This guide answers some of the important questions you might have about your breasts and breast cancer. If you're here because you're worried about your health or risk of breast cancer, talk to your doctor about your concerns.
References
How does breast cancer affect you
Ministry of Health (MOH)/Cancer selected sites 2009, 2010, 2011 tables. Number of women with breast cancer in 2011: 2862 www.moh.govt.nz (D Spinks)*
Ministry of Health (MOH)/NZHIS/BSA (2007) MOH/NZBCF communication/unpublished data. www.moh.govt.nz
Ministry of Health/BreastScreen Aotearoa (2009, November). Key Achievements & Strategic Direction: Update from BreastScreen Aotearoa (BSA). Author: Wellington. www.nsu.govt.nz
How can I be breast aware
Ministry of Health/National Screening Unit/BreastScreening Aotearoa (Revised June 2007). More about breast screening and BreastScreen Aotearoa. (booklet) Ministry of Health, Wellington. www.nsu.govt.nz
The National Screening Unit, the Cancer Society of New Zealand and The New Zealand Breast Cancer Foundation (2008, Oct). Position Statement on Breast Awareness. Ministry of Health: Wellington. www.nzbcf.org.nz
What is breast cancer
Radiologic technology; Jan/Feb 2008, vol.79. No 3
Cancer Australia: www.cancerasustralia.go.au
What should my doctor do
Macmillan Cancer Support (UK). www.macmillan.org.uk
What about mammograms
Auckland Breast Cancer Patient Register 2001-2011, n = 7000 women (Dr Rena Ramaroop – NZBCF MAC)
Ministry of Health/National Screening Unit/BreastScreening Aotearoa (Revised June 2007). More about breast screening and BreastScreen Aotearoa. (booklet) Ministry of Health, Wellington. www.nsu.govt.nz
Irwig,L., Macaskill, P., Houssami,N. (2006). Evidence relevant to the investigation of breast symptoms: The triple test. Breast, 11,215-220.
What should I do at my age
Ministry of Health/BreastScreen Aotearoa (2009, November). Key Achievements & Strategic Direction: Update from BreastScreen Aotearoa (BSA). Author: Wellington. www.nsu.govt.nz
Benson, J.R. et al. (2009, 25 April). Early Breast Cancer. The Lancet, 373, 9673, 1463-1479.
Monninkhof, E., Elias, S., Vlems, F. et al. (January 2007). Physical Activity and Breast Cancer: A systematic review. Epidemiology, 18, 1, 137-157.
Breast cancer risk factors: A review of the evidence: www.nbocc.org.au
Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and hormonal contraceptives: Collaborative reanalysis of individual data on 53,297 women with breast cancer and 100,239 women without breast cancer from 54 epidemiological studies. Lancet 1996; 347:1713-1727.
[iv] Marchbanks PA, McDonald JA, Wilson HG, et al. Oral Contraceptives and the risk of breast cancer. New England Journal of Medicine 2002; 346(26):2025-2032
Breast cancer and hormone replacement therapy in the Million Women Study. The Lancet 362, 414-5.
National Cancer Institute/US National Institutes of health (May 2006). Probability of breast cancer in American women.
How can I reduce my risk of breast cancer
National Breast and Ovarian Cancer Centre. Guide for women with early breast cancer. National Breast and Ovarian Cancer Centre, Surry Hills, NSW, 2008. p. 95. http://nbocc.org.au
National Breast and Ovarian Cancer Centre (Jan 2007) Physical Activity and breast cancer: A systematic review. Epidemiology, 8,1,137-187.
Ministry of Health/BreastScreen Aotearoa (2009, November). Key Achievements & Strategic Direction: Update from BreastScreen Aotearoa (BSA). Author: Wellington. www.nsu.govt.nz
Benson, J.R. et al. (2009, 25 April). Early Breast Cancer. The Lancet, 373, 9673, 1463-1479.
Monninkhof, E., Elias, S., Vlems, F. et al. (January 2007). Physical Activity and Breast Cancer: A systematic review. Epidemiology, 18, 1, 137-157.
Ministry of Health/National Screening Unit/BreastScreen Aotearoa (Revised June 2008). Having a mammogram every two years improves a woman’s chances of surviving breast cancer (pamphlet). Ministry of Health, Wellington. www.nsu.govt.nz
Ministry of Health (MOH)/Cancer selected sites 2009, 2010, 2011 tables. Number of women with breast cancer in 2011: 2862 www.moh.govt.nz (D Spinks)*
Boyd, N.F., Martin, L.J. et al. (2007). Mammographic density and the risk and detection of breast cancer. New England Journal of Medicine,356,227-236.
Can breast cancer affect you?
Breast cancer touches us all – our mums, daughters and wives (and the men we love as well). You might know someone who has been affected by it. What you may not know is that when detected early, breast cancer is largely treatable and survivable.
Select the number of people you think are diagnosed with breast cancer every day in New Zealand.
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Every day in New Zealand around seven people get diagnosed with breast cancer.
That's approximately 2,800 women and 20 men every year. Around 650 women will die of breast cancer this year.
Can breast cancer affect you?
Jane is one of the seven women diagnosed every day in New Zealand. Her story highlights the importance of early detection – it saved her life.
Click the play button to hear from Jane.
More stories are available at www.nzbcf.org.nz
How can I be breast aware?
Being breast aware means knowing your own breasts and what is 'normal' for you. In the early stages of breast cancer there is usually no pain and there may be no symptoms at all.
Click on each of the following symptoms that could appear as cancer grows.
Note: If any of these signs are a new symptom for you, see your doctor.
