How to be breast aware Olivia Newton-John who is a breast cancer survivor says
“Throughout my life, I have had a history of finding breast lumps during my regular check-ups with my doctor. They were always normal. But one day, I found a lump that felt different to me. The mammogram came back negative, as did the needle biopsy. But my doctor and I both had the same intuition that something was suspicious. A surgical biopsy found that I had cancer. Because I knew my body and what felt normal and what didn't, I am here today to tell you my story. I am also happy to say that most lumps women find are non-cancerous, just as my early ones were. I have learned that doing regular breast self-exams saved my life and now with the Liv Kit, it helps me feel lumps easier than with my hands alone.
By doing your breast self-exams every month, you can discover what is normal for you. Make it a habit — like exercising, using sun block or eating a healthy diet. It only takes a few minutes a month, but it can make a world of difference.” There is no one correct time or technique for breast examination. Women should get into the habit of feeling and looking at their breasts from time to time. Being breast aware means being aware of changes throughout the month. Check yourself in a way that is comfortable and convenient for you. Some women find it convenient to look at their breasts when preparing for a bath or shower, using a mirror to view their breasts from different angles. Some women find it easiest to feel their breasts with a soapy hand since this slides easily over the breasts. Some women find it more comfortable to feel their breasts when lying on the bed, in which case a skin lotion or moisturiser may help the hand slide over the breasts. Early detection of breast cancer is vital as it increases the chance of successful treatment. Women are therefore encouraged to be "breast aware". This means knowing how your breasts look and feel and the normal changes that occur at different times of your menstrual cycle. Visit your doctor if you feel a lump, or if one of your breasts changes shape or become constantly painful. There is no need to examine yourself to a strict routine, but it's sensible to look at and feel your breasts from time to time. Doing this while showering, bathing or standing in front of a mirror may be convenient. Once you are familiar with the usual feel and appearance of your breasts you will be able to detect changes. Anyone who feels uncomfortable or anxious about feeling their breasts may find it helpful to discuss their worries with a doctor or nurse, or staff at a well woman clinic.. When to see a doctor The main form of breast screening for women is mammography, a low-dose X-ray of the breast tissue. Mammography can not only detect breast cancer, but it can also show other breast problems that are not cancers. Mammography can often reveal lumps before they can be felt and it can also show small deposits of calcium in the breast, which may be a sign of early cancer. Mammography is used routinely for screening in certain groups of women. The NHS Breast Screening Programme offers mammography once every three years to women between the ages of 50 and 64 years. This will be extended to include women up to and including the age of 70 by 2004. Women with a family history of breast cancer will be offered regular mammograms from an earlier age. The usual recommendation is to start screening 10 years earlier than the age at which the youngest close relative with breast cancer was diagnosed. Younger women are not routinely invited for screening and breast cancer is quite rare in women under 50. However, breast screening is available for women over 40 at independent screening facilities including BUPA Wellness Centres. Women who are attending for mammography should continue to be breast aware. Different types of breast lumps Breast lumps are very common and most women will experience one or more at some time in their lives. However, the vast majority (at least nine out of ten) are benign, i.e. not cancerous. Benign lumps can be caused by cysts (sacs of fluid which build up in the breast tissue) or fibroadenomas (solid growths made up of fibrous and glandular tissue). Cancer cells are different from normal cells, as they go on growing and multiplying when they should not, to form lumps, or tumours. Breast tumours can be either malignant (cancerous) or benign (non-cancerous). The difference between malignant and benign tumours is that malignant tumours have the ability to invade surrounding areas. Sometimes cells from malignant tumours break away and spread to other areas of the body (through the bloodstream or the lymph system) where they may grow and form "secondary" tumours. Another name for a secondary tumour is a metastasis. The breasts have a rich blood supply and an extensive lymph gland drainage system, which can be important factors in the spread of the disease. What to look for Even though most lumps are not cancerous, if you find a lump in your breast, or notice any of the following changes, you should arrange to see your GP as soon as possible: - • change in size or shape of your breasts (after puberty is complete)
- • dimpling of the skin (skin looks like texture of orange peel)
- • lumpiness or thickening
- • newly inverted (turned-in) nipple
- • bloodstained discharge from nipple
- • a rash, often eczema-like, on the nipple or surrounding area
- • swelling or a lump in the armpit
Benign breast lumps do not normally need treatment, although they may be removed as part of the diagnostic process (if the lump is removed for biopsy, for example). What will happen next? Your GP will examine you and will then arrange for you to have any tests that you may need at the hospital or specialist breast clinic. These tests may include the following: - • Mammography (X-ray examination of the breasts).
