrolled growth, cancer cells have the ability to spread around the body (metastasise) and can cause death. Breast cancer starts in the cells of the breast, usually either the ducts (ductal cancer) or the lobules (lobular cancer). However there are also several other types and breast cancer itself is not a single disease but several diseases that happen to occur in the breast.
The problem is that we simply do not know the cause of breast cancer. In fact, there is unlikely to be a single cause and what probably happens is that lots of different things have to happen over a long period of time before a breast cancer starts. We can, however, look at things that seem to be associated with an increased risk and see if we can change any of these to reduce the risk.
There are two categories of risk factors. The first group is termed “intrinsic” factors and there is not much you can do about these. One of the main intrinsic factors is your genes. There are two genes that we know are related to breast cancer if they are abnormal (these are called the BRCA1 and BRCA2 genes). If someone has an abnormality in one of these genes the lifetime risk of breast cancer might be as high as 80% or as low as 40%. Other factors seem to relate to the number of normal ovulatoryAssociated with ovulation. cycles a women has in her lifetime; so if your periods start early and finish late and you did not have any children your risk will be slightly higher than if your periods started late, finished early and had several children, particularly if the first child was born when you were quite young. The reason breast feeding may be protective is that you tend not to have periods when you are breast feeding.
The second group is the “extrinsic” factors, also known as the environmental or lifestyle factors. These you can do something about. Put very simply, if you are fatOne of the three main food constituents (with carbohydrate and protein), and the main form in which energy is stored in the body., smoke and drink too much then you increase your risk of breast cancer. The number of breast cancers has been rising for quite a few years now and it seems that being overweight may be the single most important cause for this rise.
Dimpling of breast skin
Rashes around the nipple (similar to eczemaAn inflammation of the skin, usually causing itching and sometimes scaling and blisters.)
The most common symptom is a definite lump. Although most lumps are not cancer at all, but other sorts of benignNot dangerous, usually applied to a tumour that is not malignant. lumps such as cysts, all lumps must be checked by a specialist. Occasionally a lump in the armpit can also be related to breast cancer.
There are other changes for which women should look out. Most of these will not be related to breast cancer but all changes should be checked:
Nipple discharge is very common, particularly towards the menopauseThe time of a woman’s life when her ovaries stop releasing an egg (ovum) on a monthly cycle.. Nipple discharge will nearly always be harmless, unless there is a lump present as well.
Similarly it is very common for the nipples to turn in as women get older. If a nipple is turned in (inverted) and there is a lump then this might be due to a cancer.
The breasts can also, commonly, changes size with age. As the menopauseThe time when a woman's periods permanently cease. approaches the glandAn organ with the ability to make and secrete certain fluids.tissueA group of cells with a similar structure and a specialised function. in the breast is replaced by fatty tissue and this can cause a change in size, often greater on one side compared with the other.
Some women noticed a dimpling or puckering of the skin and this must always be reported to a doctor. Sometimes it will be due to age related changes in the elastic tissue in the breast. Sometimes there will be a lump or an area of abnormal breast tissue associated with the dimpling and this may be due to a cancer.
Rashes around the nipple can also be quite common. Most of these will turn out to be simple dermatitis or eczema. There is a very rare form of early breast cancer called Paget’s diseaseA common disorder affecting the middle-aged and elderly in which the formation of bone is disrupted. It usually affects the pelvis, skull, collarbone, vertebrae and the long bones of the leg. that can sometimes look like eczema. An important difference is that normal eczema tends to be only on the areolaThe small area of darkened skin surrounding the nipple of the breast around the nipple whereas Paget’s disease can go onto the nipple itself.
Breast pain is almost always completely harmless (although undoubtedly a nuisance).
There is no definite correct answer to this question. The NHS Breast Screening Programme (NHSBSP) performs a mammogram every three years on women aged between 50 and 70. This is supposed to be extended to women aged 47 to 73 over the next few years. Other countries, such as Australia and New Zealand start at a younger age and offer mammograms every 2 years. Some European countries suggest every 18 months and in the USA yearly from 40 is common.
All definite breast lumps should be seen by a breast specialist. The full assessment of a lump focuses on what is called the triple assessment. The lump is examined, mammograms and ultrasound scans may be performed and a tissue sample will be taken. This will give a definite diagnosisThe process of determining which condition a patient may have. in the vast majority of cases.
The most likely cause for a breast lump depends on a women’s age.
In the teens and early twenties the most likely cause is a fibroadenomaA benign tumour of breast tissue. . These are harmless but can sometimes grow quite big.
In their thirties many women find the breast tissue becomes quite nodular (this is sometimes referred to as the “packet of frozen peas” syndrome! Just as when frozen peas are removed from a freezer and a clump have stuck together, so it might be considered that breast tissue can “clump” in a similar way and cause a lump). This is a normal, age related, change.
In the forties cysts become the most common cause of a definite lump. These are harmless, fluid filled, sacs that can be drained off with a small needle if they are troublesome. Women who get cysts will often get them for several years.
Over the age of fifty breast cancer begins to get more common, although it can, of course, occur at any age.
There are other, less common lumps that can occur such as abscesses, phyllodes tumours, cysts in the skin, lipomas (fatty lumps) as well as lumps that have spread from other diseases such as lymphomaA type of cancer that affects the lymph nodes, part of the immune system. or lung cancer.
Treatments that may be used in breast cancer include surgery, radiotherapyThe treatment of disease using radiation., endocrine therapy and chemotherapyThe use of chemical substances to treat disease, particularly cancer.. Different women may need different combinations of the treatments in different orders (some will not need all of them) and the treatment will always be discussed between the patient, the surgeon and the oncologistA specialist in the treatment of cancer..