Breast cancer

Breasts are made up of fat, connective and glandular tissue, which in turn is made up of cells. Cancer is a disease of the cells that make up the breast.

Body cells gradually grow old, die and are then replaced. Cells normally divide in an orderly way, but sometimes this process goes out of control and the cells continue dividing to form a lump or tumour. Tumours are either benign (non-cancerous) or malignant (cancerous). Doctors can tell what kind of tumour it is by taking cell samples (biopsy) and looking at them under a microscope.

If a malignant tumour is left untreated, it may grow into and destroy surrounding tissues and organs. Cancerous cells can also break away from the original cancer site and spread to other organs in the body through the bloodstream or lymphatic system.

If cancerous cells have spread to other parts of the body, doctors say that the cancer has metastasised. When the cancer cells reach a different area and form a new tumour, doctors also call this a secondary cancer.

Introduction

Breast cancer is the commonest cancer in women (1), but why it happens is not completely understood.

Cancer is not a single disease with a single type of treatment - there are different kinds of breast cancer (2), each with its own name and treatment.

The risk of developing breast cancer is smaller in younger women but increases as women get older. Eighty per cent of breast cancers occur in women over the age of 50 (3).

Breast cancer survival rates are improving thanks to the national screening programme, which is detecting potential breast cancers earlier. Improvements in drugs and other treatments are also having an impact. Raising awareness among the general public is also thought to be behind the recent improvements in mortality rates.

UK guidelines (4) recommend that if you are considered an urgent case, you should get an appointment with a specialist within two weeks of seeing your GP.

What is breast awareness?

Examining your breasts yourself is very important, so you get used to their size, shape and texture (5).

The better you know your breasts, the more likely it is that you will notice anything unusual when you examine them. For example, you may notice more irregularity in the size and shape of your breasts around the time of your period.

What signs do I need to look out for?

While most women realise that a breast lump could be a sign of cancer, there are other signs and symptoms to watch out for (6):

  • Changes in the size or shape of the breast
  • Blood-stained discharge from the nipple
  • Changes in the shape of the nipple (including an inverted nipple)
  • Changes in the breast, such as puckering or dimpling of the skin
  • Rash on or around the nipple
  • Lumps or swellings in the armpits

What do I do if I find a lump?

The majority of breast lumps are benign (7), so there is no need to panic if you do find one.

If you find a strange lump or notice any other unusual changes in your breasts, discuss it with your doctor as soon as you can.

Your doctor will examine your breasts and may send you to your local breast assessment clinic, where you will be seen by a specialist and, if necessary, have further tests.

What tests will I have?

One of the tests to detect breast cancer is called a mammogram, which is an X-ray of the breasts. The breast is compressed between two plates, which can be slightly uncomfortable, but should not be painful (8).

If you are younger, you may have an ultrasound test instead, as this may give clearer results than mammography. Younger breast tissue is denser and X-rays may not show enough detail (8).

Another way to test for breast cancer is a biopsy, where cell or tissue samples are removed from your breast and examined under a microscope. Another way to extract tissue or fluid is fine needle aspiration, where cells from a lump are extracted for assessment (8).

Refs

  1. Cancer Research UK Cancer Stats | Key Facts on Breast Cancer | Accessed Mar 12 2009 | Page last updated Mar 27 2009
  2. Cancer Research UK | How many different types of cancer are there? | Accessed Mar 11 2009 | Page last updated Dec 5 2008
  3. Breast Cancer Care | 80 over 50 Policy Document (adobe pdf) | Anna Wood, Policy Analyst, Breast Cancer Care | Accessed Mar 10 2009 | Published 2003
  4. National Institute of Health and Clinical Excellence (NICE) | Breast cancer (early) - hormonal treatments | Accessed Mar 16 2009 | Date issued: November 2006 | Review due June 2009
  5. NHS Cancer Screening | Be Breast Aware (adobe pdf) | Accessed Mar 13 2009 | Published Jan 2007 | Department of Health
  6. Cancer Research UK | Breast Cancer Symptoms | Accessed Mar 16 2009 | Last updated Sep 26 2007
  7. Lancashire Teaching Hospitals NHS Trust | Benign Breast Lumps (adobe pdf) | Accessed Mar 12 2009 | Pub code: PD8313 | Published Sep 2005
  8. The Royal College of Radiologists | Information for patients visiting a symptomatic breast clinic with breast symptoms MS Word doc | Accessed Mar 18 2009 | Published May 2008

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