Article by Dr Kathleen Thompson
Currently one in eight UK women will experience breast cancer during their lives. It is now the commonest cancer in the UK—remarkable, considering it’s mainly a women’s illness (men account for 1% of cases) —and the incidence is still rising, albeit more slowly than previously.
I am a doctor, and a few years ago I had breast cancer. It taught me a great deal, and I’d like to advise you how you can reduce your breast cancer risk, or at least spot it early, to give yourself the best chance.
What Predisposes to Breast Cancer?
Data from a large number of studies indicate aspects of our lives which are definitely (strong evidence), or probably (less evidence currently) associated with breast cancer. The Cancer Research UK website provides a complete list (see link below).
Some factors are beyond our control—for example our genetic make-up. People who possess BRCA 1 and BRCA 2 genes have a high chance of developing breast cancer (both sexes), and also ovarian cancer (women), prostate cancer (men). Both sexes also have an increased risk of pancreatic cancer.
You can be tested for BRCA gene, particularly if you are in a high risk group (for example, if you have Ashkenazi Jewish heritage, or if several family members had breast cancer at a young age). If positive, you can take steps to protect yourself, including having your breast tissue removed and your breasts reconstructed surgically. When your family is complete, you could consider having your ovaries removed. Not a pleasant prospect, but, for some, preferable to a high danger of developing cancer.
For most of us though, genetics isn’t the main culprit, and there are life-style changes which can reduce our chances of breast cancer (see Table 1).
Life-style and Breast Cancer
Female hormones stimulate some breast cancers, including the oestrogen/progesterone contraceptive pill and combined hormone replacement therapy (HRT). Stopping these gradually reduces your risk.
Alcohol promotes breast cancer, susceptibility increasing with quantity—even one unit daily has an impact.
Radiation, including X-rays increases risk slightly, but this needs to be weighed against the benefits.
Excess body fat increases propensity in post-menopausal women, particularly stomach fat, and especially if weight is gained as an adult.
Factors which probably increase risk (but the evidence is currently incomplete) include smoking, physical inactivity, night shift work, a high fat intake, various medications (you should be warned if taking any), some occupations (again, you should be told), having fewer children and having your first baby later in life.
Conversely, breast feeding your babies decreases your risk of breast cancer.
This is the official list based on level of available evidence. I would suggest a few more things to consider:
Aim to eat several fresh vegetables every day.
Avoid high-sugar and processed foods.
Aim to decrease mental stress. Some interesting studies suggest that loss of control and feelings of ‘helplessness’ can predispose to cancer.
Try meditating regularly—it’s easy and natural.
Getting Diagnosed Early
Sometimes, despite all our best efforts we can develop breast cancer. Early treatment can make a huge difference to your outcome. So here are some important tips (see Table 2):
Any breast lump must be checked out—don’t procrastinate. Sometimes the lump may be under your arm.
You may not feel a lump (I didn’t). Other signs which may indicate cancer include:
Any nipple changes: the nipple may become turned in on itself (inverted)—if your nipples have always been inverted this is not a concern; a rash around the nipple, discharge, or bleeding, or a change in the nipple shape all need to be checked.
Sometimes the breast is a little swollen for no reason. This may just relate to your menstrual cycle, but an unusual pain or swelling needs checking — especially if only in one breast.
Changes in the breast skin, for example, thickening, dimpling, prominent swollen pores, redness or other colour changes or bruising. Sometimes the skin resembles orange peel (called peau d’orange). This is likely to be cancer and should always be checked.
However, your breasts can’t read textbooks and sometimes they just do their own thing. You know your breasts better than anyone, and if you think something isn’t quite right, it probably isn’t. It may not be cancer, but it deserves investigation, and if your doctor is reluctant—do insist. By checking your breasts regularly, you can be more certain when something changes.
Having said all this, most of the time you won’t have breast cancer. However catching breast cancer early can make such a difference to your outlook, so why not have a low threshold for suspicion?
By Dr K Thompson, author of From Both Ends of the Stethoscope: Getting through breast cancer – by a doctor who knows
You can find more information on breast cancer and read her personal journey as a doctor with breast cancer in Kathleen’s book, From Both Ends of the Stethoscope
Cancer Research UK Breast Cancer risk factors:
Note: This article express personal views. No warranty is made as to the accuracy or completeness of information given and you should always consult a doctor if you need medical advice
Dr Kathleen Thompson is a physician, specialising in drug research.
Her life changed completely when she was diagnosed with breast cancer. She learned a great deal from having cancer herself, and is keen to provide this insight to others. It became the inspiration for her book, ‘From Both Ends of the Stethoscope’.
She adores ballroom dancing and enjoys adventures. Over the last few years she has climbed Mount Kilimanjaro, walked the Camino de Santiago and cycled in rural India.
She has two long-suffering children, who tolerate their mother’s crazy projects, and regularly rescue her from IT catastrophes.