Breast cancer is the most commonly diagnosed cancer in Australia. Anyone can get breast cancer. Men and women. Young and old. Breast cancer does not discriminate.
53 Australians are diagnosed each and every day
Since the National Breast Cancer Foundation (NBCF) started funding in 1994, the five-year survival rates have improved from 76% to 91%. This high survival rate means that more women are living with the long-term consequences of their breast cancer and treatment than ever before.
Given that breast cancer can have far-reaching physical and psychological impacts, maintaining a positive quality of life – at the time of diagnosis, during treatment and after completion of treatment – is a crucial aspect of treatment outcomes and breast cancer care.
DETECTION AND AWARENESS
Early detection provides the best chance of survival.
It is important to be aware of how your breasts normally look and feel, so that you can identify any unusual changes. Symptoms of breast cancer will depend on where the tumour is, the size of the tumour and how quickly it is growing in the breast. Some people will not have any symptoms and the breast cancer is found during a screening mammogram.
What are the symptoms of breast cancer?
Symptoms of breast cancer may include:
A lump or thickening in the breast, especially if it is only in one breast
Changes to the shape or size of the breast
Changes to the shape of the nipple, such as crusting, sores or ulcers, redness or inversion (a nipple that turns in when it used to point out).
Changes to the skin of the breast, such as dimpling (sometimes looking like an orange peel), a rash, scaly appearance, unusual redness or other colour changes
Fluid leaking or discharge from the nipple that occurs without squeezing
Persistent, unusual pain that doesn’t go away
Swelling or discomfort in the armpit
Early detection gives the best possible chance of survival, so it is important to be breast aware to ensure that you can spot any changes as soon as they appear.
What should I do if I experience any of the symptoms of breast cancer?
It is important to remember that most breast changes are not caused by cancer, and the symptoms listed can be caused by other medical conditions. However, if you have noticed any symptoms or changes in your breasts, it is important that you see your doctor without delay so that the changes can be checked. This may include a physical examination or imaging of your breasts. Early detection gives the best possible chance of survival if you are diagnosed with breast cancer.
Three points to remember
Breast awareness is recommended for women of all ages. However, it does not replace having regular mammograms and other screening tests as recommended by your doctor.
Women and men can be diagnosed with breast cancer. Anybody can. For both men and women, if you notice any new or unusual changes in your breasts, see your doctor without delay.
Most breast changes are not due to cancer, but it is important to see your doctor to be sure. When in doubt, speak to your doctor.
HOW TO MINIMISE YOUR RISK OF DEVELOPING BREAST CANCER
The incidence (number of new cases) of breast cancer is predicted to increase year on year. And while there are many risk factors that we have no control over, such as being a woman, or getting older, there are others which can be changed or managed.
The following lifestyle factors have been linked to breast cancer risk. Although these may increase your risk (or chance) of developing breast cancer, having one or more of these risk factors does not mean that you will definitely develop cancer. Likewise, having no known risk factors also does not guarantee that you will never develop cancer. If you are concerned about any of these risk factors, see your doctor to discuss any concerns prior to making lifestyle changes.
Drinking alcohol is associated with an increased risk of breast cancer, and with breast cancer returning. The risk of breast cancer rises as the number of drinks regularly consumed increases. Currently, there does not appear to be a ‘safe’ level of regular alcohol consumption. According to Cancer Australia, approximately 6% of breast cancer cases each year in Australia are due to alcohol consumption.
Being overweight and obesity
For women who have experienced menopause (postmenopausal women), being overweight or obese, or gaining weight, is linked to an increased risk of breast cancer. Keeping to a healthy weight range reduces the risk of breast cancer. According to Cancer Australia, it is estimated that 8% of postmenopausal breast cancers each year in Australia are due to being overweight or obese.
Physical activity is associated with a reduced risk of breast cancer. Active women of all ages have a decreased risk of breast cancer compared to women who do not exercise. The more physically active you are, the greater the health benefits. Cancer Australia states that approximately 8% of postmenopausal breast cancers each year in Australia are due to a lack of physical activity.
