Your most important breast cancer questions, answered

When it comes to breast cancer, there’s so much information out there, it can seem impossible to know what advice to follow.

So we asked Dr Alison Butt, Director of Research Investment at the National Breast Cancer Foundation to answer the things you need to know.

What are the signs of breast cancer?
Early detection of breast cancer increases the chances of survival rates, which is why the NBCF encourages women to be 'breast aware' and familiar with the look and feel of their breasts. Changes to look out for include, a lump or thickening in the breast; a change in the shape or size of the breast or nipple; dimpling of the skin or the nipple; discharge or blood from the nipple; a rash or changes to the skin around the breast; persistent pain in the breast or armpit, or swelling or a lump in the armpit. But before you panic, “most breast changes aren’t due to cancer,” says Butt. “However, if you do notice these or any other changes in your breasts, you should still see a doctor.”

What are self-examinations? Can I do them at home?
“You don’t need to use a special technique when checking for breast changes,” says Butt. “You just need to be familiar with the normal look and feel of your breasts. Take the time to get to know your breasts while showering, dressing, or putting on body lotion."

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How often should I check them at home?
Even though regular breast self-examination have been promoted in the past, Butt says “there is no evidence to support that this is an effective approach for the early detection of breast cancer.” These days, simply being breast aware is recommended as the best way to notice any changes.

What happens if I find a lump?
Head straight to a doctor to check it out further. “After speaking with you about your medical history (including any family history of breast or other cancers), the nature of the breast change, and performing a clinical breast examination your doctor will decide whether you need to be referred to have some imaging to get a better look inside your breast,” explains Butt. “The imaging used will depend on your age and risk but may include ultrasound or mammography.”

What do clinical screenings involve?
If you’re over 40, regular mammograms used in conjunction with a physical breast exam provide the best chance of detecting cancer early. “A mammogram can detect a lump as small as a pea”, says Butt. Women over 40 are eligible for a free mammogram from BreastScreen, as part of a National Screening Program. “For women under 40 with a family history or prior experience of breast cancer, it is important to speak with your doctor about an individual routine screening program.”

Does postmenopausal therapy cause breast cancer?
According to Butt, there’s evidence that hormone replacement therapy (HRT) – especially when it contains both oestrogen and progesterone – can increase your breast cancer risk. “That risk increases the longer a woman is on HRT. However, the risk seems to go back to normal within five years of stopping taking it.” Chat to your doctor to assess the benefits of HRT before starting and ending treatment.

I’ve been taking the pill for years – does it increase my risk?
There’s limited evidence linking the contraceptive pill to a higher breast cancer risk. “While some studies did suggest a slightly higher risk of developing breast cancer amongst women who took early formulations of the pill with high levels of hormones,” says Butt. "This increased risk disappeared within ten years of them coming off the pill.” These days, most pills contain low levels of these hormones but your doctor can advise the right one for you.

My mother had breast cancer. Am I at a greater risk?
One of the most important things you can do for your health is be aware of your family health history. “Research shows your risk of breast cancer is increased if a close relative, like a mother or aunt, has had breast or ovarian cancer, especially if they were diagnosed at a young age.” According to Butt, 90 per cent of women who develop breast cancer don’t have a family history, so regardless of genetics, “it’s important for you to be breast aware and see your doctor if you notice any changes.”

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Does my risk of breast cancer increase with age?
“For women, simply being a woman and getting older are the two strongest risk factors for developing breast cancer,” says Butt. “Over 75 per cent of all breast cancer diagnoses are in women over the age of 50.”

What lifestyle changes can I make to help reduce my risk?
Although your risk of developing breast cancer increases with age, maintaining a healthy weight can “improve the outcomes for all women with breast cancer.” Follow the Australian Dietary Guidelines recommendations of being physically active (150 to 300 minutes of moderate to vigorous physical exercise per week), eating a wide variety of fresh vegetables and fruit and limiting your fat intake. Regular exercise will also reduce your risk of developing breast cancer, as will limiting your alcohol intake.

More: Women are skipping their mammograms

What does breast cancer treatment involve?
If you are diagnosed with breast cancer, you will discuss your treatment options with your doctor, which will take into account your personal preferences and the type of breast cancer you have. They include:
1. Surgery: “This is typically the first line of treatment for women with breast cancer,” says Butt. It may involve removing the whole breast (a mastectomy) or the cancerous tissue in the breast. Sometimes it also involves the removal of lymph nodes in your armpit.
2. Chemotherapy: “A drug therapy that works by killing cells that are rapidly dividing – such as breast cancer cells. It can be given by a drip into a woman’s arm, or in a tablet.”
3. Radiotherapy: Radiation is used to target or kill cancer cells, while reducing the exposure to healthy tissue around the tumour.
4. Anti-hormone therapy: This is used to treat young women with hormone responsive (sometimes known as oestrogen receptor positive) breast cancers.
5. Antibody therapy: These are targeted treatments that stop certain breast cancer cell types from growing.

For more information head to National Breast Cancer Foundation website.

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