Health faq
What is breast cancer?The organs and tissues of the body are made up of tiny building blocks called cells. Cancer is a disease of these cells. It is important to realise that cancer is not a single disease with a single cause and a single type of treatment. There are more than 200 different kinds of cancer, each with its own name and treatment.
A cancer that starts in the breast is known as a primary breast cancer.
Treatment for breast cancer will get rid of the cancer for many women and the cancer may not come back (so the cancer is cured).
Local recurrence
In some women, after treatment for breast cancer, the cancer cells may come back in the area of the breast. This is known as local recurrence. The cancer cells may develop in the skin of the breast over where the lump was removed, or in the operation scar. Sometimes the breast cancer may return in the breast tissue left after a lumpectomy.
What are the typical symptoms of breast cancer?
In most women, breast cancer is first noticed as a painless lump in the breast. Other signs may include:
- a change in the size or shape of a breast
- dimpling of the skin of the breast
- a thickening in the breast tissue
- a nipple becoming inverted (turned in)
- a lump or thickening behind the nipple
- a rash (like eczema) affecting the nipple
- a bloodstained discharge from the nipple (this is very rare)
- a swelling or lump in the armpit.
My mother, grandmother and maternal cousin have all had breast cancer. Is it safe for me to take HRT for menopausal symptoms?
There
is now evidence in women over the age of 50 that taking HRT long-term
(more than a year or two) increases their risk of breast cancer. The
trials on which this evidence is based did not look at the effects of
HRT on women with a family history of breast cancer, so we donÕt know
for sure whether these women are more at risk if they take HRT.
However, if a woman has an increased risk of breast cancer because of
her family history then some specialists suggest avoiding HRT, if
possible.
Between 1 in 10 to 1 in 20 cases of breast cancer seem to be caused by a faulty gene, which can be passed from one generation to the next. This partly explains why some families seem to have more relatives with breast cancer than others.
The presence of a faulty gene increasing breast cancer risk in is only likely if you have:
- Two or more close relatives with breast or ovarian cancer on one side of your family or
- One close relative who had breast or ovarian cancer at a young age (under 45) or
- a man with breast cancer in the family, or someone with cancer in both breasts (bilateral breast cancer).
What are Breast lumps
Most breast lumps are benign and
are not cancer. Common causes of benign breast lumps are cysts (sacs of
fluid which build up in the breast tissue) or fibroadenomas (solid
tumours made up of fibrous and glandular tissue). Benign breast lumps
are easily treated.
If you notice a lump or are aware of any new change in your breast, visit your doctor straight away.
Any different or unusual change in the breast should always be examined by a doctor. This is because even though most breast lumps are benign, they still need to be checked carefully to rule out the possibility of cancer. Also, if it is a cancer, the earlier the treatment is given, the more likely it is to be successful.
Can men get breast cancer?
Yes, men can develop
breast cancer. However it is rare. Less than 0.5% of all breast cancers
occur in men and they account for less than 1% of all male cancers. Or,
to put it another way, approximately 1 in 200 men will develop a breast
cancer during their lifetime whereas the figure for women is 1 in 12.
Lifetime risk refers to the risk of developing a cancer in the whole of
a personÕs lifetime assuming that a person lives to be elderly (85).
Breast cancer is more common in men over 60 years. Because many are
unaware that breast cancer can occur in men, some delay consulting
their doctors about breast lumps resulting in a delay in diagnosis.
For the majority of men who do develop breast cancer no obvious cause can be found. In about one third there is a strong family history of breast cancer, suggesting a possible genetic link in these cases. Other factors known to increase the chances of developing male breast cancer include chronic liver disease and some testicular abnormalities, both of which can alter the balance of hormones in the body, which may lead to the development of breast cancer.
I am a man of 60. Two years ago I had treatment for a
breast cancer. My doctors think I am cured but I wondered if having had
breast cancer means that I am at risk of getting other cancers?
Breast cancer in men is quite uncommon. Less than 1% of breast cancers occur in men.
This means there is not as much information about male breast cancer as there is about breast cancer in women. However, a recent study investigated the risk of men who had previously had breast cancer developing another primary or different cancer.
This study looked at the medical records of almost 1800 men treated for breast cancer between 1973 and 1996. It discovered that men who had a breast cancer did have an increased risk of getting a new and separate primary cancer in their other breast, when compared to men who had never had breast cancer. But even though this risk was increased, only 12 men in the study developed breast cancer in their other breast. Therefore the risk of this occurring is relatively small.
Apart from this small risk of a second new breast cancer the study showed that overall men with a previous breast cancer were at no greater risk of getting other different cancers than the rest of the male population.
So these results are very reassuring, showing that the chances of developing another different cancer are not increased and the risk of developing a cancer in the other breast is very small.
Men who have had a primary breast cancer are at risk of developing secondaries from the breast cancer in other parts of the body. The extent of that risk will depend of many factors, including the size and grade of the cancer and whether or not the lymph glands are involved.
My daughter is pregnant and has just been found to have a
breast cancer. Are breast cancers which appear during pregnancy worse
than those in other people? Do they behave more aggressively?
Breast
cancer in pregnancy is uncommon. As a result of this, the relatively
small number of women in this situation has made it difficult to
produce absolutely reliable statistics.
In recent years, however, a number of studies have been done comparing women whose breast cancers have been discovered during pregnancy with other women of a similar age who have developed the condition but were not pregnant.
Before these studies were done there was a general belief among specialists that breast cancers discovered during pregnancy carried a worse outlook than normal. What the recent results have shown is that it does seem that women who are found to have a breast cancer while they are pregnant do not seem to do so well but this is not because their cancers are more aggressive but because, on average, they tend to be more advanced at the time they are diagnosed than the cancers discovered in women of as similar age who are not pregnant.
This means that for a women who is pregnant and found to have a small breast cancer with no sign of spread, her chances of successful treatment and cure will be just as good as those of a woman who is not pregnant with a similar cancer. In the same way, if the cancer is a little more advanced, with evidence of spread to the nearby lymph nodes, the outcome of treatment will be the same whether the woman is pregnant or not.
But, during pregnancy the chances of the tumour being 'early' and very small when it is discovered are less likely. The most likely reason for this is that there is a delay in making the diagnosis. This is partly because the breasts enlarge (often doubling in volume) during the course of a pregnancy and this increase in size, together with other changes in the breast, tends to hide any signs of breast cancer. There is certainly good evidence from the studies that it takes longer to make a diagnosis of breast cancer in women who are pregnant and this extra time does seem sufficient to explain why the cancers are often at a later stage when they are finally confirmed.
So, overall, pregnancy does not make the breast cancer behave any worse, or any better, than it would have done if the woman was not pregnant and the results of treatment can still be very successful.