Breast Cancer and Screening Awareness.

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Bernadette Johnston
5 years ago
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Midlands and East (East) Breast Cancer and Screening Awareness. ABOUT BREAST CANCER Breast cancer is the most common type of cancer in the UK. About 12,000 in the UK die of breast cancer every year.

About 4 out of 5 breast cancers are found in over 50 years old. Most with breast cancer do not have a family history of the disease.

breast cancer. Unfortunately there is little that can be done about some of the other risks, apart from being aware of them.

BREAST SCREENING INVITATION AND ELIGIBILITY Breast screening involves the use of a mammogram to check the breast for signs of cancer. It can spot cancers that are too small to see or feel.

1 Midlands and East (East) Breast Cancer and Screening Awareness. ABOUT BREAST CANCER Breast cancer is the most common type of cancer in the UK. About 12,000 in the UK die of breast cancer every year. Survival from the disease has been improving over time, and now about 3 out of 4 diagnosed with breast cancer are alive 10 years later. The risk of getting breast cancer increases with age. About 4 out of 5 breast cancers are found in over 50 years old. Most with breast cancer do not have a family history of the disease. REDUCING THE RISK Eating healthily, maintaining a healthy weight, not smoking, doing regular moderate exercise and drinking alcohol in moderation, are all factors that will help reduce the risk of breast cancer. Unfortunately there is little that can be done about some of the other risks, apart from being aware of them. It is important for all to consider attending for breast screening when invited, and to know the signs and changes to look out for. BREAST SCREENING INVITATION AND ELIGIBILITY Breast screening involves the use of a mammogram to check the breast for signs of cancer. It can spot cancers that are too small to see or feel. All aged 50 to 70 in the UK are invited for 3 yearly mammograms as part of the NHS Breast Screening programme. Some older and younger are also being invited as part of a study of screening in different age groups. Those over 70 are still at risk of breast cancer. Although no longer automatically invited to screening, they can be screened every three years by contacting their local breast screening unit or GP for an appointment. BREAST SCREENING RESULTS On average, 96 out of every 100 screened, the mammogram will show no sign of cancer -- this is a normal result. About four in every 100 are asked to come back for more tests after screening. Out of these four, one will be found to have cancer. The rest will not have cancer found and will go back to having screening invitations every three years. The chart overleaf summarises what happens for every 100 screened.

cancer AGE SPECIFIC INCIDENCE RATES The incidence of female breast cancer is strongly related to age, with the highest incidence rates overall being in older females.

2 SCREENING OUTCOME: For every 100 screened. 100 have breast screening 96 have a normal result 4 need more tests These Women will Receive further Invitations for Breast screening Every 3 years 3 have no cancer found 1 woman is diagnosed with cancer AGE SPECIFIC INCIDENCE RATES The incidence of female breast cancer is strongly related to age, with the highest incidence rates overall being in older females. In the UK in , on average each year almost half (46%) of female breast cancer cases were diagnosed in females aged 65 and over. Agespecific incidence rates rise steeply from around age 30-34, level off for females in their 50s, and then rise further to age Rates drop slightly for females aged and then increase steadily to plateau in the and 90+ age groups. The age distribution of female breast cancer cases largely reflects the age groups eligible for breast screening in the UK, and the increase in rates with age indicates a link with hormonal factors.

3 Age RISK FACTORS FOR BREAST CANCER The risk for breast cancer increases with age and most breast cancers are diagnosed after the age of 50 years. Early and late menstrual periods Starting their periods (menarche) at an early age (before the age of 12) has been linked with an increased risk of breast cancer. If they have a late menopause (after the age of 55) this increases the breast cancer risk compared to who have an earlier menopause. Late or no pregnancy Women who have children have a slightly lower risk of breast cancer than who don't have children. The risk reduces further the more children they have. The age when they have their first child also has an effect. The younger they are when they have their first child, the lower the risk. Breast cancer genes There may be a faulty gene present in the family that increases the risk of breast cancer. Of the several possible gene faults which increase the risk of breast cancer, two (BRCA1 and BRCA2) can be tested for. The risk of getting breast cancer by the age of 70 if either of these breast cancer gene faults are present, is between 45 to 65%. The presence of one of these faulty genes increases the probability of breast cancer, but is not a certainty. The NHSBSP has a high risk screening programme for those at the highest risk (incorporating gene carriers). It is accessed by referral from clinical genetics or consultant oncologist. A previous breast cancer Women who have had breast cancer have an increased risk of getting another breast cancer. The cancer may occur in the same breast or in the other breast. This is monitored by the specialist, and secondary cancers will be picked up quickly. Having cancer other than breast cancer Breast cancer risk is increased in people who have had other cancers. The risk is further increased if people were diagnosed when they were young and if they had radiotherapy treatment rather than chemotherapy. This group of can be screened through the NHS high risk screening programme and referred into the programme by an oncologist. Breast cancer risk is higher in people who have had melanoma skin cancer, lung cancer, bowel cancer, womb cancer, and a type of leukaemia called chronic lymphocytic leukaemia. Sex hormones and other hormones The female sex hormone, oestrogen, and the male hormone, testosterone, can affect the development of breast cancer. Studies generally show that after menopause with higher levels of oestrogen and testosterone in their blood have a risk of breast cancer that is double that of with the lowest levels. Before the menopause, levels of oestrogen vary during the menstrual cycle and studies have not shown clearly that these hormones affect the risk of breast cancer in this group of. Many of the major risk factors for breast cancer can be explained through their effect on hormone levels.

