Rebecca Minton, Cancer Nurse Specialist at Reframe, shares her thoughts on breast cancer and answers questions she is often asked.
Having been a Cancer Nurse for many years after training at the Royal Marsden, Bex (as we know her) has worked on oncology wards throughout Hampshire, where she gained experience in many cancer types and treatments.
How often should you check your breasts, and does it really make a difference?
Breast cancer is the most common type of cancer in the UK. While it’s mainly diagnosed among women, it does occur in men and non-binary communities too. The good news is survival rates are considered generally high when diagnosed and treated early.
The signs are the same for everyone. We should check our breasts, pecs, chest and collarbone on a monthly basis.
Nearly half of breast cancers are found by women who feel a lump, so getting into the routine of regularly checking is very important. The best time for women to check is the week after their period has stopped. This is because during menstruation, the ducts get swollen due to changes in oestrogen and progesterone levels. For the first few months of checking, it is good to check at different times of the month, as breasts will change shape and consistency.
Mammograms are not routinely offered to men as they are with women over 50 and are difficult to perform because there is less breast tissue. It is therefore very important for males to know what is “normal” for them, so that they can detect any lumps or abnormalities. Be sure to check around the collarbone and under the armpits as that’s where the lymph nodes are located.
How does menopause affect the risk of cancer?
I previously attended The Christie’s School of Oncology Breast Cancer Conference to stay up to date with the latest developments in diagnosis, research and treatment. Interestingly, menopause was a key theme discussed, as there are trials underway to better support people with cancer who are also going through menopause.
Women of menopausal age are more likely to get breast cancer. Menopause is a rising health concern among female employees. While it doesn’t cause cancer, people’s chances of getting cancer increases with age.
Living with breast cancer doesn’t stop the symptoms when going through menopause. Women may already be in the menopause, peri-menopausal or put into early induced menopause due to the menopause-induced medications.
Common symptoms of menopause include:
- Hot flushes
- Night sweats
- Vaginal dryness and low sex drive
- Difficulty sleeping
- Low mood or anxiety
- Problems with memory and concentration
Is it hereditary?
About 5% to 10% of breast cancers are thought to be hereditary, caused by abnormal genes passed from parent to child.
The more likely risk factors for genetics are:
- A blood relative with breast cancer e.g. Mother, Sister and Aunt
- The blood relative was diagnosed before 50
- They have/had triple-negative breast cancer
- If they have had cancer in both breasts
Leading a healthy lifestyle can play a crucial part in preventing breast cancer – perhaps as far as 30-40%.
What about genetic testing?
I am often asked about genetic testing and hereditary links to breast cancer. If you are worried, I always advise to speak to an oncologist about this, as not all breast cancers are hereditary. You can speak to your GP to get a referral for genetic testing.
The main genes tested for in genetic testing are BRACA, BRACA1 AND BRACA2. This genetic testing is as simple as a blood test. There is counselling available after receiving the results if they come back highly likely to have the gene.
I encourage to ask about Oncotype DX testing, to see how likely cancer is to respond to treatment. It can also give an indication of the recurrence rate too.
What does it mean if it's in the lymph nodes?
I also get lots of questions about breast cancer being in the lymph nodes. Often, someone will ask, "what does it mean if it's in my lymph nodes?"
It means the cancer has detached itself from the initial tumour and has now attached to the lymph nodes. It usually involves a needle biopsy of the lymph nodes to determine if there is active cancer and more than likely, these lymph nodes will need to be removed at the time of surgery.
The removal of a single lymph node is known as a biopsy, but a lymph node dissection is when more than one is removed.
Surgery alone does not always cure the cancer if it has spread to lymph nodes, hence why further treatment, for example chemotherapy, or immunotherapy, may be needed after surgery.