Sunday, 5 October 2014

Breast Cancer Awareness Month 2014

October is Breast Cancer Awareness Month so I wanted to use this blog post to raise awareness. Breast cancer is one of the most common cancers and I know many women (and men) that have suffered from this cancer type. This post is dedicated to all my friends that have been affected by breast cancer in some way. 

The Breast:
Breasts are made up of fat, gland tissue and connective tissue which is divided into lobes. A network of ducts spread from these lobes towards the nipple. Breasts are not usually the exact same size as each other and they can also vary in size and shape throughout your monthly cycle. They also change with age – younger women have a lot more glandular tissue so their breasts are usually more dense. After the menopause this tissue is gradually replaced by fat, which is less dense.

Breast Cancer Symptoms:
As with all cancers; the earlier breast cancer is found, the easier it is to treat. This means ladies need to be aware of what is normal for their breasts. You need to regularly have a good old feel of your breasts so you become used to how they look and feel. That way it will be easy for you to spot any changes that may actually be cancer symptoms. Do not panic as about 90% of breast lumps are not cancerous but if you do think something is not right, it is vital that you visit your GP ASAP.

The most common symptoms of breast cancer is a lump or some thickened tissue in their breast. There are also other symptoms to watch out for:
A change to the size or shape of one or both breasts
Nipple discharge
A lump in your armpit
Dimpling on the skin of your breasts
A rash on or around your nipples
A change in how your nipple looks (for example it can become sunken or invert into your breast)
A pain in your breast or armpit that is not period related

It is hugely important to know what is normal for your breasts so I fully encourage all ladies to regularly feel their breasts. Just after a shower is probably the best time. Maybe you can get your partner to feel to so you can have a second opinion if you feel something has changed.


Types of Breast Cancer:
Lobular Carcinoma in Situ (LCIS)
This is not cancer. LCIS means cells changes have occurred inside your breast lobes and you have an increased risk of developing breast cancer in the future as a result. However most women with LCIS do not get breast cancer. LCIS is also found in men but this is very rare.
If you are diagnosed with LCIS then you will need to be monitored closely. Your doctor may suggest  breast examinations every six months and mammograms every year. You may also be offered hormone therapy to lower your risk of breast cancer. This monitoring is vital as cancer is easier to treat, the earlier it is diagnosed.

Ductal Carcinoma in Situ (DCIS)
DCIS is cancer that has developed inside some of your ducts but has not started to spread into the surrounding breast tissue. There is very little chance that this type of cancer will have spread to your lymph nodes or other parts of your body
In most cases, the main treatment for DCIS is surgery. Usually the area of DCIS and some healthy surrounding tissue will be removed. This is known as local excision. Radiotherapy may also be required after surgery to ensure any stray cells are caught and destroyed.
Tamoxifen may be prescribed for you after treatment. This is a type of hormone therapy which will help protect you from developing breast cancer again in the future.

Invasive Ductal Breast Cancer
This is the most common type of breast cancer. Around 70-80 out of every 100 breast cancer cases are invasive ductal breast cancer (80%)
This cancer will have started in the cells lining the breast ducts and it will have spread into the surrounding breast tissue.
Treatment varies depending on the staging and grading of the cancer. You may be offered surgery to remove the cancer and some surrounding healthy tissue. This will be followed by radiotherapy or chemotherapy to destroy any remaining stray cells. Radiotherapy or Chemotherapy may be used to shrink the cancer before surgery. You may also be offered hormone therapy. Your specialist will discuss the options with you as they vary for every patient.

Invasive Lobular Breast Cancer
About 10% of breast cancer cases are invasive lobular carcinoma. It is mostly found in women aged between 45 and 55. This type of cancer will have started in the cells that line the lobules of your breast. This type of cancer is also found in men but it is very rare. This type of cancer can be hard to diagnose as it does not always create a firm lump in your breast nor does it show up on mammograms.
Treatment for this type of breast cancer will usually involve surgery to remove the cancer and some surrounding healthy tissue.  This will normally be followed by radiotherapy or chemotherapy to destroy any stray cells left behind. Hormone therapy may also be recommended.

Inflammatory Breast Cancer
This is a very rare type of breast cancer, only about 4% of breast cancer cases are inflammatory breast cancer.  The breast tissue will have become inflamed and the cancer cells will be blocking the smallest lymph node channels in your breast. This will cause your breast to become swollen, hard, read and hot to touch. It can also be painful. It may also cause nipple discharge and your nipple may become inverted.
Chemotherapy is usually the first form of treatment and that is normally followed by surgery. Radiotherapy may also be an option.

Mammograms - Screening for Breast Cancer
The NHS Breast Screening Programme means women aged between fifty and seventy are invited for breast screening every three years in the UK. Each country within the UK has their own guidelines and screening programme but the age limits in the UK have been extended to cover women between forty seven and seventy seven whilst Scotland, Wales and Northern Ireland have stuck with the original age guidelines.

The aim of the programme is to discover breast cancer at an early stage to give sufferers a much better chance of survival. As I mention a lot – CANCER IS EASIER TO TREAT THE EARLIER IT IS DIAGNOSED.