4 Hormone replacement therapy (HRT) A 2003 Cancer Research UK study showed clearly that HRT increases the risk of breast cancer while take it and for up to five years afterwards. The study also showed that combined HRT (oestrogen and progesterone) is more likely to cause breast cancer than oestrogen only HRT. More recent studies have shown that taking HRT are 2.7 times more likely to develop breast cancer than who do not. HRT can have some health benefits therefore any concerns should be discussed with a doctor. The contraceptive pill The combined pill contains oestrogen which can stimulate breast cancer cells to grow. In theory, taking extra oestrogen could trigger a breast cancer to develop. Findings from several large studies have shown that there is a small increase in risk, but the increase in risk goes back to normal 10 years after stopping taking it. The pill has been linked to reduced risk of some other cancers, such as ovarian and womb cancers. Having dense breast tissue Breast tissue density relates to how breast tissue shows up on a mammogram. Women with dense breast tissue have less fat and more breast cells and connective tissue in their breasts. This makes abnormalities more difficult to detect by mammography. Also, because they have a greater proportion of breast cells, the risk of breast cancer is higher. Dietary fat Women who have a high amount of fat in their diet have a higher risk of breast cancer than with lower dietary fat levels according to a meta-analysis. Eating higher amounts of saturated fats also increases breast cancer risk. Alcohol intake Drinking alcohol has been shown to increase the risk of breast cancer by a small amount. Two large combined reviews of the published evidence and the UK Million Women Study showed an increase in risk of 7 to 12% with every extra unit of alcohol per day. One unit is a half pint of beer, a small glass of wine, or a measure of spirits. Alcohol in moderation can have some beneficial effects on the risk of heart attack or stroke. It is advised for not to drink more than 14 units of alcohol per week. Weight and Height Weight and height can both affect the risk of breast cancer. Women who are overweight before their menopause may have a slightly lower than average breast cancer risk, according to several meta-analyses. Taller have an increased risk of breast cancer after the menopause. It's not clear why this is, but taller may have more breast tissue, which might increase the risk. Women who are overweight or obese have a higher risk of breast cancer after the menopause. X-rays or radiotherapy Exposure to radiation is known to increase the risk of many types of cancer. There is known to be a slight increase in risk in people who work with low doses of radiation over a long period of time for example, X-ray technicians. But most of us are never exposed to enough radiation to make much difference to our risk. Other factors Research suggests that factors such as smoking, exposure to carcinogenic chemicals, night shift working, and certain medical conditions (such as diabetes and benign thyroid conditions) and medications may increase the risk of breast cancer.

5 SIGNS AND SYMPTOMS KNOWING WHAT IS NORMAL KNOWING WHAT TO LOOK OUT FOR Before the menopause normal breasts feel different at different times of the month. The milk-producing tissue in the breast becomes active in the days before a period starts. In some, the breasts at this time feel tender and lumpy, especially near the armpits After a hysterectomy the breasts usually show the same monthly differences until the time when your periods would have stopped. After the menopause activity in the milkproducing tissue stops. Normal breasts feel soft, less firm and not lumpy. Appearance: Any change in the outline or shape of the breast, especially those caused by arm movements, or by lifting the breasts. Any puckering or dimpling of the skin. Feelings: Discomfort or pain in one breast that is different from normal, particularly if new and persistent. Lumps: Any lumps, thickening or bumpy areas in one breast or armpit which seem to be different from the same part of the other breast and armpit. This is very important if new. Nipple change: Nipple discharge, new for you and not milky. Bleeding or moist reddish areas which don t heal easily. Any change in nipple position pulled in or pointing differently. A nipple rash on or around the nipple. If you have any change to your breast, you should make an appointment to see your GP straight away. You may not have cancer. But if you do, being diagnosed and treated at an early stage may mean that you are more likely to survive breast cancer. WHO CAN I CONTACT? You can find more detailed information on breast screening, including the sources of evidence used in writing this leaflet at: The NHS Breast Screening Programme: Informed Choice about Cancer Screening; www. informedchoiceaboutcancerscreening.org You may also find the following charity websites provide helpful information about breast screening. Cancer Research UK Health talk on line Breakthrough Breast Cancer Breast Cancer Campaign Breast Cancer Care If you have questions about screening, please contact the National Helpdesk on If you would like to talk to someone about whether to have breast screening, your GP can help. Together, you can weigh up the possible benefits and risks, to help you decide.

Information leaflet for women with a slightly increased risk of breast cancer. Breast cancer in the family

Information leaflet for women with a slightly increased risk of breast cancer Breast cancer in the family Breast cancer in the family what does this mean? Breast cancer is the most common cancer affecting