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Frequently asked questions

 

What is breast cancer?

 

Key facts about breast cancer

 

1 in 8 women in the UK will be diagnosed with breast cancer at some point in their lifetime  31% of cancers diagnosed in women are breast cancer, making it the most common cancer in women  1 in 5 cases of breast cancer are in women under 50 

 

Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast.  The malignant cells can invade surrounding tissue, or spread to other areas of the body, however with early detection and treatment, most people are able to continue a normal life.

 

Cancer begins when the process of cell growth goes wrong and malignant cells form when the body doesn't need them and old or damaged cells do not die as they should.  This results in a build-up of cells forming a mass of tissue called a lump called a tumour.  

 

Cancer cells can spread by breaking away from the original tumour and entering lymph or blood vessels.  When cancer cells travel to other parts of the body and begin damaging other tissues and organs, the process is called metastasis.

 

With early detection and treatment there is an excellent chance breast cancer can be treated successfully.  The further the cancer has spread the more difficult it is to treat, so it is important to be breast aware and proactive about breast screening.

 

Contact us today to learn more or to make an appointment to see one of our specialist team.

 

Breast cancer risk factors

 

Key risk factors for breast cancer include:

 

  • gender
  • age
  • reproductive history
  • exogenous hormones
  • some previous breast disease
  • family history
  • genetic inheritance
  • lifestyle factors such as alcohol intake and obesity
  • increased breast density (which makes mammography less sensitive)

 

Gender

 

Women are far more likely to develop breast cancer than men.  Although much rarer, than in women there are about 400 men diagnosed with male breast cancer each year in the UK, compared with 50,000 cases of breast cancer in women.

 

Age

 

Age is the next biggest risk factor for both men and women.

 

Reproductive history

 

Many factors related to reproductive history affect the risk of breast cancer.  Women in developed countries have a higher risk of breast cancer as a result of the late age of first pregnancy, having fewer children and lower rates of breastfeeding.  The age when a woman starts her periods, the age at first birth, the number of children she has and the age at menopause can all affect risk.

 

Exogenous hormones

 

Hormone therapies such as HRT and some high-dose oestrogen-only oral contraceptives have been found to increase the risk of breast cancer.

 

Previous breast disease

 

Some non-malignant breast conditions can cause an increased risk of breast cancer.

 

Family history

 

If you have a mother or sister who has had breast cancer your risk factor is higher than that of a woman with no family history.  The risk increases further if your relative was diagnosed with breast cancer under the age of 40.

 

Lifestyle factors

 

Many lifestyle factors have been found to affect the risk of getting breast cancer.  These include:

 

  • weight 
  • level of physical activity undertaken
  • level of alcohol consumption
  • radiation exposure from previous radiotherapy 
  • alterations in biological rhythms from disrupted and shortened sleep

 

Breast density

 

Breast density is related to breast cancer risk.  Breast density refers to how solid your breast tissue feels and appears on diagnostic imaging such as mammography and ultrasound.  The density of breasts can be affected by weight, the number of children a woman bears, menopause as well as family history.

 

Pros and cons of detecting breast pathology early

 

It's important that you have as many facts as possible before making an informed decision about whether to proceed with formal breast examination and subsequent diagnostic imaging.  Some of the pros and cons include:
 

Pros

Cons       

 
It may give you an indication of cancer
before symptoms develop 
Cancer screening can miss cancer and provide false reassurance: no screening test is 100% accurate

It may find cancer at an earlier

Screening can lead to unnecessary worry and 
possible needle or operative biopsy when there
is no cancer
If breast cancers are detected at a more
advanced stage the patient outcome is less favourable - screening aims to detect
cancer early
 
Sreening results may find slow-growing cancers, that may never have caused any symptoms or shorten your life
Advanced cancers detected during
screening that are treated with modern therapies will usually extend the patient's life
 

 

Male breast cancer

 

The most common symptom of male breast cancer is a hard, painless lump in the breast.  The lump is usually located underneath the nipple and areola (the dark skin around the nipple) and in some cases the lump can be painful.

 

Other male breast cancer symptoms may include:

 

  • the nipple is hard or inflamed
  • oozing from the nipple (nipple discharge) that may contain blood
  • the nipple turns into the breast (nipple retraction)
  • lumps under the arm
  • a sore or ulcer in the skin of the breast
  • breast swelling

 

In most cases the above symptoms could indicate an innocent problem and are not necessarily male breast cancer.  However any symptoms should be checked by your GP or by one of our specialists as soon as possible.

 

The key with any symptoms relating to the breast and nipple is to get them checked straight away.  Early detection saves lives and improves outcomes.

 

Worried about male breast cancer symptoms?

 

If you are worried you may have symptoms of male breast cancer and would like to make an appointment then please contact us today.  We can arrange appointments and any treatment needed quickly, without delay.

 

Breast cancer survival rates for men 

 

Because the incidence of male breast cancer is so low, there is not enough data to provide accurate survival rate statistics.  If you are a man with breast cancer you should discuss outcomes with your GP or consultant.

