Home
Bupa members

Support and offers for individual members and customers

Breast cancer Q&As

Published by Bupa's health information team, December 2008.

Answers to questions about breast cancer

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

Are there any risk factors associated with breast cancer?

Yes, there are several risk factors that increase a woman's chances of developing breast cancer.

Explanation

Research has found that some women are more likely to develop breast cancer than others. These risk factors include the following.

  • Age. As you get older your risk of breast cancer increases - eight out of 10 breast cancers are diagnosed in women aged 50 and over. Breast cancer is rare in women under 30.
  • Social class. Women from wealthier social groups are more likely to develop breast cancer than those from less well-off groups.
  • Where you live. Breast cancer is more common in developed countries than in the Far East or developing countries.
  • Early periods or late menopause. You are at a higher risk if you started your periods at an early age or began the menopause late.
  • Age at first pregnancy. Having children when you are older increases your risk of breast cancer. A woman who has her first pregnancy aged 30 has double the risk of developing breast cancer than a woman who has her first pregnancy at 20.
  • Never having children. Women who never have children are more likely to develop breast cancer than those who have children.
  • The Pill and HRT. Taking the combined contraceptive pill slightly increases your risk of developing breast cancer, although this risk disappears 10 years after you stop taking it. Taking hormone replacement therapy (HRT) to help with menopausal symptoms increases your risk of breast cancer.
  • Diet and lifestyle. An unhealthy diet, high in fat, combined with an inactive lifestyle or being obese puts you at greater risk of developing breast cancer. Also, drinking alcohol is associated with breast cancer.
  • Height. Taller women are more likely to have breast cancer than shorter women.
  • Radiation exposure. If you have been exposed to radiation, for example radiotherapy as part of cancer treatments, you are at greater risk of developing breast cancer.
  • Breast disease. If you have previously had benign or malignant breast lumps, you have a higher risk of developing breast cancer.
  • Family history. If your mother or sister has had breast cancer, your risk of developing the disease doubles. If several members of your family have had breast cancer, you should talk to your GP about the possibility of genetic screening.

Having any or several of these risk factors does not automatically mean you will develop breast cancer, it just means that your risk may be higher than average. But it is important to be aware of your risks and to make lifestyle changes (if possible) to reduce them.

If you have any questions or concerns about breast cancer, you should talk to your GP.

Further information

Sources

  • Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2007:218-519
  • Cassidy J, Bissett D, Spence RAJ. Oxford Handbook of Oncology. Oxford: Oxford University Press, 2002:296-322
  • Breast cancer. Cancer Research UK. www.cancerresearchuk.org, accessed 11 September 2008
back to top

What is TNM staging for breast cancer?

The TNM staging system is a way for doctors to assess cancerous tumours. It's used to assess many different types of cancer, including breast cancer, and helps doctors understand how advanced the cancer is. Staging is also important in deciding the best treatments to use.

Explanation

TNM staging is a commonly used system in the UK to assess breast cancer tumours. Your doctor will use the information gathered during your diagnostic tests to give your tumour an overall TMN grade. The letters refer to your tumour of parts of your body it may have spread to.

'T' stands for tumour and gives your doctor information about the size of your tumour. Numbers, and sometimes lower case letters, are added to give specific details about its size, as follows.

  • Tis - carcinoma in situ; non-invasive ductal carcinoma or Paget's disease of the nipple with no tumour.
  • T0 - there is no evidence of a tumour.
  • T1 - tumour is 2cm or less across (this is sometimes further broken down to more accurately describe the size - T1a (less than 0.5cm across), T1b (0.5cm to 1cm across) and T1c (1cm to 2cm across)).
  • T2 - tumour is between 2cm and 5cm across.
  • T3 - tumour is larger than 5cm across.
  • T4 - describes the location of the tumour and is subdivided as follows:
    • T4a - tumour is attached to your chest wall
    • T4b - tumour is attached to your skin
    • T4c - tumour is attached to both your skin and your chest wall
    • T4d - tumour is inflamed, and the skin over it is red, swollen and painful to touch

N is for nodes and tells your doctor if your cancer has spread to your lymph nodes and by how much. Lymph nodes are part of your lymphatic system which helps protect your body against infection. Cancer is able to spread (metastasise) to other parts of your body through your lymphatic system. Numbers, and sometimes lower case letters, are added to give specific details about the spread, as follows.

