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Be Breast Aware

About Your Breasts

Breasts consist mainly of glandular, fibrous and fatty tissue. Breast tissue extends into the armpits and is supported by ligaments.  Ducts run from the milk producing glands to outlets at the nipple.  The area around the nipple called the areola contains sweat glands and sebaceous glands.  A major network of lymph vessels surround the breast and drain into lymph nodes the armpit.

 

Normal Breast Changes

Breasts change constantly throughout life from puberty to the menopause.  This is due to the variance in the level of the female hormones oestrogen and progesterone during the different stages of life.

 

Before a period

From puberty onwards oestrogen and progesterone play a major part in regulating the womans menstrual cycle.  These are the hormones that are responsible for changes in the breasts just before a period.  Breasts may feel heavier and fuller also become tender and lumpy.  This normally disappears after the period however some women have tender lumpy breasts all the time.  Many women also experience cyclical breast pain.

 

During Pregnancy

Large amounts of milk are produced to breastfeed a newborn baby and the breasts will vary in size throughout the day to adjust to the baby’s feeding requirements.  At first nipples can become sore and cracked but this normally improves over time.  When the woman stops breastfeeding the breasts revert to their pre-pregnancy state, although they may be a slightly different size and less firm than previously.

 

Around The Menopause

From the mid 30’s onwards the glandular tissue in the breast is gradually replaced by fat. During and after the menopause the oestrogen levels drop causing the breasts to change size and lose their firmness.  Breast lumps are fairly common at this time – they are often benign breast cysts (fluid filled sacs) however they must be checked out.

 

Breast Cancer Facts

  • Breast cancer is the most common cancer in women in the UK- more than 45,000 are diagnosed each year.   
  • Breast cancer affects around 300 men per year in the UK.
  • 1in 9 women will develop breast cancer – most are post menopausal but around 8,000 diagnosed each year are under 50 years of age.
  • However the number of women dying from the disease has dropped significantly over the last 20 years. 

  • The earlier that it is diagnosed means that the tumour is likely to be smaller and therefore less likely to have spread and more easily treatable.   

 

Breast Cancer Risks and Causes 

  • Increasing Age
  • In the UK women from South Asian origin have a lower risk, possibly due to the low alcohol consumption and vegetarian diet.
  • Previous breast cancer
  • Significant family history of the disease (in blood relatives)
  • Women who have had children have a slightly lower risk than those who don’t. The younger the women is when having the first child the lower the risk.
  • Starting periods early slightly increases the risk of breast cancer as does a late menopause.
  • Taking combined HRT may increase the risk, however this only equates to about 19 extra breast cancers per 1000 women who take HRT for 10 years. The risk is lower in those women who take oestrogen only HRT for 10 years, equating to about 5 extra breast cancers per 1000 women.
  • Taking the oral contraceptive pill slightly increases the risk but this reverts 10 years after stopping.
  • Alcohol can increase the risk.
  • Having dense breast tissue means that there are more breast cells and less fat which can increase the risk.  A recent study showed the risk to be 5 x those who had lower density breast tissue.
  • Benign breast lumps that show ‘atypical hyperplasia’ (the cells are not cancerous but are growing abnormally) increase the risk by 4 x.
  • Being overweight before the menopause lowers the risk but being overweight after the menopause can increase the risk. This is because overweight women tend to ovulate less therefore their breasts are exposed to less oestrogen.  Postmenopausal women’s oestrogen levels are related to body fat.
  • Taller women have an increased risk but the reason is unclear.
  • Diabetes is another risk factor. Again the reason is unclear.
  • Working night shifts may cause a slight increase in the risk.  Studies are being undertaken to determine the reason. 

 

Protective Factors

  • In studies physical activity has shown to have a protective effect of 30-40%
  • Breastfeeding reduces the risk.
  • Women who regularly take Aspirin and Non-steroidal anti-inflammatory drugs have a lower risk but both of these can be dangerous if taken long term without a doctors advice.
  • Tamoxifen has been used to prevent breast cancer in high risk women and the results have been encouraging. Other hormone drugs are being investigated for this use.
  • It is thought that foods containing soya phyto-oetrogens may have a protective effect.
  • A healthy balanced diet high in fruit and vegetables is thought to prevent many cancers and this may be true for breast cancer.
  • It is recommended that you -
  •  Replace animal fats with polyunsaturated fats.
  •  Eat more isoflavones (found in soy, peas and beans)
  •  Eat more lignans ( found in fruit, veg, grains, tea and coffee)
  •  Eat more fibre (found in wheat bran, cereals, beans, fruit and veg)
  •  Eat food high in carotenoids (found in carrots, sweet potatoes, spinach, kale and tomatoes)

  •  Ensure that you have a good calcium intake.

 

Breast Cancer Treatment

Treatment includes surgery, radiotherapy, hormone treatment, chemotherapy and biological therapy and may be a combination of any or all of these depending on the individual situation.

The treatment depends on –

  • Type of cancer.
  • Size of the tumour.
  • Stage of the cancer.
  • Grade of the cancer cells.
  • Whether the cells have particular receptors.
  • The patient’s general health.

  • Whether the patient is pre or post menopausal. 

 

Breast Examination – What to Look Out For

Get used to looking and feeling regularly either in the shower or when getting dressed.

Remember breast tissue extends into the armpit.

Look and feel for –

  • A lump or thickened area
  • Change in size or shape
  • Dimpling of the skin
  • Change in shape of nipple especially if it turns in, sinks in or has an irregular shape.
  • Blood stained discharge from the nipple.
  • A rash on the nipple or surrounding area.
  • Swelling or lump in the armpit.

These signs don’t necessarily mean cancer but they must be checked out.

If cancer is diagnosed by identifying it early on there is a good chance of successful treatment.

About 90% of lumps are benign – not cancerous.

Benign lumps can be –

  • Areas of breast cell change that causes lumpiness more obvious just before a period and occurs particularly in women over 35.
  • Cysts which are sacs of fluid in the breast tissue – these are very common.
  • Fibroadenoma which is a collection of fibrous, glandular tissue and occurs particularly in younger women.

 

Be Breast Aware

Whatever your age, size or shape it is very important to take care of your breasts.  Being breast aware is an essential part of looking after your body.  You should get to know how your breasts look and feel so that you can identify and changes that could indicate a problem.

 

The Breast Awareness 5 Point Code

Know what is normal for you

  1. Know what changes to look and feel for
  2. Look and feel
  3. Report any changes to your GP without delay
  4. Attend routine breast screening if you are over 50