- • Ultrasound (sound waves are used to create an image of the lump).
- • Needle aspiration – a fine needle and syringe is used to take a sample of cells from the breast lump to send to the laboratory for testing.
- • Colour Doppler (a special type of ultrasound which gives a colour. picture showing the blood supply to the lump - tumours often have a very rich blood supply).
- • MRI (magnetic resonance imaging) - a scan using a magnetic field to build up a cross-sectional picture of your body.
- • Core biopsy – a small sample of the breast tissue is taken for examination in the laboratory.
- • Excision biopsy – the lump is removed under general anaesthetic and sent to the laboratory for examination.
Different types of breast cancer Breast cancer is the most common cancer found in women. One in nine women will develop the disease at some time in their lives, but it is mostly a disease that affects women over 50. Breast cancer can occur in men, but is 100 times less common than in women There are different types of breast cancer, which are classed as invasive and non-invasive, depending on their ability to spread to neighbouring tissues.
Non-invasive breast cancers The most common type of non-invasive breast cancer is ductal carcinoma in situ (DCIS). Cancer cells are found inside the milk ducts but have not yet spread through the walls of the ducts into the breast tissue. Nearly everyone diagnosed with DCIS at an early stage is able to have the cancer completely removed. In some cases, DCIS may develop into an invasive form of breast cancer. Invasive breast cancers The most common type of invasive breast cancer is called invasive ductal carcinoma (IDC) which is responsible for around 80% of all breast cancers. Cancer cells are found both in the ducts and in the breast tissue. These cells are also able to metastasize (spread) to other parts of the body. Invasive lobular carcinoma (ILC) accounts for between 10-15% of all breast cancers. With ILC, cancer cells initially grow in the lobes of the breast and have the ability to spread both to other areas of the breast and to other parts of the body. Risk factors for breast cancer The causes of breast cancer are not yet completely understood but there are certain factors known to increase the risk. These include: - • Age – approximately 80% of women diagnosed with breast cancer are over 50 years of age.
- • Family history – women whose mother, sister or daughter developed breast cancer have double the risk of developing the disease. If any of these relatives developed breast cancer before menopause, this adds to the risk.
- • Cancer in one breast – if a woman has had cancer in one breast already, there is an increased risk of developing a new cancer in the other breast.
- • Age when periods started – If periods started early (before age 12) or if menopause happened after age 50.
- • Age at first pregnancy – women who do not have children or who have their first child after the age of 30.
- • Exposure to radiation – such as radiotherapy at a young age, e.g. for treatment of Hodgkin’s disease.
- • Taking hormones – women who take the pill or are on HRT have a slightly increased risk of breast cancer (while the risk of other cancers is reduced).
- • Obesity – there is some evidence to suggest that being very overweight can contribute to the risk.
- • Diet – diets that are high in fat and alcohol are linked to an increased risk of breast cancer.
- • Not breast-feeding – there is evidence that women who breast feed are at less risk of developing breast cancer.
There is no evidence that damage to a breast, such as a knock or bruise, causes cancer. Diagnosis of breast cancer If changes to the breast show up on a mammogram (an X-ray picture of the breast taken as part of routine screening), or when a woman finds a lump in her breast, a number of tests can help to determine whether the lump is cancerous. These include fine needle aspiration, where a sample of cells from the breast are removed using a needle and examined in a laboratory. Ultrasound and magnetic resonance imaging (MRI) scans may also be used. A suspicious lump can also be surgically removed (biopsy) and sent for analysis. Breast Screening – Mammography Breast screening (mammography) is an X-ray examination of the breasts. It can show up abnormalities at an early stage, when they are too small for you or your doctor to feel. A mammogram only takes a few minutes and involves only a small dose of radiation – much less than an X-ray for a broken bone. The health risk is therefore very small. Some women find breast screening uncomfortable as the breasts have to be held firmly in position and compressed for a few seconds in order to take a clear picture. This discomfort usually passes as soon as the mammogram is over. The NHS runs a National Breast Screening Programme, where all women aged 50-70 are invited for breast screening every three years. However, until recently the upper age for screening was 64. Accordingly, in some areas, women aged 65-70 will not be automatically invited for screening until 2004. Breast screening for women under 50 is currently under investigation in the to determine how effective it is in reducing deaths from breast cancer. However, screening is available for women over 40 at private screening facilities, including BUPA Wellness. If you are over 70 (or are over 65 and live in an area where the screening is not extended to 70) you will be not be invited for NHS screening. However, if you request an appointment, then this will continue to be provided free every three years. Breast screening is estimated to save around 1,250 lives per year in the. However, no test can give you an absolute "all clear" and mammograms may still miss breast cancer. So you should see your doctor at once if you feel a breast lump, even you have had a clear X-ray result. Treatment of breast cancer Breast cancer treatment depends upon a number of factors. These include whether or how far the cancer has spread; the age of the woman and whether she has been through the menopause; the grade of the cancer (what the cells look like under a microscope); and whether the cancer cells respond to hormones, particularly oestrogen.
