October marks Breast Cancer Awareness Month – a month that not only aims to show support for those affected by the disease, but also to hammer home the importance of checking your breasts regularly.
Around one in eight women are diagnosed with breast cancer in their lifetime – and there is a good chance of recovery if detected at an early stage.
And one local survivor who understands the importance of regularly checking your breasts is Dr Liz O'Riordan.
A consultant breast surgeon at West Suffolk Hospital, Liz was working at Ipswich Hospital when she was unfortunately diagnosed with stage three left breast cancer in 2015.
She’s here to explain what breast cancer is, and how you should best examine your breasts in order to catch it early.
“Breast cancer develops from the cells in the ducts, nodules and connective tissue of the breast. It essentially occurs when a cell starts to divide, and something goes wrong with the cell’s genes and chromosomes. It starts to mutate, and the body stops recognising it.
“Those cancer cells then develop and are able to grow much more quickly than normal cells. These then spread around the body, and that’s what makes a cancer a cancer.”
It can take around five to 10 years for one cell to develop into breast cancer. It is most common in women who are aged 50 and above, with around eight out of 10 cases occurring in women over 50.
Studies have shown that if you have family members who've had breast or ovarian cancer, you may be at higher risk of developing breast cancer yourself.
But what are the symptoms of breast cancer, and what should you be on the lookout for?
“The most common symptom is a lump that you can either see in the mirror, or feel when you’re examining your breasts.
“Another is a pucker or dimple in the skin that you might see when you put your arms above your head in the mirror. That is because the cancer in your breast is pulling your skin inwards.
“You may also experience bleeding from your nipple, or your nipple being pulled inwards. And sometimes, you can also experience an angry red rash on the breast that mimics mastitis.”
Prior to being diagnosed herself, Liz was certain that she didn’t have breast cancer and assumed it was just another cyst.
“I had a very lumpy breast full of small cysts, and six months prior to being diagnosed, I had a mammogram and ultrasound that were normal. I noticed a lump in my cleavage and ignored it because I thought I knew what it was – I’m a breast surgeon and I’m used to feeling these things all the time.”
But it wasn’t until her mother said she should get it checked out that she decided to go for a check-up.
“I went along, and the mammogram was normal but the ultrasound showed a two-and-half centimetre cancer.”
Following her breast cancer diagnosis, Liz underwent five months of chemotherapy before undergoing a nipple-sparing mastectomy and implant reconstruction. “Although I was a surgeon, I was still scared. I hated not being in control of what was happening to me.”
With around 55,000 women diagnosed every year in the UK with breast cancer, it is therefore important to regularly check your breasts.
But how do you check your breasts, and how often?
“I didn’t check my breasts regularly, but ideally you should do it every month so you know what’s normal for you and your body. If you’re still having periods, you should check in the middle of your cycle as your breasts are less painful and easier to feel.”
The best position to examine your breasts is when you are lying down, with your head propped up on a couple of pillows.
You should feel around in a circular motion using a smooth, firm touch, while keeping your fingers flat and together. Ensure you go over your entire breast, from the top to the bottom, and side to side.
“In that position, all of your breast tissue is lying on your chest wall and easy to feel. If you’re standing up in the shower and have large, heavy breasts, it’s hard to feel them and the tissue that’s hanging down off the ribcage.”
Everyone’s breasts are different – but by regularly examining them and checking for lumps, you can get to grips with your body and understand what’s normal for you, in order to spot any potential abnormalities that may arise.
And how do you check when you have breast implants?
“You feel exactly the same way, and you need to feel the tissue on top of the implant. It might be harder to feel, so lying flat will definitely help spread the tissue over the implant. When you get to the age when you need a mammogram, it is important you let the hospital know you have implants as you will need special x-ray plates to check your breasts.”
Liz adds that neither breast implants nor nipple piercings will increase your chance of developing breast cancer in the future.
And it is also just as important for anyone who has undergone a mastectomy to check the area where their breasts once were.
“I had a mastectomy, but two and a year later I had a local recurrence,” explains Liz.
A local recurrence simply means the breast cancer has come back in the same place or near where it was originally found in the breast.
“It was a fixed nodule on the edge of my scar, which I originally thought was scar tissue. You can get a local recurrence in around two to three per cent of mastectomies because it’s impossible to remove every breast cancer cell from beneath the skin.
“The best way to self-examine when you’ve had a mastectomy is to feel the skin where the breast used to be – so from the collarbone to where the nipple was. You should be looking out for little nodules, spots, rashes, or ulcers on the skin as that could be a recurrence that needs to be checked out.
“Sadly, almost a third of breast cancer patients will get a recurrence, and it could be five, 10, or 20 years later, so we all need to be vigilant and check ourselves regularly.”
And examining your breasts isn’t something that is just limited to women.
“Men still have a very small amount of breast tissue behind the nipple, so it’s important they check their breasts as well,” explains Liz.
While it’s rare for men to develop breast cancer, around in one in 100 cases will be a man – which equates to around 350 men a year in the UK.
The biggest risk factors for men include age, being overweight, and a high alcohol consumption.
“Men would get the same symptoms as women, but they can check their breasts while stood up as they don’t have as much breast tissue. They don’t need to check as often as women, but they should still do it. Perhaps check your nipples when you check your testicles too.”
For anyone who notices any changes in their breasts, the best course of action to take is to visit your GP, who may refer you to a specialist breast cancer clinic for further tests.
To find out more about breast cancer, visit nhs.uk or cancerresearchuk.org
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