Women at high risk of developing breast cancer or women that have discovered lumps or breast changes may also be invited to take part in the screening programme.

What is a Mammogram?
A mammogram is an x-ray of breast tissue and is used to identify early breast cancer. You have to remove all clothing on your upper body, including your bra to have a mammogram and are positioned so that both breasts are x-rayed individually. This means your breasts are gently squashed with a clear, flat plastic plate. This means you can get a clear picture whilst having a minimal amount of radiation. It can be uncomfortable but it doesn’t take very long. Most radiographers aim for two mammograms, at different angles, for both breasts.

A new technique is currently being introduced. This is known as digital mammogram and this uses computer imaging. This new technique has been shown to be better at picking up breast cancer in younger women and those with denser breast tissue.

Some Important Facts about Mammograms:
*Mammograms do not prevent cancer but they can discover a cancer that has already developed.
*Mammograms can be uncomfortable but this does not usually last long. Some women may be a little sore afterwards
*Mammograms involve x-rays which mean you will be exposed to a small amount of radiation, although it is not likely to be a harmful amount and as you only need a mammogram every three years it is unlikely to have a large effect in the long run.
*Can sometimes produce false positives which can cause a huge amount of unnecessary worry. Sometimes mammograms pick up on an abnormal area in the breast which later proves to be non cancerous.
*Occasionally mammograms need to be repeated due to blurry images, equipment failure or parts of the breast being missed by the original images.
*Mammograms are the most effective way of detecting early breast cancer but it is not 100% accurate at all times. Sometimes cancers are too small to be detected on a mammogram or the person reading it may miss a cancer, although this risk is reduced by having at least two people check the mammogram
*Women taking part of the programme may still develop breast cancer between mammograms. This is called interval cancer and the patient will have a mammogram done at the time of diagnosis so it can be compared to previous ones to notice any patterns. It is important to note that cure rates for women with interval cancer are a lot better then those for women that have never had screening.

Breast screening is hugely important, especially for women in the age group mentioned above as well as those at high risk of developing breast cancer. If you receive an invitation for a mammogram then please do have one! If you are worried about it then you should talk to your GP or nurse as soon as you can. A mammogram can save your life!

What is a Mastectomy?
A mastectomy is the removal of a whole breast. There are five different types of mastectomy:

Simple or Total Mastectomy - This concentrates on the breast tissue itself. The surgeon removes the entire breast but does not usually remove the lymph nodes located in the armpit (although this can happen occasionally if the lymph nodes are found in the breast tissue during the surgery). No muscles are removed from underneath the breast during this type of mastectomy.


Modified Radical Mastectomy – This involves removal of both the breast tissue and lymph nodes. The entire breast is removed by the surgeon and an axillary lymph node dissection is performed to remove level I and II of the lymph nodes in your armpit. No muscles from underneath the breast are removed.


Radical Mastectomy – This is the most extensive type of mastectomy and involves removing the entire breast, level I, II and III of the armpit lymph nodes and the chest wall muscles found under the breast.


Partial Mastectomy – This involves removing the cancerous part of the breast tissue and normal margins of healthy tissue around it. This is kind of like a lumpectomy, although more tissue is removed.

Subcutaneous Mastectomy (Nipple Sparing) – This is seen as a controversial option by some specialists as  all of the breast tissue is removed but the nipple is not touched and as some tissue could be left behind and develop into cancer. It can cause distortion or numbness in the nipple.

Reasons to Have a Mastectomy:
A mastectomy is a huge surgical procedure with lifelong repercussions so it isn’t for everyone. It could be the best way forward for you if you fit any of the following criteria:
*If your tumour is over 5cm
*If your breast is small and a lumpectomy would leave very little scar tissue
*If you have already undergone multiple lumpectomies to try and remove a tumour and have been unable to obtain clear margins.
*If a lumpectomy and radiation is not an option for you
*If you believe total removal of breast tissue would give you better peace of mind then a lumpectomy

Breast Reconstruction Surgery:
It may be possible for you to have your breasts reconstructed during the same surgical procedure as the mastectomy. This is known as immediate reconstruction. An advantage of this may be sparing yourself the trauma of having an empty space where your breast used to be. However, the decision to reconstruct your breast on top of having a mastectomy may be too much emotionally and physically so you may also wait months or years to have your reconstructive surgery.

There are many different techniques available for breast reconstruction, including inserting an implant or tissue from another body part.

You Are Not Alone:
Lots of women have been through this procedure, some for preventative reasons and others because they have had breast cancer. In recent years celebrities such as Sharon Osbourne, Michelle Heaton, Giuliana Rancic and Christina Applegate have all had mastectomies. It doesn’t make you any less of a woman; in fact it makes you a warrior and enables you to beat cancer at its own game.

If you are a breast cancer survivor, are currently undergoing treatment for breast cancer, are supporting a loved one or have lost someone you love then I'm sending you lots of love and dedicating this rather long post to you all xxxx

If you are worried about breast cancer then please do visit or make an appointment to speak with your GP ASAP.

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