Even if you have mammograms, you must continue to check yourself for signs of breast cancer. Photo / Getty Images
Research shows that almost half of women do not regularly check for signs of the disease.
Breast cancer is the most common female cancer, with a new case diagnosed every 10 minutes. Most diagnoses are in women over 50, like the Duchess of York, Sarah Ferguson, 63, who recently revealed she has undergone surgery for breast cancer that was diagnosed following a routine mammogram. But it can affect women (and occasionally men) of any age.
Almost everyone will know someone who has, or has had, breast cancer. Yet there is still a knowledge gap: research from Breast Cancer Now found that 47 per cent of women do not regularly check their breasts for unusual changes that could indicate breast cancer, and the latest NHS data shows that nearly 40 per cent of women offered routine breast screening don’t take it up.
“I think a lot of people are frightened of what they might find and what that might mean, and there might be people who aren’t aware of the signs and symptoms,” says Katy Goford, a clinical nurse specialist at Breast Cancer Now. But regular self-examination could be lifesaving: around 11,500 women in the UK die from breast cancer each year, but if it is diagnosed early, at stage 1 or stage 2, between 90-100 per cent of women will survive.
“It’s important to get the message out to encourage people to check on a regular basis, because if you catch it early, then it can be treated much more successfully,” says Goford.
Most breast cancers are picked up after women spot new or unusual changes in their own breasts, although some, like the Duchess’s, are picked up through screening. But even if you have mammograms, you must continue to check yourself, Goford says. “Being aware of any changes that happen in between your mammograms is important as well.”
Here are the symptoms you need to know, and the ways you can reduce your risk.
Age is the most significant risk factor for developing breast cancer: 82 per cent of cases occur in women over 50, says Goford. “The main risk is getting older,” she says. “After your menopause, you’re more at risk of developing breast cancer. But as I said, anybody can develop breast cancer at any age.”
Younger women should not be complacent: rates of breast cancer have risen in every age group since the 1990s, including by 17 per cent in women under 50, according to Cancer Research UK. Both men and women should be “breast aware”: 99 per cent of breast cancer cases occur in women, but around 400 are diagnosed each year in men (most of whom are over the age of 60).
There are other built-in risk factors you can’t control: according to Breast Cancer Now, women who started their periods early (before the age of 12) have a slightly increased risk; likewise if you go through menopause late (after the age of 52). This is likely to be due to increased lifetime exposure to the growth hormone oestrogen, which can stimulate the growth of some breast cancers. Taking hormone replacement therapy (HRT) or the combined contraceptive pill can also contribute to an increase in risk, although this is small. The risk disappears a few years after stopping.
Genetic factors, such as the BRCA gene, can play a role, but more rarely than people assume. “A lot of people think that there is a big [genetic] risk with family history, says Goford, but that only really affects about five to ten per cent of people… we would always say if you’re concerned about your risks, go to your GP and talk to them about your family history and you might be eligible for increased screening.”
Around a quarter of cases are preventable. “Increased weight, obesity and increased alcohol intake can increase your risk of breast cancer,” says Goford. This inclues the 8 per cent of cases caused by overweight and obesity and the 8 per cent caused by alcohol.
Although most people are aware that a lump can be a symptom of breast cancer, not everyone is aware of the other signs: for example, polling shows that 96 per cent of women know a lump can be a symptom, but only 39 per cent recognise that a rash or redness can be a symptom.
Here is what to look out for:
Straightforward lifestyle changes such as reducing alcohol intake, taking enough exercise (at least 150 minutes of moderate, or 75 minutes of vigorous, physical activity weekly) and eating healthily by avoiding highly processed foods and increasing your fibre intake are the obvious ways to reduce risk, says the prevention charity Breast Cancer UK. Evidence shows that you can reduce your risk of breast cancer with just 20 minutes of physical activity per day.
When it comes to alcohol, the reason increased consumption contributes to breast cancer risk is not well understood. Breast Cancer Now says: “It might change the levels of hormones in the body, including oestrogen… There may be other ways that alcohol increases the risk of breast cancer, but these are not yet clear.”
What is clear, however, is that limiting your intake reduces your risk: the World Health Organisation warns that the risk of breast cancer increases with each unit of alcohol consumed per day.
“The most important thing is to be aware of what your breasts look and feel like normally, and check them on a regular basis,” says Goford. “We don’t say you have to do it a certain time every week or anything like that. Make it part of your routine, whether you’re in the shower, or lying in bed, whichever is most comfortable for you.”
She suggests using the principles of TLC: touch, look (in the mirror), check. “Examine all the breast tissue right up into your armpits and to your collarbone; if you notice anything that’s different for you, go to your GP and ask them to check it out.”
For a step-by-step guide, visit the CoppaFeel! website and use its online “Self Checkout” tool. The charity also offers a free monthly text reminder service.
The bottom line is that, if you notice anything new or unusual, you should see your GP. “A lot of people are afraid of contacting their GP and they don’t want to bother them, but it’s really important if you notice anything that’s different; if it’s something new for you, it’s something that needs to be checked,” says Goford. “Your GP will be able to examine you. and they may be able to reassure you there and then, but if they feel further investigations are needed, they will refer you to a breast clinic.”
In the shower
With the pads/flats of your 3 middle fingers, check the entire breast and armpit area pressing down with light, medium, and firm pressure. Check both breasts each month feeling for any lump, thickening, hardened knot, or any other breast changes.
Check for:
In front of a mirror
Visually inspect your breasts with your arms at your sides. Next, raise your arms high overhead.
Look for any changes in the contour, any swelling, or dimpling of the skin, or changes in the nipples.
Next, rest your palms on your hips and press firmly to flex your chest muscles.
Left and right breasts will not exactly match—few women’s breasts do, so look for any dimpling, puckering, or changes, particularly on one side.
Check for:
Lying down
When lying down, the breast tissue spreads out evenly along the chest wall. Place a pillow under your right shoulder and your right arm behind your head. Using your left hand, move the pads of your fingers around your right breast gently covering the entire breast area and armpit.
Use light, medium, and firm pressure. Squeeze the nipple; check for discharge and lumps. Repeat these steps for your left breast.
Check for:
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