  • N0 - there are no cancer cells in any nodes.
  • N1 - cancer is in the nodes in your armpit on the same side as the cancer, but not attached.
  • N2 - is split into two types:
    • N2a - there are cancer cells in the lymph nodes in your armpit and are fixed
    • N2b - there are cancer cells in the lymph nodes under your breastbone, but there is no evidence of cancer in the lymph nodes in your armpit
  • N3 - is split into three types:
    • N3a - cancer is in the lymph nodes below your collarbone
    • N3b - cancer is in the lymph nodes in your armpit and under your breast bone
    • N3c - cancer is in the lymph nodes above your collarbone

M stands for metastases and tells your doctor whether your tumour has spread to other parts of your body. Numbers are added to give specific details about how much its spread, as follows.

  • M0 - there is no sign that the cancer has spread to other parts of your body.
  • M1 - the cancer has spread to other parts of your body (apart from your breast and lymph nodes under your arm).

Your doctor will put all this information together to come up with an overall stage for your cancer. You may have seen this written on test forms and other notes made by your doctor, or your doctor may have mentioned it to you. Example, T1a N0 M0 means that your tumour is less than 0.5 cm across and there is no evidence that is has spread to your lymph nodes or any other part of your body.

Having an overall stage for your cancer is important. It's used to try and predict how your cancer will develop and establish how advanced it is. This helps your doctor to plan your treatment.

If you have any questions or concerns about breast cancer or the TNM staging system, you should talk to your GP or doctor.

Further information

Sources

  • Cassidy J, Bissett D, Spence RAJ. Oxford Handbook of Oncology. Oxford: Oxford University Press, 2002:296-322
  • TNM breast cancer staging Cancer Research UK. www.cancerhelp.org.uk, accessed 11 September 2008
  • Souhami R, Tobias J. Cancer and its management. 5th ed. Oxford: Blackwell Publishing, 2005:216-234
back to top

How often should I check my breasts for signs of breast cancer?

There is no recommended time period or routine for breast self-examination. You should check them as often as you feel necessary and at a time that is convenient to you.

Explanation

There is no evidence to show that checking your breasts to an exact schedule or using specific self-examination techniques is any more effective than simply being breast aware.

Being breast aware means getting into the habit of checking the look and feel of your breasts on a regular basis. Being familiar with your breasts means that if there are any changes, you are able to spot them straightaway.

Check yourself in a way that's comfortable and convenient for you. You may find it convenient to look at your breasts when you are getting ready for a bath or shower. Also, using a mirror can make it easier to view your breasts from different angles.

If you feel uncomfortable or anxious about checking your breasts, you may find it helpful to discuss your worries with your GP or a nurse.

Specific changes to look for when checking your breasts include:

  • a change in size or shape of your breasts (after puberty is complete), for example one breast becoming larger or lower
  • skin changes such as puckering or dimpling (skin looks like the texture of orange peel)
  • a rash or crusting on the nipple or surrounding area
  • nipple changes, such as a change in the position of your nipple, or a newly inverted (turned-in) nipple
  • discharge from one or both nipples (unless you are breastfeeding and it's milky discharge)
  • discomfort or pain in your breast or armpit
  • swelling, thickening or a lump in your breast or armpit

If you notice any of these changes, you should see your GP straight away. It's important to remember that all women's breasts are different and that changes to your breasts are not always a cause for concern. They can be related to your menstrual cycle, age, pregnancy, the menopause and taking the contraceptive pill.

The NHS run a national breast screening programme which offers mammography once every three years to women between the ages of 50 and 70 years. If you are eligible for breast screening it's important that you attend your appointments.

If you have any questions or concerns about checking your breasts or breast cancer, talk to your GP.

Further information

Sources

back to top

Related topics

back to top

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: December 2008

 

Rate this page

Up to £100 off a Bupa Health assessment

Bupa health insurance

Free online health check

Bupa Care Homes

Bupa travel cover