Having children and breastfeeding
Having children is linked to a reduced risk of breast cancer. According to Cancer Australia, the risk of breast cancer decreases by 7% for each child the women has had. Breastfeeding is probably associated with a small decreased risk of breast cancer as well – the longer the duration of breastfeeding, the lower the risk of breast cancer.
There is evidence that suggests an association between smoking and breast cancer risk. There may be an increased risk of breast cancer for women who started smoking at a very early age, or for many years before their first child. However, tobacco smoke contains more than 70 chemicals that are known to cause cancer; smoking is also known to cause cancer of many organs of the body including lung, throat, liver, bowel and bladder cancers.
BREAST CANCER RISK FACTORS YOU CAN’T CHANGE
While a person’s risk of breast cancer can be increased due to certain lifestyle factors, there are factors that people have no control over (known as non-modifiable risk factors). Although these may increase your risk (or chance) of developing breast cancer, having one or more of these risk factors does not mean that you will develop cancer. Having no known risk factors also does not guarantee that you will never develop cancer.
While non-modifiable risk factors cannot be changed, you can still reduce your risk of breast cancer by making healthy lifestyle choices and managing modifiable risk factors. If you are worried about your risk of developing cancer, see your doctor to discuss any concerns.
Non-modifiable risk factors include:
99% of breast cancer cases occur in women. While some men do get breast cancer (estimated at 1 in 675), women are at a much higher risk (estimated at 1 in 7 women will be diagnosed).
The older women get, the higher their risk of developing breast cancer. In Australia, breast cancer can occur in younger women, but about three out of four breast cancer cases occur in women aged 50 years and older. The average age of diagnosis for breast cancer is 61 years.
A family history of breast cancer means having a first-degree relative who had or has breast cancer. The relative can be from the father’s or mother’s side of the family. Since breast cancer is the most commonly diagnosed cancer in Australia, many women will have a family history by chance. However, sometimes there is a specific genetic variation (or mutation in a gene), that we inherited from one of our parents that increases the risk of breast cancer. Only about 5-10% of breast cancer cases can be explained by an inherited mutation. The importance of family history rises with the number of family members affected and the younger their ages at diagnosis.
BRCA1 and BRCA2 genes
Having a fault (or mutation) in the BRCA1 and BRCA2 genes is associated with an increased risk of breast and ovarian cancer. BRCA1 and BRCA2 mutations are considered rare to very rare. About 1 in 400 to 1 in 800 people have a BRCA1 or BRCA2 gene mutation. Over her lifetime, a woman who carries a mutation in one of these genes has about 70% chance of developing breast cancer. However, not everyone who has a faulty BRCA1 or BRCA2 gene will develop cancer. Only about 5-10% of female breast cancers can be explained by inherited mutations. If you are concerned that you may have an increased risk of breast cancer, please speak with your GP, who will help you assess your risk and refer you for further genetic testing if needed.
Age when periods (or menstruation) started
Periods commencing at an early age (before the age of 12) is linked to a slightly increased risk of breast cancer. This is likely to be related to hormonal factors. For example, women who begin having periods at a younger age have a higher lifetime exposure to oestrogen and progesterone, which may increase the risk of breast cancer.
Having menopause later is linked to an increased risk of breast cancer. Menopause occurs when a woman stops having periods permanently. The average age of menopause for women in Australia is 51 years. A woman who is at menopause when she is 55 has about 12% higher risk of breast cancer compared to a woman who has menopause aged 50-54 years.
High breast density
Having higher than average breast density (as detected by a mammogram) is linked to an increased risk of breast cancer. Breast density can only be measured by a mammogram and is not related to how the breasts look, feel, their size or firmness. How breast density contributes to breast cancer risk is not well understood. Other genetic and established risk factors, such as age, body mass index and whether a woman has had children, also contribute to breast density.
To help all Australians to know and manage their personal breast cancer risk, NBCF has funded the innovative work of Professor Kelly-Anne Phillips. Her development of web-based tool, iPrevent -https://www.petermac.org/iprevent , was designed to help all Australian women to estimate their risk of developing breast cancer so they can take appropriate action.