 

Breast cancer survival rates in women

 

There are many factors that affect the survival rate for breast cancer in women including the way the cancer was detected, the stage and grade of the cancer and the type of treatment.

 

The good news is that breast cancer survival rates are improving in the UK and have been for the last 30 years.  This is largely due to improved treatments, earlier diagnosis and screening.

 

Breast cancer survival rates for 1, 5 and 10 years

 

Cancer Research UK states that for women of all ages, with all stages of breast cancer, 95.8% will be expected to survive the disease for at least 1 year.

 

85% of women are expected to survive the disease for at least 5 years post-surgery and 77% will survive for at least 10 years.

 

Breast cancer survival rates and patient age at diagnosis

 

Overall in England and Wales the expected rates for 1yr, 5yrs and 10yrs are:

 

  1yr survival    5yr survival  10yr survival
Women   96.0%   86.6%  78.3-78.4%

 

Age at diagnosis % Survival rate
15-39 83.5%
40-49 89.1% 
50-59 90.4% 
60-59  90.1%
70-79 80.9% 
80-99 68.5% 

 

Data from Cancer Research UK, 2010-2011.  The age at diagnosis can have a significant effect on breast cancer survival rates.

 

Breast cancer stages and survival rates

 

The breast cancer stage is a measure of the progression of the disease and how far it has spread beyond the tumour.  It has a significant effect on breast cancer survival rates.  You may hear your doctor talk about the grade of your cancer.  Tumour grade describes a tumour in terms of how abnormal the tumour cells are compared to normal cells.  It also describes how abnormal the tissues look under a microscope.

The grade gives you doctor some idea of how the cancer might behave.  A low grade cancer is likely to grow more slowly and be less likely to spread than a high grade one.  Doctors can't be certain exactly how the cells will behave, however the grade is a useful indicator.

Tumour grade is sometimes taken into account as part of cancer staging systems.  The stage of a cancer describes how big the cancer is and whether is has spread or not.

The outlook for breast cancers varies according to whether the cancer is diagnosed early or when it is more advanced.  The earlier a breast cancer is diagnosed, the smaller it is likely to be and the lower the chance it has spread.  The outlook will also depend on various other factors, including the grade of the cancer and whether the cells are receptors for particular hormones or biological therapies.

Survival statistics are available for each stage of breast cancer in one area of England.  These figures are for women diagnosed between 2002 and 2006.  The statistics are likely to be similar in the rest of the UK.
 

<Stage  
1 <99%  
2 <90%  
3 <60%  
4 <15%   

 

Data from Cancer Research UK, 2010-2011.

The evidence is overwhelming that early recognition and detection of cancer is the key to long term survival.  In 5 in 100 women, or 5%, the cancer has already spread to another part of their body when they are first diagnosed.  Sadly, the outlook once a cancer has spread to another body organ is not so good.  It is not curable at this point, but may be controlled with treatment for some years.  15 out of 100 women with stage 4 tumours (15%) will survive for 5 years or more after they are diagnosed. 

Doctors define the progression of breast cancer in terms of stages with stage 1 being the earliest and stage 4 being the most advanced form of breast cancer.  The stages define the size of the tumour, whether the cancer has spread to any nearby lymph nodes and whether the tumour has spread to other parts of the body (metastasised) e.g. bones, liver, lung or brain.

 

This data clearly shows that detection of breast cancer in the early stages results in much better outcomes.

 

Our treatments

Aspiration of cyst under ultrasound
Biopsy breast under ultrasound
Block dissection of axillary lymph nodes (axillary clearance) levels 1-3
Breast reconstruction
Excision biopsy of breast lesion after localisation
Excision biopsy of breast lesion after localisation bilateral
Excision of breast lump/fibroadenoma
Excision of mammary fistula
Local mobilisation of glandular breast tissue to fill surgical cavity
Lymph node biopsy
Lymph node clearance
Mammogram
Mastectomy - radical
Mastectomy - simple
Mastectomy and immediate reconstruction of breast using extended latissimus dorsi flap
Mastectomy and immediate reconstruction of breast using latissimus dorsi
Mastectomy for gynaecomastia bilateral
Mastectomy for gynaecomastia unilateral
Microdocchectomy or mammodochectomy (Hadfields procedure)
Modified radical mastectomy
Modified radical mastectomy (including lymph node clearance)
Modified radical mastectomy (including lymph node sampling)
Plastic procedures on nipple
Prophylactic mastectomy - bilateral
Prophylactic mastectomy - unilateral
Radical mastectomy (including block dissection)
Re-excision of lesion of breast if resection margins are not clear
Reconstruction of the breast using extended latissimus dorsi flap (including delayed reconstruction)
Sampling of axillary lymph nodes
Sentinel node biopsy
Sentinel node mapping and sampling with blue dye and radioactive probe for breast cancer
Subcutaneous mastectomy with immediate implant
Ultrasound breast
Wide excision of lesion of the breast
Wide local excision of breast +/- mobilisation of glandular breast
Wire localisation under x-ray control

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