Breast cancer: frequently asked questions and advice
To help patients better understand breast cancer, Mo Keshtgar, consultant oncological surgeon, held a breast cancer web chat.
The questions and answers from this session are below.
How can I reduce the risk of breast cancer?
We believe that breast cancer can be caused by a number of factors; however we do not know the exact cause. Having a healthy lifestyle, a balanced diet, maintaining a healthy weight and reducing your alcohol intake are very important. You should also avoid long-term use of hormonal supplements, such as contraceptive pills and hormone replacement therapy.
Can I get breast screening before I am 50?
Yes, the earliest age for breast screening in the UK has now dropped to 47. However, if you are deemed to be at a high risk of developing breast cancer based on your family history, breast screening can be started at a much earlier age (based on the advice of your doctor/geneticist).
What are the different breast cancer symptoms I should look out for?
Breast cancer usually presents as a lump or thickening in the breast tissue. It is important to note that in the majority of cases, this is painless.
Some patients have a lump in their armpit (axilla) as their first symptom of breast cancer. Others see a change in shape – a deformity of the breast including dimpling of the skin, a red or itchy rash or nipple discharge, particularly if it’s blood stained.
Breast pain is rarely one of the symptoms of breast cancer.
It’s important to note that 9/10 cases of breast lumps turn out to be non-cancerous (benign) and the majority of patients who experience nipple discharge do not have breast cancer. However, if you have any of these symptoms it’s important to get it checked out as soon as possible.
I understand that breast cancer is the most common cancer in the UK – why is it so common?
In fact, breast cancer is one of the most common cancers in the western world. It could be related to western lifestyles, including diet, but the actual cause of most breast cancers is unknown.
What we do know is that the younger you were when your periods started, the later your menopause, and the longer you delay starting a family, then the greater your risk of developing breast cancer, but these effects are very small for individual women. Contraceptive pill use, hormone replacement therapy, diet and lifestyle may contribute too.
If the cancer returns multiple times does that reduce the likelihood of responding to breast cancer treatment?
We have different breast cancer treatment options in our armoury so if one doesn’t work we can try another. It’s important to have a positive attitude towards the disease as patients who stay positive tend to do better, although understandably it’s not always easy.
Why is there a link between breast cancer and ovarian cancer?
The link between breast cancer and ovarian cancer is mainly due to faulty genes. You can find more information about breast cancer genes on Cancer Research UK’s cancer help website.
How unusual is it to have two different types of breast cancer?
It is possible to have different types of breast cancer within the same breast or in both. It’s not very common.
How common is male breast cancer?
For every 100 breast cancer patients that I see, one is a man. The national statistic is in line with this – one in 10. More information about male breast cancer is available on the NHS Choices website.
Is it safer to have a double mastectomy rather than a single mastectomy?
There is no evidence that a double mastectomy is safer than a single mastectomy, although more patients are now requesting for this to be done. It is important to remember that the reason for having a double mastectomy is risk reduction – not risk elimination.
Is breast reconstruction surgery normal practice after a mastectomy and if so is it always done on the NHS?
It is normal practice that every woman, irrespective of their age, should be offered breast reconstruction surgery either at the same time or after their mastectomy. This service is offered on the NHS. There are different types of reconstruction that your surgeon can discuss with you (see the left hand navigation for more details).
A sabbatical with a difference