The survival rate for Breast Cancer has risen dramatically over the last 20 years. With increased education and research, we trust this trend will continue.
We hope you find these FAQs helpful. As we receive no government or other statutory funding, a small donation would assist AICR in supporting further research and education - please consider donating here.
You can also listen to the Breast Cancer Edition of the AICR podcast.
Thank you!
Q. How common is breast cancer?
A. In it the most common type of cancer in most western countries, apart from skin cancer. There are over 47,000 cases of breast cancer diagnosed in the UK each year. In The USA the figure is 207,000, in Canada it is 23,000, and in Australia nearly 13,000. Overall, one in every eight women will get breast cancer at some time in her life. Men can also get breast cancer, but it is very rare, with only 340 cases a year in the UK.
Q. How dangerous is breast cancer?
A. Breast cancer is the second most common cause of cancer deaths amongst women (after lung cancer), responsible for 12,000 deaths a year in the UK. In the USA there are nearly 40,000 breast cancer deaths a year, 5,000 in Canada and 2,600 in Australia.
Q. Are there different types of breast cancer?
A. There are two main places in the breast where cancer can occur: the lobules (the milk-producing tissue) and the ducts (which carry the milk to the nipple).
-
Ductal carcinoma in situ (DCIS) means an early form of cancer in the ducts. It can be detected by mammograms and is normally easy to cure.
- Invasive ductal carcinoma means a cancer that started in the milk ducts but has now spread beyond them. This is the most common type of breast cancer.
- Lobular carcinoma in situ is not considered to be cancer. It is a pre-cancerous condition caused by changes in the cells lining the lobules where the milk is made. Most women with lobular carcinoma in situ do not get breast cancer, but they have an increased risk of getting it, so they are given frequent checkups.
-
Invasive lobular carcinoma is a cancer that starts in the lobules and has spread. These can be difficult to diagnose as they do not always form a lump or show up on mammograms.
Another important way to classify breast cancers is based upon whether their cells have certain proteins, called receptors. This determines whether they can respond to particular treatments:
ER positive – breast cancers which have the oestrogen receptor will respond to hormone therapy drugs such as tamoxifen or Arimidex.
HER2 positive - breast cancers which have a receptor called HER2 will respond to Herceptin.
Triple negative – ie ER negative, HER2 negative and PR (progesterone receptor) negative. This type of breast cancer is usually more aggressive and difficult to treat.
Causes/Risks/Symptoms
Q. What causes breast cancer?
A. In most cases, we do not yet know the cause of breast cancer. However, about 3% of cases are caused by inheriting faulty versions of the BRCA genes, which carry a very high risk (50-80%) of a woman getting breast cancer.
Q. Who is at risk of breast cancer?
A. Breast cancer is overwhelmingly a female disease, but about 1% of cases occur in men (around 340 per year in the UK). Amongst women it becomes more common as age increases. More than 80% of cases occur in women over 50. There are many known risk factors:
-
Having more children slightly reduces the risk.
- Breast feeding slightly reduces the risk.
- Taking the contraceptive pill slightly increases the risk.
- Taking hormone replacement therapy increases your risk, significantly (for the oestrogen-only HRT) or substantially (for oestrogen and progestagen HRT). Overall, the health benefits of HRT outweigh the disadvantages, at least for the first five years.
- Drinking alcohol, even in moderation, slightly increases the risk, but heavy drinking substantially increases it.
- Physical activity slightly reduces the risk.
Q. Is the use of deodorants linked to breast cancer?
A. There has been a persistent internet rumour that underarm deodorants cause breast cancer and even one or two newspaper articles that suggested this was backed up by research findings. However, there is no good evidence to support this idea. On the contrary: in a large study comparing breast cancer patients and healthy women, there was no difference found at all in their use of underarm deodorants.
Q. Is diet linked to breast cancer?
A. Extensive research has failed to find any linked between the diet and breast cancer risk, apart from fat. Studies suggest that a diet high in fat carries a slight increase in breast cancer risk.
Q. Can breast cancer be prevented?
A. The only known way to prevent breast cancer is the surgical removal of all the breast tissue. Although this sounds an extreme measure, it is used by some of the few women who inherit faulty BRCS genes which give a very high risk of breast cancer. Reconstructive surgery can replace the breast tissue with muscle to restore their shape.
Q. Does breast cancer run in families?
A. Having one close relative (mother, daughter or sister) with breast cancer doubles your risk of getting breast cancer, when compared to women with no cases in the family. Having two close relatives affected, or one close relative diagnosed under the age of 50, increases your risk further.
