The incidence of breast cancer has increased over recent decades, and it’s now the most common cancer in women (outside of skin cancers). One in seven women in Australia are diagnosed with breast cancer at some point during their lives: because it occurs so frequently, many people have a relative or know a friend or colleague touched by breast cancer.
Thankfully, effective therapies are available especially if breast cancer is detected and treated early. Medical advances have improved survival to over 90% at five years after diagnosis. Fortunately, breast cancer usually doesn’t return after contemporary treatment.
Risk Factors related to Breast Cancer
There are a number of factors that increase your risk of developing breast cancer:
If you notice any of the following symptoms, a prompt an evaluation by an experienced doctor is recommended.
- A new breast lump or lump in the armpit
Irritation, thickening, dimpling or tethering of the breast skin
- Nipple discharge, bleeding or retraction
- Crusting, ulcers or rash around the nipple or elsewhere on the breast
- Persisting breast redness or redness not responding to prescribed antibiotics
- A change in the shape or size of the breast
- Breast pain that doesn’t go away
- A sudden development of fluid or swelling around a breast implant placed for any reason
- Any change in the breast that “doesn’t seem normal” or is of concern
Breast self-awareness (prior to diagnosis)
Breast self-awareness is noticing and understanding what is normal for you in terms of how the breasts appear and feel. Many women are the first to discover their own breast cancer simply by identifying a change and having it looked into by an experienced clinician. It is equally important not to ignore changes in the breasts. Formal clinical self-examination is not required.
Physical examination by an experienced clinician
Formal clinician-based physical examination is a routine part of doctor or nurse led assessment of breast changes, and should be performed by a trained and experienced medical professional. Occasionally, breast cancer can be detected only by physical examination (breast imaging does not demonstrate the cancer) or may find more extensive disease. Physical examination, therefore, is an important part of breast cancer diagnosis.
Mammograms are low-dose X-rays of the breast tissue which are safe and effective in finding breast cancers. All women without symptoms aged over 40 years of age have access to free mammograms through BreastScreen Queensland without need for a GP or specialist referral though you should see your GP (rather than BreastScreen) if you have any symptoms.
Ultrasounds use sound waves (not radiation) to produce images of structures within the breast and underarm. This test is complimentary to a mammogram, and does not replace it: it can give new or extra information.
Breast MRI (magnetic resonance imaging)
An MRI may be recommended if you have dense breast tissue, but is not required in most cases. It uses magnetic waves to create internal images of breast, chest wall and under arm. Breast MRIs may carry Medicare subsidy in some situations (such as high risk family cases, for planning surgery and when referred by a specialist surgeon).
CT Scan/Whole body bone Scan/PET Scan (“Staging scans”)
Additional scans help to look at areas of the body outside of the breast. They may be used to look for spread of breast cancer to other organs, or to monitor a response to treatment. Most women with early breast cancer do not require staging scans because the chance of finding further disease is so low.
A small sample of tissue is removed under local anaesthetic by a surgeon or radiologist and sent to a pathology laboratory for testing under a microscope. A special needle and X-ray guidance are used to extract the tissue sample. Whilst the procedure may be uncomfortable, it is rarely too painful. Tissue sampling is needed to confirm the diagnosis of breast cancer and often the type of breast cancer present too.