Risks and causes

The following things affect a person's chances of developing breast cancer.

The strongest risk factor for breast cancer (apart from gender) is age (the older you are, the higher your risk). The disease is rare in women under 30.

The more children a woman has, and the younger she is when she has them, the lower her risk of breast cancer.

Women who start their periods when young or have a late menopause have an increased risk of breast cancer.

Breastfeeding reduces the chances of developing the disease. The longer a woman breastfeeds her children, the more she lowers her risk.

The contraceptive pill causes a slight increase in breast cancer risk, but this very gradually returns to normal once a woman stops taking it.

Women taking HRT are more likely to develop breast cancer, especially those taking combined oestrogen/progestagen HRT. This risk increases the longer you take HRT, but falls back to normal within 5 years of stopping the treatment.

Being overweight after the menopause increases the risk of breast cancer because body fat affects levels of the hormone oestrogen. Combining a balanced diet with regular exercise helps to maintain a healthy body weight.

Drinking alcohol increases the risk of breast cancer. The more a woman drinks every day, the greater her risk.

A woman’s risk is increased if one or more close relatives (for example, her mother or sister) have been diagnosed with breast cancer, but most women with one or two affected relatives will not get breast cancer. Most women with breast cancer do not have a family history of the disease.

You can find out more about what 'cancer risk' means in the 'Understanding 'risk'' section of this website.

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Signs and symptoms

It is often women themselves who first notice their breast cancer. Most changes are not caused by cancer, but it is very important to report anything unusual to your doctor.

Women should be “breast aware” through knowing what is normal for them, and looking out for the following symptoms:

• changes in the size, shape or feel of your breasts
• a new lump or thickening in one breast or armpit
• any puckering, dimpling or redness of the skin
• changes in the position of the nipple, a rash or nipple discharge
• pain or discomfort that is new to you and felt only on one side

Women should report any signs to their doctor. 9 in 10 breast lumps are not cancers, and all of these signs may have other causes. However, it is important that breast cancer is detected early.

Breast screening for the over 50s and breast awareness for all women, offer the best chance of finding breast cancer early.

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Screening

The NHS breast screening programme was set up in 1988 with the aim of reducing the death toll from breast cancer.

In the UK women aged between 50 and 64 are offered screening for breast cancer every three years. The programme is gradually being extended to include women up to 70 years old.

Screening involves taking x-rays of the breasts (mammography). Breast screening can show cancers at an early stage, when they are too small to be felt. When changes are found early, there is an excellent chance of successful treatment.

Detection

The doctor will ask questions about a woman’s medical history and about any risk factors she might have. The doctor will also carry out an examination of the breasts, armpits and neck and look for any lumps or suspicious changes.

If necessary, a specialist may carry out further tests. These can include:

• Mammogram
• Ultrasound scan
• Tissue biopsy
• CT or MRI scan.

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Treatment

The main treatment options for breast cancer include:

The two most common operations for breast cancer are lumpectomy (surgery to remove the lump and some of the surrounding tissue) and mastectomy (removal of the whole breast).

During most breast cancer operations, some lymph nodes are removed from the armpit (axillia). This is to look for cancer cells that have spread.

Quite often, women will have a course of radiotherapy starting two to four weeks after lumpectomy. This is to destroy any cancer cells that may still be present. Sometimes, women might also have radiotherapy after mastectomy.

If the cancer has spread to other parts of the body, radiotherapy may be used to relieve symptoms such as bone pain.

Doctors often treat breast cancer with a combination of chemotherapy drugs. Women may receive chemotherapy before or after breast surgery. The doctor can also use chemotherapy to treat cancer that has come back.

The female hormone oestrogen is a major factor for the growth of many breast cancers. Hormone therapy lowers the amount of oestrogen in the blood, or blocks oestrogen from stimulating the cancer to grow. Tamoxifen is the most common hormone therapy used.

To find out about how you can support us in raising funds for breast cancer research, go to our breast cancer awareness website.

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