Facts and other helpful information including answers to common questions about breast cancer, symptoms, current treatments and screening.
We strongly encourage all women and men to be breast aware and follow the 5 point plan. Remember, if you notice anything unusual or you become worried, go to your GP.
What is breast cancer?
Breast cancer occurs when breast cells divide in an uncontrolled manner. It’s not a single disease; there are at least 10 subtypes of breast cancer identified that grow at different rates and respond differently to hormones. For example, 70% of breast cancers develop in the milk ducts and 10-15% develop in the breast lobules. Left untreated, breast cancer cells may spread and establish secondary breast cancer tumours (made up of breast cells) in other parts of the body.
- Breast cancer is the most common form of cancer in the UK with a lifetime risk for women of 1 in 8
- Breast cancer is more common in women over the age of 50, with 8 out of 10 newly diagnosed cases falling into this age category
- Around 350 men in the UK are diagnosed with breast cancer each year
- Over 90% of people diagnosed with the earliest stage of breast cancer (small tumours in the breast) survive for more than 5 years
- Around 15% of people diagnosed with advanced (Stage IV) breast cancer (when secondary spread is detected in other parts of the body) survive for more than 5 years
- Secondary spread occurs in 1 in 5 breast cancer cases
- Almost 30% of breast cancer cases in the UK are estimated to be preventable through lifestyle changes (e.g. moderate alcohol intake, maintaining a healthy weight, exercising
- 1000 people a month in the UK lose their lives to breast cancer
- There are at least 10 subtypes of breast cancer
In the UK each year;
- Over 48,000 new cases are diagnosed
- 75% of new breast cancer diagnoses are in post-menopausal women
- Around one man a day is diagnosed with breast cancer
- Breast cancer is the single most common cause of death in women aged 35-54 years and 1 in 8 women will develop the disease in their lifetime.
Striking international differences exist in the incidence of fatal breast cancer. For every 100,000 people there are:
- 24.3 deaths in England and Wales
- 18.9 in Italy
- 8.3 in Japan
Women moving from low incidence to high incidence countries seem to develop the higher risk of their new country, indicating that environment, diet and lifestyle play a large role.
The number of women diagnosed with breast cancer each year is increasing, which may be due to improved screening programs
Breast x-rays (mammograms) are most successful in detecting breast cancer in women over the age of 50. Mammograms are offered to:
- all women aged 50-70 every three years
- women over 71 on request
- women between 40 and 49 at high risk annually
In women below the age of 35, breast tissue is usually too dense for accurate screening using a mammogram, and an ultrasound scan is usually offered instead.
- Every woman who has a mastectomy is entitled to a suitable breast reconstruction or prosthesis on the NHS.
- Surgeons use breast or other tissue to create a new breast to match the remaining one. It can be done during the mastectomy or later on. Another option is a prosthesis which is worn inside a bra.
- More information regarding reconstruction can be found here.
All people who have had breast cancer should be monitored for recurrence (a repeat diagnosis) with an annual check-up for at least five years after surgery. Recurrence happens in 20-30% of cases but with early diagnosis and treatment almost 90% of people will survive for at least five years.
Breast cancer cells are carried in the blood and lymphatic system to other areas of the body, most commonly the bones, liver and lungs. Surgeons will often remove some lymph nodes to check for evidence of spread. Secondary spread is the main cause of all breast cancer related deaths.
- The type of surgery undertaken will depend on the type of breast cancer you have. For example, with single, small tumours just the affected lump or segment of breast is removed.
- For larger or more aggressive, fast growing tumours that are more likely to spread, mastectomy is likely to be recommended, when the breast is removed. Nowadays, reconstructive surgery can be performed at the same time as mastectomy if desired, though if you’re also receiving radiotherapy you may be advised to wait for reconstructive surgery.
- Surgery is often accompanied before or after with chemotherapy or radiotherapy treatment, also depending on the type of breast cancer you have.
If you experience any of these symptoms you should see your doctor immediately. However, 90% of breast lumps are not cancerous and for those that are, two-thirds can be initially treated without a mastectomy.
- Lumps/thickening in breast or armpit – first sign in 80-90% of cases
- Dimpling on the skin of your breasts`
- Nipple discharge or bleeding from the nipple
- Change in breast size or shape
- Change in feel of breast
Treatment of secondary spread
Chemotherapy targets actively growing cells, which destroys cancer cells as they grow faster than most healthy cells. Chemotherapy can be given before surgery to shrink a tumour or after surgery to reduce the chances of spread or recurrence.
Different combinations of chemotherapy drugs can be used depending on your breast cancer type or if you have any medical conditions. Side effects vary depending upon the combination of chemotherapy being given but include hair loss, tiredness and digestive problems.
Radiotherapy helps reduce pain and tumour size by destroying the DNA in cancerous cells. It may be given before or after surgery and can be given in combination with other treatments depending on the type of breast cancer you have. Radiation can cause slight reddening or discomfort in the treated area, tiredness and nausea.
Tamoxifen is an hormonal therapy that works by blocking oestrogen from binding to cancer cells which stops the cell from receiving growth signals. Tumour cells that are characterised as oestrogen-responsive (ER+) may be treated with this drug.
Tamoxifen is especially helpful for post-menopausal patients, but recent research suggests pre-menopausal patients may also benefit. Side effects can include vaginal irritation, occasional nausea, hot flushes and irregular menstruation. Tamoxifen is usually prescribed for two or five years.
Herceptin is a treatment used against ~30% of breast cancers that are classed by doctors as HER2 positive – which means the cancer cells make more of a protein called HER2 than is usually found in healthy cells. HER2 proteins relay growth signals from the cell surface into the cell telling it when to divide. In healthy cells, these signals go through checkpoints to prevent uncontrolled cell division but in a HER2+ cancerous cell these checks can be bypassed, allowing uncontrolled cell division and tumours to develop.
Herceptin is the trade name for an antibody (Trastuzumab) which sticks to the HER2 protein and blocks the extra growth signals, slowing down or preventing uncontrolled cell division and tumour growth. It can also act as a bridge between killer white blood cells and the cancerous cell, flagging up the presence of the cancerous cell to the body’s natural immune system allowing it to kill off the breast cancer cells. Comprehensive information about HER2 can be found at www.herceptin.com