TOPICAL READS BELOW:
8) Aug 17 Breast Cancer in the Family
Should you worry about Breast Cancer in the Family? – most forms aren’t hereditary, but there’s new drug advice for women with a family history
Breast cancer is one of the commonest cancers – new cases each year (including MEN), almost one in eight women will face this diagnosis. Rates have increased since the 1990s; around a 1/4 may be preventable and almost 1/2 occur in women over the age of 65. But survival rates are increasing too, thanks to earlier diagnosis and better treatments; almost 90% live at least 5 years after being diagnosed, while many live for 20 years or more.
CAUSES – Enviroment/lifestyle factors can trigger gene mutations that lead to cancer, but some may be avoidable. Almost 1 in 10 cases are linked to excessive body weight, possibly because it affects hormone levels; 1 in 16 are linked to alcohol. Inactivity is another factor; smoking may increase some women’s risk. Starting periods early or a late menopause, increase our risk, but childbearing and breastfeeding reduce it. Risks increase while taking hormone replacement therapy (HRT) or the oral contraceptive pill, but fall to normal 5 to 10 years after stopping.
FAMILY HISTORY – Almost 90% of women with an affected first-degree relative (parent, sibling, child) won’t develop breast cancer. However, some of us (few than 1 in 400) carry abnormal genes, such as TP53, PALB2 and PTEN, that significantly increase risk. Up to 2/3 of women who carry the BRCA1/BRCA2 gene mutations develop breast cancer by the age of 70. Your personal risk may be affected if you have Jewish ancenstry, an affected male relative, or a relative who has had breast cancer on both sides, ovarian cancer, a brain tumour, or a childhood adrenal gland tumour, or relatives who developed cancers at an early age.
If you’re worried, find out as much as you can before consulting your GP. If you’re sure no one in your family has any of these, and you have just one affected first-degree or second-degree (grandparent, aunt, uncle niece,nephew or grandchild) relative, whose breast cancer developed after the age of 40, you may not need to worry, although you still need to be breast aware (see 5 Symptoms to Report)
TESTS and TREATMENT – If your family tree suggests you could have inherited high-risk genes you’ll be counselled about genetic testing. Depending on your age and any results, you may be offered more frequent tests, such as MR scans, ultrasound or mammography.
You may also be offered risk-lowering treatment, ususally anti-oestrogen hormones such as Tamoxifen if you;re pre-menopausal; if you’re post-menopausal taking Anastrozole for at least 5 years. These drugs can have side effects including bone-thinning osteoporosis, so you’ll need calcium/vitamin D supplements and regular bone scans. Some women at very high risk are offered double mastectomy and/or ovary removal.
5 SYMPTOMS to REPORT
1 Any change in your breast shape, outline or skin (for example, dimpling/puckering)
2 Any new lump, lumpiness, thickening, or different ‘feel’ in your breast, nipple or armpit.
3 Persistent pain in your breast or armpit
4 Persistent change in the skin around your nipple – a rash, dryness, redness, weeping – or a change in the shape/direction of your nipple, including being drawn in.
5 Discharge from the nipple (clear or bloodstained)