There are a very few families in which breast cancer is really common - ie four or more cases amongst close relatives. Most of these families carry faulty versions of the BRCA breast cancer genes, which can be passed on from mother to daughter. Women with a faulty BRCA gene have a 50% to 80% chance of getting breast cancer. Testing for faulty BRCA genes is available on the NHS.
Q. What are the symptoms of breast cancer?
A. The main symptoms of breast cancer are
-
A lump on or inside the breast
-
Change in the size or shape of a breast
- Long-term dimpling of the breast skin
- The nipple becoming inverted
-
Swelling or a lump in the armpit
Testing/Screening
Q. How is breast cancer diagnosed?
A. The main method used to diagnose breast cancer is by taking a biopsy (a tissue sample). A hollow needle is pushed into the breast lump to take a tiny sample of the tissue. This is examined under a microscope. The shape and appearance of the cells in the tissue sample reveals whether the lump is benign (ie non-cancerous), which is true of the vast majority, or if it is cancerous.
Q. Is early diagnosis important?
A. It is extremely important. We can currently cure six out of every seven patients who are diagnosed when their breast cancer is at the early stage. However, if they are diagnosed when it has become advanced, the cure rate falls to about one in seven. It is extremely important to catch breast cancer at an early stage.
Q. What tests can be used to detect breast cancer?
A. The main test is a mammogram – an X-ray of the breasts. This detects any lumps or dense areas in the breast, which may need further tests. The majority of these lumps or dense areas are not cancers, but they should all be checked. The further tests can include more x-rays, an ultrasound or a biopsy (a small tissue sample taken by inserting a needle into the suspect area of the breast). Seven out of every eight women sent for further tests do not have breast cancer.
Q. Who should have a test?
A. All women over 50 or any woman who finds a lump, or has any other symptoms of breast cancer, or has one or more close relatives diagnosed with breast cancer should be tested for breast cancer.
Q. Is there screening?
A. Screening for breast cancer by mammography (X-raying the breast) is offered every three years in many countries to all women aged over 50.
Mammography can detect very early breast tumours, when they are too small to be felt. In fact, most of the breast cancers detected by screening are at this very early stage, when they are relatively easy to cure. Studies have shown that women who take part in screening are more likely to have breast cancer diagnosed early and more likely to have it cured and, as a result, are less likely to die from it, than women who do not take part in mammography screening. Experts estimate that this screening can cut the death rate from breast cancer by a third.
Treatment
Q. Can breast cancer be cured?
A. Yes, if diagnosed early enough, treatment will usually give a long-term cure.
Q. What treatments are available for breast cancer?
A. The main treatment for breast cancer is surgery. In most cases, conservative surgery is used, which preserves the shape and appearance of the breast. For very early breast cancer, only the lump and a small area of tissue around it are removed. For later stage breast cancer, much more tissue is removed but it is replaced with muscle to rebuild the breast. Since breast cancer cells usually spread first to the lymph node in the armpit, the surgeon will usually cut into it to check for any spread.
The surgery may be followed by a short course of radiotherapy or chemotherapy, depending on the type of tumour and how advanced it is. Herceptin – a biological therapy – can also be used in a minority of cases. Most patients will be given a long course of hormone therapy (eg Arimidex or tamoxifen) to reduce the risk of the cancer recurring.
Q. What newer treatments are available?
A. Surgeons are currently testing out keyhole surgery for breast cancer to find out if it is as effective as traditional breast surgery. Several new drugs, biological therapies and combinations are also being tested. Genetic tests are being developed which may be able to predict which treatments will be most effective for individual cases of breast cancer.
Q. What are the side-effects of breast cancer treatment?
A. Surgery, of any sort, causes tiredness and some pain, but these pass. The main side effects of chemotherapy can be thinning or loss of hair (which only happens with some drugs and is temporary), tiredness, diarrhoea, nausea, sore mouth and minor infections. These all stop when the treatment stops. Radiotherapy has some similar side effects (tiredness, diarrhoea and nausea) and some different ones: eg red and sore skin where the treatment was given. The removal of the lymph nodes in the armpit can cause lymphodema – swelling of the arm in one in five patients. This cannot be cured, but there are ways to reduce the risk and the severity when it does occur.
Q. How effective are the treatments for breast cancer?
A. The treatment for breast cancer has been improving for the last twenty years. In the early 1970's, only half of all women diagnosed with the disease survived for five years. Now, over 80% (four fifths) survive for that long and most of them will live for very much longer.
Sources of information
If you found these FAQs helpful and would like to assist AICR in funding further research and education, please consider donating here.
