We all know we should check our breasts regularly, but how many of us actually make the time to do it? It's easier not to think about it, but breast cancer is now the most common cancer in women in the UK. It is the leading cause of death for women aged 34 to 54* and early diagnosis is the key to beating it.
Kylie Minogue announced she had breast cancer in mid-May, forcing her to cancel the Australian leg of her world tour and to pull out of Glastonbury Festival. Thankfully, according to her sister Dannii, Kylie was diagnosed at a very early stage and is responding well to treatment.
Emma Pennery, nurse consultant at Breast Cancer Care, says, 'Our thoughts are with Kylie, her family and friends. Of the 40,790 women diagnosed with breast cancer each year in the UK, around 2,000 are in their twenties and thirties. However, it is important to remember that 80% of breast cancer cases occur in women over the age of 50. We would encourage everyone to remain breast-aware throughout their adult lives, reporting any changes to their doctor as soon as possible. We wish Kylie well with her treatment and hope to see her back soon.'
The five-point code
Know what is normal for you Know what changes to look and feel for Look and feel Report any changes to your GP without delay Attend for routine breast screening if you are 50 or over
Practicalities
Breast awareness is about becoming familiar with your normal breast tissue and how it changes, for example at different times of the month. Get into the habit of looking at and feeling your breasts from time to time.
One way of looking is by using a mirror so that you can see your breasts from different angles. You may find feeling your breasts is easier to do with a soapy hand in the bath or shower, or you may prefer to do it lying down. You can decide when is convenient for you and what you are comfortable with.
Know what is normal for you
Your breasts will go through many perfectly normal changes throughout your lifetime. They are affected by hormonal changes during your menstrual cycle, pregnancy, breast-feeding, the menopause (change of life) and weight loss or weight gain.
The menstrual cycle
Each month during your child-bearing years your breasts prepare for pregnancy and breast-feeding. Breasts often become enlarged, tender and lumpy shortly before a period starts but return to normal once the period is over (although some women may have tender, lumpy breasts throughout their cycle).
The menopause
Breast tissue changes after the menopause; it is often less dense and firm, and becomes more fatty, making your breasts feel softer. As you grow older your breasts may get smaller. If you take HRT (hormone replacement therapy) your breasts may feel firmer and sometimes quite tender.
What changes should I be aware of?
These are the changes that you should be aware of when you look at and feel your breasts:
a change in size – it may be that one breast has become noticeably larger or noticeably lower a nipple has become inverted (pulled in) or changed its position or shape a rash around the nipple discharge from one or both nipples puckering or dimpling of the skin a swelling under your armpit or around your collarbone (where the lymph nodes or glands are) a lump or thickening in your breast that feels different from the rest of the breast tissue constant pain in one part of your breast or in your armpit.
What if I find a change?
You will know better than anyone how your breasts feel and look normally, so if you do notice a change, see your GP as soon as possible. Don't worry that you may be making an unnecessary fuss, and remember that most breast changes will be benign (non-cancerous) and harmless.
When your GP examines your breasts s/he may be able to reassure you that there is nothing to worry about. (If s/he thinks the change is connected with your hormones, you may be asked to come back at a different time in your menstrual cycle.)
Alternatively, s/he may decide to send you to a breast clinic for a more detailed examination. For more information about benign breast problems, what happens at a breast clinic and the tests used to make a diagnosis, see Breast Cancer Care's booklet Making A Diagnosis: Breast Problems And Breast Cancer.
Screening for breast cancer
If you are between 50 and 64 you are entitled to be screened every three years as part of the National Breast Screening Programme. Your name will be taken from your GP's list and you will be sent an invitation to come for a mammogram (breast X-ray). This may not happen the year you turn 50, but it will within three years of you turning 50.
At present, younger women are not invited for screening as part of the NHS programme. A clinical trial is underway to look at whether the NHS breast-screening programme should be extended to include younger women. However, breast screening is available for women over 40 from private health-screening centres.
If you are 65 or over you will not be invited for screening. However, you are still at risk of breast cancer and entitled to free breast screening every three years on request. All you need to do is ask your GP or practice nurse to arrange an appointment for you, or you can contact the breast-screening unit yourself.
You can find out where your local breast-screening unit is by calling the free Health Information Service on 0800 665544 (or the NHS Health Helpline on 0800 224488 in Scotland), or by contacting your GP practice.
Finding out more
If you want more information or practical advice about being breast-aware, contact your practice nurse at your GP surgery. You can also phone the Breast Cancer Care helpline on 0808 800 6000 or visit the Breast Cancer Care website.
Raise money for Breast Cancer Care and win a mountain bike!
Why not join in the Breast Cancer Campaign's challenge to cycle 50 miles on your exercise bike throughout October. The top fundraiser wins a specialised mountain bike from Evans Cycle. Click here to join the challenge
*British Nursing News online, 15 April 2005