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A new lump
A new lump or thickening of the skin in the breast or armpit area.
Changes to your nipple
For example, a newly retracted or inverted (pulled in) nipple.
Skin change
A change in the skin of the breast, areola, or nipple. This could be dimpling, puckering, reddening, or any change in colour.
Discharge
A discharge from the nipple that occurs without squeezing.
Shape
A change in breast shape or size.
What is breast cancer?
Our body is made entirely of cells. Cells in our body replace themselves normally. The nucleus controls the cell and tells it what to do.
What is breast cancer?
Cancer is a malignant growth and occurs when just one cell starts to divide and multiply without control.
The cells may grow and divide quickly or slowly to form a cluster of cells or lump called a tumour.
What is breast cancer?
Breasts are made up of lobules and ducts surrounded by fatty tissue. The lobules produce milk and the ducts carry it to the nipples.
What is breast cancer?
For people who develop breast cancer, those cancer cells most commonly form in the ducts of the breast.
What is breast cancer?
The earlier cancer cells are detected, generally the better the outcome.
This is the size of the smallest lump found by a mammogram.
What is breast cancer?
This is the average size of a lump that you would generally be able to feel.
Early detection by a mammogram is your best chance of surviving breast cancer.
What should I expect my doctor to do?
If you present with any unusual breast changes, your doctor may recommend one of the following tests. Any significant changes should have triple testing. This means a clinical examination, a mammogram or ultrasound, and a biopsy.
Click on each test to find out more.
A clinical breast exam
Your family doctor or nurse will examine each breast and underarm, and the collarbone area for changes in breast size, lumps, skin change, or signs of injury or infection.
A mammogram
A mammogram is a low dose x-ray of the breast that can pick up very small breast cancers. This is the most common form of testing.
An ultrasound
An ultrasound uses sound waves to produce an image of the breast and/or armpits. They are used most commonly for younger women.
M.R.I
M.R.I or magnetic resonance imaging is a way of examining the breasts, armpits or chest using magnetic fields. This is a very sensitive screening tool.
A biopsy
A biopsy is a removal of cells or tissue from the body for examination under a microscope.
What about mammograms?
Your best chance of early detection is with a mammogram. A mammogram can find cancer long before a lump can be felt. The decision to get a mammogram could save your life.
Mammograms are recommended annually from 40‒49 years, then every two years from the age of 50.
Click play to see Anne's mammogram.
What should I do at my age?
What should I do at my age?
What should I do at my age?
What should I do at my age?
How can I reduce my risk of breast cancer?
We don't know what causes breast cancer, but we do know some of the factors that can contribute to it developing. Some of them you can't change, but some you have control over.
The things you can do.
The risks you can't change.
A healthy lifestyle
Overweight women have a higher risk of being diagnosed with breast cancer compared to women who maintain a healthy weight. Evidence indicates that regular exercise combined with a low-fat diet reduces the risk of breast cancer. Aim to exercise 3‒5 times a week for at least 30 minutes each time.
Less alcohol
The risk increases with the amount of alcohol consumed. If you drink 2 to 5 drinks daily your risk of breast cancer is 1½ times higher than women who drink no alcohol.
Hormone exposure
Being exposed to hormones for long uninterrupted periods can affect your breast cancer risk. Factors include:
- using combined hormone replacement therapy (HRT) with oestrogen and progesterone for at least 5 years
- taking the oral contraceptive if you are a woman over 40
- not having had children or having your first child after 30 years
- breast feeding for a short time or not at all.
Being an older woman
Being a woman is the highest risk factor. One percent of breast cancer occurs in men.
Around 75% of breast cancers occur in women over 50.
Family history
A small percentage (approximately 5%‒10%) of breast cancers are due to family history and genetics. If your mother, sister, or daughter has had breast or ovarian cancer (particularly if she was less than 50 years of age when diagnosed), you may have a higher risk of developing it yourself. Talk to your doctor about this.
Most women who develop breast cancer have no family history of the disease.
BRCA 1 & 2 gene mutation
These are genes that if mutated increase the likelihood of developing breast and/or ovarian cancer. These genes can be inherited from either parent. If you are concerned about a family history, or the BRCA 1 or BRCA 2 gene, contact your doctor who can refer you to a genetic specialist.
Dense breast tissue
Your breasts comprise a mix of fatty and dense tissue. Some women have dense breast tissue, which is a risk factor for breast cancer. It also makes it harder for a mammogram to detect tumours. If you do have dense breast tissue then it may be advisable to get mammograms yearly rather than every two years. When you have your mammogram, ask your radiologist about your breast density.
Do you know your B.R.A.S?
To reduce the risk of breast cancer developing, know your B.R.A.S because every woman needs support and protection. It's a fact that early detection saves lives.
You can download and print this information for later.
| B | Be breast aware | Check your breasts regularly. If you notice any changes, go and see your doctor. Talk to your doctor about any family history of breast or ovarian cancer. |
| R | Reduce your risk | Lower your alcohol intake, exercise regularly, and maintain a healthy body weight. Women who do are at lower risk of breast cancer than women who don't. |
| A | Act quickly | Don't wait if you are worried. Show changes to your doctor. Ask questions. |
| S | Screen regularly | Get a mammogram every year from the ages of 40‒49. After 50, get a mammogram every two years (unless recommended otherwise by your doctor). |
What did you think?
This e-learning program was kindly funded by Goldman Sachs Gives.
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For information about breast cancer, check out the New Zealand Breast Cancer Foundation website or call one of our educators on 0800 902 732. We're here to help.
Thank you! Please share this guide with the important women in your life. It could save theirs.