Breast Cancer

What is Breast Cancer?

Breast cancer is when abnormal cells in the breast begin to grow and divide in an uncontrolled way and eventually form a growth (tumour). Breast cancer most commonly starts in the cells that line the milk ducts of the breast. It is the most common cancer in the UK. It mainly affects women, but men can get it too.

Symptoms of Breast Cancer

The first symptom of breast cancer most people notice is a lump in their breast or some thickening.

Breast symptoms to look out for:

a new lump or thickening in your breast or armpit
a change in size, shape or feel of your breast
skin changes in the breast such as puckering, dimpling, a rash or redness of the skin
fluid leaking from the nipple in a woman who isn’t pregnant or breastfeeding
changes in the position of the nipple

Symptoms of Secondary Breast Cancer

If breast cancer spreads to other parts of the body it's called secondary breast cancer.

You may also have general symptoms including:

feeling tired or having no energy
loss of appetite or losing weight without trying to
feeling unwell with no clear cause
feeling or being sick
difficulty sleeping

Causes of Breast Cancer in Women

Anyone can get breast cancer and it's not always clear what causes it.

You might be more likely to get it if you:

are over 50
have dense breast tissue – you may be told this after a breast screening (mammogram)
have other people in your family who've had breast or ovarian cancer – you may have inherited a faulty gene, such as a faulty BRCA gene
have certain breast conditions, such as benign breast disease, ductal carcinoma in situ or lobular carcinoma in situ

You may also be more likely to get breast cancer if you have higher levels of the hormones oestrogen, progesterone or testosterone. This may be more likely if you:

started your periods before you were 12, or went through the menopause after you turned 55
have not given birth, or gave birth for the first time after 30
did not breastfeed your children
have used the contraceptive pill in the last 10 years, or take hormone replacement therapy (HRT) – these only slightly increase your risk and for many people the benefits of taking them outweigh the risks
Many breast cancers are also linked to lifestyle, such as smoking.

Diagnosis of Breast Cancer

You usually start by seeing your GP. They will examine you and refer you to a breast clinic to see a specialist.

Or you may be referred through NHS breast screening programmes. This is usually if there are changes on your mammogram. Breast screening is a way of finding breast cancer at an early stage, when it is too small to be felt or seen.

At the breast clinic
At the clinic, you will see a specialist breast doctor or a nurse. You may also see a breast care nurse. They usually ask you if:
• you have had any other breast problems or health problems
• anyone in your family has had breast cancer or ovarian cancer
• you have been through the menopause
• you are taking any medicines – for example, hormone replacement therapy (HRT) or the contraceptive pill.
• The doctor or nurse will examine your breast or chest area and the lymph nodes in your armpits and above your collarbone.

Tests
• Mammogram
• Breast ultrasound
• Breast biopsy

Treatment for Breast Cancer

A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).

Your doctor will explain the different treatment options and their side effects. They will also talk to you about the things you should consider when making treatment decisions.

The first treatment for breast cancer is often surgery to remove it. Your surgeon will talk to you about having one of these operations:

Breast-conserving surgery
Mastectomy

You will usually need some, or all, of the lymph nodes in your armpit removed.You may be asked to decide if they want surgery to make a new breast shape (breast reconstruction) during the operation. Others may decide to have this done later.

After Breast Cancer Treatment

Follow Up

After treatment, you will have regular check-ups with your cancer doctor or regular contact with your breast care nurse.
You will have mammograms every year for 5 years on the other breast. If you have had breast-conserving surgery, you will have mammograms on both breasts. If you have had a double mastectomy, you will not be offered mammograms.

After 5 years, if you are 50 or over, you usually have mammograms through the NHS breast screening programmes. Younger women usually continue to have yearly mammograms after the first 5 years, until they reach 50.

Macmillan is also here to support you. If you would like to talk, you can:

Call the Macmillan Support Line for free on 0808 808 00 00.
Chat to the specialists online.
Visit the breast cancer forum to talk with people who have been affected by breast cancer, share your experience, and ask an expert your questions.