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How to be 'Breast Aware' this October
Monday 3 October 2016

October is Breast Cancer Awareness Month and so Mr ChandraSekharan, Consultant Breast Surgeon at Oaks Hospital, takes the opportunity to explain the importance of breast awareness.

Breast cancer

* Is one of the most common cancers affecting women in the developing countries.
* In UK, for example, breast cancer causes 12,000 deaths each year.
* 60,000 new cases are diagnosed annually, ie 1 person every 10 to 15 minutes with 1 in 8 women developing breast cancer in their lifetime.
* Marked geographical variations with the highest incidence in western countries and lowest in African and Asian countries (although this is changing).

Factors influencing your risk of breast cancer

                                              High risk           Low risk

Age at first pregnancy             > 30 yrs             <20 yrs

Age at puberty                       <12 yrs              >14 yrs

Age at menopause                   >55 yrs             <45 yrs

Obesity (postmenopausal)         Obese                Thin

Breastfeeding                           None                 Several yrs

Oral contraceptive pill (<45)      Yes                    No

HRT                                         Yes                    No

Risk and protective factors

* Age is by far the greatest risk factor
* Family history
* Hormonal factors
* Lifestyle – smoking, alcohol, obesity
* Previous history of breast cancer or other premalignant conditions like LCIS, ADH etc
* Protective factors – hormonal factors, lifestyle

Pathology of breast cancer

* Cancer is not a single step event.
* A number of “hits” or injuries to DNA are needed before a normal cell becomes a cancer cell.
* It is said that on an average about 5 to 7 injuries to the DNA has to happen by the time it becomes a cancer cell.

?Signs and symptoms

* The most common sign of breast cancer is a lump or mass in the breast.
* Dimpling of the breast.
* Lump in the underarm.
* Nipple discharge, pain, or inversion (turning inward).
* Skin irritation (e.g. redness, scaling) of the breast or nipple.
* Swelling.

?Diagnosis of breast cancer

* Triple assessment is the gold standard.
* Physical examination by a breast specialist.
* Imaging – mammography, ultrasound and MRI when indicated.
* Pathology which may be cytology, core biopsy or very rarely open biopsy.

Breast screening

Breast screening aims to find breast cancers early. It uses an x-ray test called a mammogram that can spot cancers when they are too small to see or feel.

Breast screening is currently offered automatically to women who are registered with a GP and are aged 50-70 years in England. However, the NHS is in the process of extending the programme as a trial, offering screening to some women aged 47-73 years.

Breast screening cannot prevent cancer and it’s possible for a cancer to develop in between each routine screening mammogram. That’s why it’s important to continue to be breast aware and report any changes to your GP even if you’ve had a mammogram recently.

If you are not eligible for the NHS screening programme but are over 40 years old, you can self-refer to pay for a mammogram at Oaks Hospital. You may also choose to supplement your NHS screenings with a private mammogram in between times.

Please remember:

More people are surviving breast cancer than ever before, thanks to earlier detection and better treatments. So please be ‘BREAST AWARE’ not just for October but all of the year!

Oaks Hospital is currently investing in the latest digital mammography to offer breast screening for women over 40 years. Please keep an eye on our website for more details.              

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