Studies have shown that treatment of breast cancer is often most successful when the woman affected is fully involved in the decisions made about her care. Surgery The first step in treating breast cancer is usually to surgically remove the lump and this may be the only treatment that is needed. Surgical treatments include a lumpectomy, also known as a wide local excision (removal of the lump, usually with some healthy tissue) or a mastectomy, where the whole affected breast is removed. Often the lymph glands in the armpit are removed at the same time. Surgery may be followed by chemotherapy, radiotherapy or hormone treatment. This adjuvant (add-on) treatment reduces the chance of the cancer coming back, or spreading to other organs. Chemotherapy This is a course of treatment using drugs that interrupt the growth of cancer cells. Usually a combination of two or three different chemotherapy drugs are given in a course of around six treatments, each one separated by a few weeks. Chemotherapy may also be given to shrink a tumour in preparation for surgery.
There have been recent advances in the treatment of breast cancer including drugs, such as tamoxifen to block the oestrogen that can encourage certain types of breast cancer to grow, and taxanes, such as paclitaxel (Taxol), a chemotherapy that attacks cancer cells in a new way. Certain cancers may also respond to novel treatments with monoclonal antibodies. One such drug, trastuzumab (Herceptin), which is becoming more widely available in the N.H.S., attacks only cancer cells that have a particular structure. Radiotherapy A beam of radiation is targeted very precisely to destroy cancer cells. An important advance in radiotherapy has been much improved control of the side-effects, such as nausea. Living with breast cancer Many women who are diagnosed with breast cancer can be completely cured. Women whose cancer cannot be completely cured can often expect their disease to be controlled and to live a normal life for many years. For other women, palliative treatment is available. This aims to slow down the spread or growth of cancer cells, and control any associated pain or other symptoms. Coping with cancer is different for each individual. There may be feelings of anger, anxiety, depression or denial. Help and support from family, friends and, often, other women affected is extremely valuable. Further information CancerBACUP 0808 800 1234 (open 9am - 7pm Monday - Thursday) http://www.cancerbacup.org.uk Breast Cancer Care 0808 800 6000 http://www.breastcancercare.org.uk What doctors think of Liv Kit Dr Julian Kenyon, Medical Director of the Dove Clinic for Integrated Medicine, London & Winchester www.doveclinic.com
"The LIV Kit is an excellent aid to doctor and nurse breast examinations. We feel it has a good chance of helping women to discover problems at an earlier stage and this, together with the preventative approaches we use, is a step in the right direction.". Dr Mark Atkinson, holistic medical physician
"The Liv kit represents a significant development and advancement in the area of breast self-examination. I wholeheartedly recommend women to invest in the kit as it significantly enhances the likelihood of identifying changes in breast tissue structure that might not have been picked up upon by simple breast self-examination alone - this can lead to earlier medical intervention and a higher probability of a successful clinical outcome". Dr Rajendra Sharma - Medical Director of the pioneering doctor-led "The Diagnostic Clinic"
"We have been using the Liv Kit for the past twelve months to ascertain it's efficacy as part of our Doctor and Nurse breast examinations. In the controversial area of self -examination our current opinion is that the simple device makes self examination much easier and may help women discover problems earlier. Our studies are on going but we are hopeful this is an advance in prevention of breast disease". Christopher Head - Chief Executive, Bristol Cancer Help Centre
"Bristol Cancer Help Centre is the leading UK holistic cancer care charity and we see, all too often, the devastating effects of a cancer diagnosis. We firmly believe that the Liv Kit is a valuable tool to help women detect breast changes. The Bristol Approach encourages the individual to take responsibility for their own health and well being - the Liv Kit is an important part of helping people to do just that." |
