Breast Cancer

October is Breast Cancer Awareness Month so we thought now was a good time for an update on this important topic, particularly in light of some recent studies showing that many women have been delaying screening because of the Covid-19 pandemic. Early detection through screening programs and prompt investigation of symptoms offers the best chance of cure and is one of the reasons behind a big drop in the mortality (deaths) from breast cancer in recent decades. There has also been a recent focus on risk reduction, offering some hope that we might be able to work towards prevention (an ounce of which is always worth a pound of cure!). Read on for a 10-step plan to reduce your risk.

What is breast cancer exactly?
Breast cancer is the most common cancer in women, with around 20,000 Australian women diagnosed every year. 80% of breast cancers occur in women over the age of 50. Although the incidence of new breast cancer diagnoses has been increasing at a rapid rate over the last few decades, the mortality rate, or deaths due to breast cancer, has dropped dramatically over the same period, thanks to earlier detection and significant advances in treatments.

Breast cancer occurs when cells lining the milk ducts or other tissues within the breast, become damaged or abnormal and start multiplying in an uncontrolled way until a growth, or tumour, is formed. These cancerous cells can be contained within these structures, known as non-invasive, or carcinoma in situ, or can be invasive with potential spread beyond the breast to nearby lymph glands, other organs such as the liver or lungs, and into the bones. Some may have certain receptors on the cells which provide different treatment options. Because breast cancer is not just one disease, recent advances in our understanding have meant that treatment is becoming increasingly personalised.

Screening and Early Detection
There is no doubt that the breast cancer screening program, offering women aged 40-74 a free screening mammogram every 2 years, has saved countless lives. In the 30 years since the establishment of Breast Screen Australia, five year survival rates have jumped from 77% to 92%. In fact, for women whose breast cancer is detected early enough and is still confined to the breast, the five year survival rate is almost 100%.

Also important is to have any breast changes promptly checked by your GP at any age. It’s therefore a good idea to be “breast aware” by checking your own breasts once a month from about the age of 20. See the link below for how to do a self-check and what changes should trigger a visit to your GP. We will often offer to do a breast check for you as part of a routine health check every 1-2 years depending on your age and other risk factors.

What are the symptoms to look out for?
Some women have no symptoms and their breast cancer is picked up by a screening mammogram or by their doctor during a check-up. If there are symptoms, they may include the following:

• A new lump, or thickening, especially if only in one breast
• Nipple changes such as a rash or sore, discharge, change in shape or turning in of the nipple
• Change in size or shape of the breast
• A rash or red swollen breast
• Skin dimpling of the breast
• Pain, especially in one breast, that doesn’t go away after a menstrual period.

Any new breast symptom should be checked out as soon as possible by your GP.

What are the risk factors for breast cancer?
We can think of risk factors as things about us or what we are exposed to, that might increase our chance of developing a disease. Risk factors don’t tell the whole story though; many women with some of these risk factors don’t develop breast cancer whilst many who are diagnosed have no known risk factors. Some, such as gender and age, we can’t control, but there are some lifestyle changes that may help. Talk to your GP about your own personal risk and what actions you can take.

Non-modifiable risk factors:

• Being female
• Increasing age
• Family history – having one or more first degree relatives (parent, sibling or child) can increase your risk, as can inheriting one of the known breast cancer genes. These only account for around 5% of breast cancers though
• Commencing menstrual periods under the age of 12

Modifiable risk factors:

• Number of pregnancies – more are protective
• Breastfeeding  – protective
• Being overweight
• Consuming alcohol – even moderate alcohol intake can significantly increase the risk
• Not enough physical activity
• Poor diet
• Some ingredients in cosmetics and household cleaning products may cause estrogen-like effects: research is ongoing in this area

A 10-step plan for reducing your risk

1. Talk to your GP about your personal risk – if your risk is higher than average you may need more frequent screening or from an earlier age
2. Perform regular self-checks each month
3. See your GP promptly if you detect any changes or develop new symptoms
4. Regular screening mammograms every 2 years from the age of 50, for some women this may be recommended from 40.
5. Maintain a healthy weight
6. Watch alcohol consumption – even 1 drink a day can increase risk by 30-50%
7. Eat a healthy diet rich in a variety of fresh foods and low in processed foods – the Mediterranean diet is an easy and delicious option
8. Breast feed your baby if you can
9. Exercise regularly – at least 30 minutes most days
10. Check the ingredients in cosmetics and other household products, more information on this in the link below

Please see us if you have any concerns about your breast cancer risk, or any breast symptoms at all.